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Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy
Introduction: The absolute BK viral load is an important diagnostic surrogate for BK polyomavirus associated nephropathy (PyVAN) after renal transplant (KTX) and serial assessment of BK viremia is recommended. However, there is no data indicating which particular viral load change, i.e., absolute vs...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770438/ https://www.ncbi.nlm.nih.gov/pubmed/35071271 http://dx.doi.org/10.3389/fmed.2021.791087 |
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author | Omić, Haris Kläger, Johannes Phillip Herkner, Harald Aberle, Stephan W. Regele, Heinz Weseslindtner, Lukas Schrag, Tarek Arno Bond, Gregor Hohenstein, Katharina Watschinger, Bruno Werzowa, Johannes Strassl, Robert Eder, Michael Kikić, Željko |
author_facet | Omić, Haris Kläger, Johannes Phillip Herkner, Harald Aberle, Stephan W. Regele, Heinz Weseslindtner, Lukas Schrag, Tarek Arno Bond, Gregor Hohenstein, Katharina Watschinger, Bruno Werzowa, Johannes Strassl, Robert Eder, Michael Kikić, Željko |
author_sort | Omić, Haris |
collection | PubMed |
description | Introduction: The absolute BK viral load is an important diagnostic surrogate for BK polyomavirus associated nephropathy (PyVAN) after renal transplant (KTX) and serial assessment of BK viremia is recommended. However, there is no data indicating which particular viral load change, i.e., absolute vs. relative viral load changes (copies/ml; percentage of the preceding viremia) is associated with worse renal graft outcomes. Materials and Methods: In this retrospective study of 91 biopsy proven PyVAN, we analyzed the interplay of exposure time, absolute and relative viral load kinetics, baseline risk, and treatment strategies as risk factors for graft loss after 2 years using a multivariable Poisson-model. Results: We compared two major treatment strategies: standardized immunosuppression (IS) reduction (n = 53) and leflunomide (n = 30). The median viral load at the index biopsy was 2.15E+04 copies/ml (interquartile range [IQR] 1.70E+03–1.77E+05) and median peak viremia was 3.6E+04 copies/ml (IQR 2.7E+03–3.3E+05). Treatment strategies and IS-levels were not related to graft loss. After correction for baseline viral load and estimated glomerular filtration rate (eGFR), absolute viral load decrease/unit remained an independent risk factor for graft loss [incidence rate ratios [IRR] = 0.77, (95% CI 0.61–0.96), p = 0.02]. Conclusion: This study provides evidence for the prognostic importance of absolute BK viremia kinetics as a dynamic parameter indicating short-term graft survival independently of other established risk factors. |
format | Online Article Text |
id | pubmed-8770438 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87704382022-01-21 Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy Omić, Haris Kläger, Johannes Phillip Herkner, Harald Aberle, Stephan W. Regele, Heinz Weseslindtner, Lukas Schrag, Tarek Arno Bond, Gregor Hohenstein, Katharina Watschinger, Bruno Werzowa, Johannes Strassl, Robert Eder, Michael Kikić, Željko Front Med (Lausanne) Medicine Introduction: The absolute BK viral load is an important diagnostic surrogate for BK polyomavirus associated nephropathy (PyVAN) after renal transplant (KTX) and serial assessment of BK viremia is recommended. However, there is no data indicating which particular viral load change, i.e., absolute vs. relative viral load changes (copies/ml; percentage of the preceding viremia) is associated with worse renal graft outcomes. Materials and Methods: In this retrospective study of 91 biopsy proven PyVAN, we analyzed the interplay of exposure time, absolute and relative viral load kinetics, baseline risk, and treatment strategies as risk factors for graft loss after 2 years using a multivariable Poisson-model. Results: We compared two major treatment strategies: standardized immunosuppression (IS) reduction (n = 53) and leflunomide (n = 30). The median viral load at the index biopsy was 2.15E+04 copies/ml (interquartile range [IQR] 1.70E+03–1.77E+05) and median peak viremia was 3.6E+04 copies/ml (IQR 2.7E+03–3.3E+05). Treatment strategies and IS-levels were not related to graft loss. After correction for baseline viral load and estimated glomerular filtration rate (eGFR), absolute viral load decrease/unit remained an independent risk factor for graft loss [incidence rate ratios [IRR] = 0.77, (95% CI 0.61–0.96), p = 0.02]. Conclusion: This study provides evidence for the prognostic importance of absolute BK viremia kinetics as a dynamic parameter indicating short-term graft survival independently of other established risk factors. Frontiers Media S.A. 2022-01-06 /pmc/articles/PMC8770438/ /pubmed/35071271 http://dx.doi.org/10.3389/fmed.2021.791087 Text en Copyright © 2022 Omić, Kläger, Herkner, Aberle, Regele, Weseslindtner, Schrag, Bond, Hohenstein, Watschinger, Werzowa, Strassl, Eder and Kikić. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Omić, Haris Kläger, Johannes Phillip Herkner, Harald Aberle, Stephan W. Regele, Heinz Weseslindtner, Lukas Schrag, Tarek Arno Bond, Gregor Hohenstein, Katharina Watschinger, Bruno Werzowa, Johannes Strassl, Robert Eder, Michael Kikić, Željko Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy |
title | Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy |
title_full | Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy |
title_fullStr | Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy |
title_full_unstemmed | Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy |
title_short | Clinical Relevance of Absolute BK Polyoma Viral Load Kinetics in Patients With Biopsy Proven BK Polyomavirus Associated Nephropathy |
title_sort | clinical relevance of absolute bk polyoma viral load kinetics in patients with biopsy proven bk polyomavirus associated nephropathy |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770438/ https://www.ncbi.nlm.nih.gov/pubmed/35071271 http://dx.doi.org/10.3389/fmed.2021.791087 |
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