Evaluation of new-onset BK viruria in post-renal transplant recipients by quantitative PCR

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2024-10-04 DOI:10.1016/j.trim.2024.102136

Raza Ullah Asif, Eijaz Ghani, Muhammad Ali Rathore, Saadiya Mushtaq, Faraz Ahmed, Hammad Hussain

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Abstract

Background

The BK polyomavirus infection poses a substantial challenge for organ transplant recipients due to immunosuppression, resulting in BK virus-associated nephropathy (BKVAN) and a considerable risk of graft loss. Screening and prompt decrease of immunosuppression are essential for averting these consequences. We examined the frequency of BK viruria (viral load in urine) among post-renal transplant recipients, along with its association with age, viral load, and the timing of viral reactivation.

Methods

The prospective cohort study was conducted at the Tertiary Care Hospital in Rawalpindi over a 12-month period, from January 1 to December 31, 2023. Urine specimens from 108 renal transplant recipients were collected and analysed for BK viruria every three months during the follow-up assessments. DNA extraction was performed using TANbead extractor, and amplification was carried out with Bio-Rad CFX-96 thermal cycler using Sacace TM amplification kit. Data was analysed using SPSS version 27.

Results

In the cohort of 108 renal transplant recipients, BK viruria was detected in 16.7 % of cases. There was a higher prevalence of BK viruria in females (20 %) than males (16 %). The majority of positive cases were within the 41–60 years age group (61.1 %). Most of the patients (66.6 %) had viral loads below 1 million copies/ml. BK viruria was predominantly detected during the third quarter (between 7 and 9 months) post-transplant. The Chi-square test was applied between age and viral load, showing a significant association (p = 0.01). Similarly, gender and viral load also showed a significant relationship (p = 0.019).

Conclusion

The study showed the frequency of 16.7 % of BK viruria in our small cohort after renal transplantation during the initial 12 months post-transplant. Age of recipients correlated with viral load and time of viral reactivation: middle-aged recipients had higher viral loads. BK viruria increased progressively over the initial nine months, with peak incidence in the third quarter post-transplant.

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通过定量 PCR 评估肾移植后受者中新发的 BK 病毒感染。

背景：由于免疫抑制，BK 多瘤病毒感染给器官移植受者带来了巨大挑战，导致 BK 病毒相关性肾病（BKVAN）和相当大的移植物丢失风险。筛查和及时减少免疫抑制对避免这些后果至关重要。我们研究了肾移植术后受者出现 BK 病毒尿（尿液中病毒载量）的频率及其与年龄、病毒载量和病毒再激活时间的关系：这项前瞻性队列研究于 2023 年 1 月 1 日至 12 月 31 日在拉瓦尔品第三级医院进行，为期 12 个月。在随访评估期间，每三个月收集 108 名肾移植受者的尿液标本并分析 BK 病毒。使用 TANbead 提取器提取 DNA，并使用 Bio-Rad CFX-96 热循环仪和 Sacace TM 扩增试剂盒进行扩增。数据使用 SPSS 27 版进行分析：结果：在 108 例肾移植受者中，16.7% 的病例检测出 BK 病毒。女性 BK 病毒感染率（20%）高于男性（16%）。大多数阳性病例年龄在 41-60 岁之间（61.1%）。大多数患者（66.6%）的病毒载量低于 100 万拷贝/毫升。BK 病毒主要在移植后第三季度（7 至 9 个月）检测到。年龄与病毒载量之间进行了卡方检验，结果显示两者之间存在显著关联（p = 0.01）。同样，性别与病毒载量也有显著关系（P = 0.019）：研究表明，在我们的小规模队列中，肾移植后最初 12 个月内 BK 病毒感染率为 16.7%。受者年龄与病毒载量和病毒再激活时间相关：中年受者的病毒载量较高。在最初的九个月中，BK 病毒感染率逐渐增加，在移植后的第三季度达到高峰。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.