BK BK polyomavirus infection after renal transplantation: Surveillance in a resource‐challenged setting

摘要

Abstract Background There is a paucity of data available about BK polyomavirus ( BKP yV) infection after renal transplantation ( RTX ) in resource‐limited countries with a predominantly living‐donor, ABO ‐compatible RTX program. We aimed to assess BKP yV infection in such patients in a public hospital in India. Methods We prospectively evaluated plasma BKP yV replication in 62 patients at 1, 3, 6, 9, and 12?months after RTX . Sustained significant BK viremia ( SSBKV ) was defined as significant viremia (≥10?000 copies/mL) detected ≥2 times, and BKP yV‐associated nephropathy ( BKVAN ) as histologic changes of BKVAN with BK viremia with/without graft dysfunction. Results All patients underwent RTX without requiring desensitization. Incidence of BK viremia was: 17.7%, 41.9%, 16.1%, 25.8%, and 17.7% at 1, 3, 6, 9, and 12?months, respectively. Of 62 patients, 64.5% had BKP yV viremia during the study, 32.2% had significant viremia, all except one detected in the first 6?months. Nine (14.5%) patients had SSBKV . There was no biopsy‐proven BKVAN. At the end of 1?year, mean serum creatinine was higher and graft dysfunction was significantly more common in patients with SSBKV compared to those without SSBKV . Conclusion Transient BK viremia is common in low/intermediate immunologic risk RTX recipients in India, with a peak occurring at 3‐6?months. Most clear their viremia by 12?months. Graft dysfunction seems to be more frequent in patients with SSBKV , although BKVAN is uncommon on biopsy in these patients.