Polyomavirus JC Urinary Shedding in Kidney and Liver Transplant Recipients Associated With Reduced Creatinine Clearance

• Published in: The Journal of infectious diseases 2012-09, Vol.206 (6), p.875-880
• Main Authors: Kusne, Shimon, Vilchez, Regis A., Zanwar, Preeti, Quiroz, Jorge, Mazur, Marek J., Heilman, Raymond L., Mulligan, David, Butel, Janet S.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; BK virus; BK Virus - isolation & purification; Creatinine - blood; Creatinine - metabolism; Female; Fundamental and applied biological sciences. Psychology; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - therapeutic use; Infectious diseases; JC virus; JC Virus - physiology; Kidney - pathology; Kidney - virology; Kidney Diseases - pathology; Kidney Diseases - virology; Kidney Transplantation - adverse effects; Kidneys; Leukoencephalopathies; Liver; Liver Transplantation - adverse effects; Logistic Models; Major and Brief Reports; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Polyomavirus; Polyomavirus Infections - urine; Polyomavirus Infections - virology; Risk Factors; Transplantation; Tumor Virus Infections - urine; Tumor Virus Infections - virology; Urine; Viral Load; Virology; Virus Shedding; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jis469

Background. Polyomavirus reactivation can cause significant morbidity in solid organ transplant recipients, particularly BK virus (BKV) in kidney transplant patients. Less is known about dynamics of John Cunningham virus (JCV) in nonkidney organ transplant patients. Methods. We examined the frequency of urinary shedding of polyomaviruses BKV and JCV and their relationship to creatinine clearance (CrCl) in a longitudinal study of 41 kidney and 33 liver transplant recipients. Results. Any polyomavirus urinary shedding was more frequent in liver than kidney recipients (64% vs 39%; P = .03). JCV was excreted more frequently by liver than kidney recipients (71% vs 38%), whereas BKV was shed more often by kidney than liver patients (69% vs 52%). Mean JCV loads were significantly higher than those of BKV in both patient groups (P< .0001). Lower mean CrCl values were significantly associated with JCV shedding in both kidney and liver recipients (P < .001). Conclusions. These findings suggest that BKV and JCV display different patterns of reactivation and shedding in kidney and liver transplant patients and that JCV may have a role in renal dysfunction in some solid organ transplant recipients.