BK Virus Infection in Kidney Transplant Recipients: Genotypic Variations and Clinical Outcomes in Tehran, Iran (2018-2019).

Abstract

BK virus is a childhood virus that can reactivate in immunocompromised individuals, particularly organ transplant recipients, causing transplant rejection due to BK virus-associated nephropathy. The study aimed to assess the prevalence of BK virus infection in kidney transplant recipients, examine the relationship between demographic and laboratory factors and active infection, evaluate the impact of reducing immunosuppressive drug doses on BK virus reactivation, and explore the genotyping of BK virus strains in this population. This cross-sectional study utilized 245 serum samples from kidney transplant recipients. Viral DNA was extracted from these samples, and initially, Nested PCR was employed for screening to ensure accuracy, with primers targeting a segment of the VP1 gene used to detect the BK virus genome. Real-Time PCR was subsequently performed on positive samples to measure viral load more precisely. The prevalence of BK virus infection among kidney transplant recipients was 5.3%. Out of 245 kidney transplant recipients, 13 individuals were diagnosed with active BK virus infection. Genotype I was the most prevalent, accounting for 90% of the cases. The relationship between demographic factors (gender and age) and laboratory parameters (fasting blood glucose, creatinine, hemoglobin, and platelet count) was examined in both kidney transplant recipients with and without active BK virus infection. The results revealed that a reduction in immunosuppressive drug dosages, particularly tacrolimus, was associated with a decrease in BK viral load, potentially contributing to a lower incidence of active BK virus infections. Additionally, hematological analysis showed a significant decrease in hemoglobin levels in kidney transplant recipients with active BK virus infection, accompanied by a significant increase in serum creatinine levels. Balancing immunosuppressive therapy, especially reducing tacrolimus, helps control BK virus reactivation and preserve graft function. Regular monitoring of hematological parameters and viral load is crucial for optimal management in kidney transplant recipients.