Risk factors for BK virus infection in living-donor renal transplant recipients: a single-center study from China

Ren Fail. 2018 Nov;40(1):442-446. doi: 10.1080/0886022X.2018.1489843.

Abstract

Objectives: BK virus (BKV) infection has become one of the main complications in renal transplant recipients (RTRs) with the arrival of newer potent immunosuppressive agents. However, reports on the epidemiology of BKV infection and risk factors in Chinese population after renal transplantation are scarce.

Methods: From June 2015 to July 2016, living-donor renal transplant recipients (LDRTRs) who routinely received the quantitative BKV DNA testing of urine and plasma samples using quantitative real-time polymerase chain reaction (PCR) for the first time after transplantation were selected, while dialysis patients and healthy living donors during that period served as controls. Potential variables were compared and analyzed using logistic regression model multivariate analysis to assess the BKV infection related factors in LDRTRs.

Results: Among the 52 LDRTRs identified, BKV DNA was detected in 16 urine samples (30.8%), significantly higher than that of dialysis patients (6.3%) and healthy living donors (4.2%) (p < .001). Nevertheless, no statistically significant difference wax noted between the latter two groups in urine samples (p = .842). Meanwhile, BKV DNA detection in blood samples was all negative in the three groups. Univariate analysis shown tacrolimus (Tac) trough level and lymphocyte percentage were associated with BKV infection in LDRTRs. Multivariate regression analysis also showed Tac trough level (HR, 1.644; p = .03), lymphocyte percentage (HR, 0.878; p = .026) were associated with BKV infection in LDRTRs.

Conclusions: In Chinese population, the incidence of BKV infection increased significantly after living-donor renal transplantation. Significantly increased Tac trough level and decreased lymphocyte percentage might be the risk factors for BKV infection in LDRTRs.

Keywords: BK virus; infection; polymerase chain reaction; renal transplantation; risk factors.

Publication types

  • Clinical Study

MeSH terms

  • Adult
  • BK Virus / isolation & purification*
  • China
  • DNA, Viral / blood
  • DNA, Viral / isolation & purification
  • DNA, Viral / urine
  • Female
  • Humans
  • Immunosuppressive Agents / pharmacokinetics*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / therapy
  • Kidney Failure, Chronic / virology
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Living Donors
  • Logistic Models
  • Male
  • Middle Aged
  • Polyomavirus Infections / epidemiology*
  • Polyomavirus Infections / pathology
  • Polyomavirus Infections / urine
  • Real-Time Polymerase Chain Reaction
  • Risk Factors
  • Tacrolimus / pharmacokinetics*
  • Tacrolimus / therapeutic use
  • Transplant Recipients
  • Viral Load
  • Young Adult

Substances

  • DNA, Viral
  • Immunosuppressive Agents
  • Tacrolimus

Grants and funding

This work was supported by a grant from National Natural Science Foundation of China to Jiqiu Wen [grant number 81570681].