Epidemiology of BK virus in renal allograft recipients: independent risk factors for BK virus replication.
Epidemiology of BK virus in renal allograft recipients: independent risk factors for BK virus replication.
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DOI：
10.1097/tp.0b013e31817c6447
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发表时间：
2008-08-27
期刊：
影响因子：
6.2
通讯作者：
Suthanthiran M
中科院分区：
文献类型：
--
作者：
Dadhania D;Snopkowski C;Ding R;Muthukumar T;Chang C;Aull M;Lee J;Sharma VK;Kapur S;Suthanthiran M
Identification of risk factors for BKV replication may improve transplant outcome. We investigated the impact of immunosuppressive drugs on the prevalence of BKV replication in recipients of human renal allografts. One hundred twenty renal allograft recipients were studied prospectively at one, three, and six months post-transplantation to identify risk factors for BKV replication. BKV replication was quantified by measurement of urinary cell BKV VP1 mRNA levels using BKV specific primers and TaqMan® probe in a real-time quantitative PCR assay. Levels of urinary cell mRNA for granzyme B, CD103 and TGF-β1 were measured to ascertain whether BKV replication is associated with an inflammatory signature. The prevalence of BKV replication increased over time and was highest at six-months compared to 1 or 3 months post-transplantation (P<0.001). A logistic regression model analysis demonstrated that steroid maintenance therapy (odds ratio: 8.3, P= 0.003) and induction with rabbit anti-human thymocyte globulin (ATG) (odds ratio: 5.8, P= 0.008) were independent risk factors for BKV replication. Neither mycophenolate mofetil dose nor tacrolimus dose or trough levels were different between those with or without BKV replication. The development of acute rejection or anti-rejection treatment with methylprednisolone did not increase the risk of BKV replication. BKV replication was associated with heightened levels of urinary cell mRNA for granzyme B (P<0.002), CD103 (P<0.005) but not for TGF-β1 (P>0.05). Steroid maintenance therapy and induction with ATG are independent risk factors for BKV replication in renal allograft recipients treated with tacrolimus and mycophenolate mofetil.
