Human Polyomavirus Infections with JC Virus and BK Virus in Renal Transplant Patients

Abstract
Infection with the human polyomaviruses JC virus and BK virus was studied in 61 immunosuppressed renal transplant patients. Urine cytologic studies, indirect immunofluorescence microscopy, EM and serologic studies were used to assess viral activity. Patients records were abstracted for events associated with polyomavirus infections. Polyomavirus excretion in urine was detected in 12 of 61 patients (20%). Eleven excreted JC virus and 9, BK virus. Fourfold hemagglutination-inhibition antibody titer rises occurred in 25 of 61 patients (41%). Most JC virus infections apparently were primary, whereas most BK virus infections resulted from virus reactivation. During this 2 yr study, 32 of 61 patients (52%) had evidence of active viral replication. Urinary tract excretion was associated with drug-requiring diabetes mellitus (P = 0.001), arterial occlusive disease (P = 0.03) and ureteral stricture with loss of renal function (P = 0.02). Antibody increases to BK virus were associated with a rising serum creatine (P = 0.02) and need for transplant biopsy (P = 0.02). Polyomavirus replication was associated with an increased frequency of transplant related complications.

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