Molecular epidemiology and risk factors associated with BK and JC polyomavirus urinary shedding after kidney allograft

Author:

Demey Baptiste12ORCID,Aubry Aurélien12,Descamps Véronique2,Morel Virginie2,Le My Hanh Hillary1,Presne Claire3,Brazier François34,Helle François2,Brochot Etienne12

Affiliation:

1. Department of Virology CHU Amiens‐Picardie Amiens France

2. AGIR Laboratory UR4294 Université Picardie Jules Verne Amiens France

3. Department of Nephrology, Dialysis, and Transplantation CHU Amiens‐Picardie Amiens France

4. MP3CV Laboratory EA7517 Jules Verne University of Picardie Amiens France

Abstract

AbstractPolyomaviruses BK (BKPyV) and JC (JCPyV), belonging to the Polyomaviridae, are responsible for human pathologies. In kidney transplant recipients, BKPyV replication can lead to irreversible nephron damage whereas JCPyV replication remains asymptomatic. Concomitant replication is rare and potential competition between the infections has been described. The aim of this retrospective case‐control study was to describe the molecular epidemiology and risk factors associated with BKPyV and JCPyV replication in a cohort of kidney transplant recipients. In total, 655 urine samples from 460 patients were tested for BKPyV and JCPyV DNA. Positive samples were submitted to strain genotyping. Demographic and clinical characteristics were also compared. Isolated JCPyV and BKPyV was found in 16.5% and 23.3% of patients, respectively; co‐replication was rare (3.9%). BKPyV strains Ib‐2, Ib‐1, and IVc‐2 were the most prevalent. JCPyV strains mostly belonged to genotypes 4 and 1B. During follow‐up, JCPyV shedding significantly reduced the risk of BKPyV DNAuria, with an odds ratio of 0.57 (95% confidence interval: 0.35–0.99), and was associated with better prognosis than BKPyV replication, based on the estimated glomerular filtration rate. Molecular epidemiology of BKPyV and JCPyV strains in our region was similar to previous studies. This study suggests that JCPyV is benign and appears to limit damaging BKPyV replication. JCPyV DNAuria screening could thus be a useful strategy to predict BKPyV‐related outcomes.

Publisher

Wiley

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