Early monitoring of the human polyomavirus BK replication and sequencing analysis in a cohort of adult kidney transplant patients treated with basiliximabReport as inadecuate




Early monitoring of the human polyomavirus BK replication and sequencing analysis in a cohort of adult kidney transplant patients treated with basiliximab - Download this document for free, or read online. Document in PDF available to download.

Virology Journal

, 8:407

First Online: 17 August 2011Received: 30 May 2011Accepted: 17 August 2011

Abstract

BackgroundNowadays, better immunosuppressors have decreased the rates of acute rejection in kidney transplantation, but have also led to the emergence of BKV-associated nephropathy BKVAN. Therefore, we prospectively investigated BKV load in plasma and urine samples in a cohort of kidney transplants, receiving basiliximab combined with a mycophenolate mofetil-based triple immunotherapy, to evaluate the difference between BKV replication during the first 3 months post-transplantation, characterized by the non-depleting action of basiliximab, versus the second 3 months, in which the maintenance therapy acts alone. We also performed sequencing analysis to assess whether a particular BKV subtype-subgroup or transcriptional control region TCR variants were present.

MethodsWe monitored BK viruria and viremia by quantitative polymerase chain reaction Q-PCR at 12 hours Tx, 1 T1, 3 T2 and 6 T3 months post-transplantation among 60 kidney transplant patients. Sequencing analysis was performed by nested-PCR with specific primers for TCR and VP1 regions. Data were statistically analyzed using χ test and Student-s t-test.

ResultsBKV was detected at Tx in 4-60 urine and in 16-60 plasma, with median viral loads of 3,70 log GEq-mL and 3,79 log GEq-mL, respectively, followed by a significant increase of both BKV-positive transplants 32-60 and median values of viruria 5,78 log GEq-mL and viremia 4,52 log GEq-mL at T2. Conversely, a significantly decrease of patients with viruria and viremia 17-60 was observed at T3, together with a reduction of the median urinary and plasma viral loads 4,09 log GEq-mL and 4,00 log GEq-mL, respectively. BKV TCR sequence analysis always showed the presence of archetypal sequences, with a few single-nucleotide substitutions and one nucleotide insertion that, interestingly, were all representative of the particular subtypes-subgroups we identified by VP1 sequencing analysis: I-b-2 and IV-c-2.

ConclusionsOur results confirm previous studies indicating that BKV replication may occur during the early hours after kidney transplantation, reaches the highest incidence in the third post-transplantation month and then decreases within the sixth month, maybe due to induction therapy. Moreover, it might become clinically useful whether specific BKV subtypes or rearrangements could be linked to a particular disease state in order to detect them before BKVAN onset.

KeywordsBKV BKVAN basiliximab Q-PCR TCR VP1 BKV subtype-subgroup Electronic supplementary materialThe online version of this article doi:10.1186-1743-422X-8-407 contains supplementary material, which is available to authorized users.

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Author: Elena Anzivino - Anna Bellizzi - Anna Paola Mitterhofer - Francesca Tinti - Mario Barile - Maria Teresa Colosimo - Daniela

Source: https://link.springer.com/







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