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The impact of pre-graft serology on the risk of BKPyV infection post-renal transplantation
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Edité par CCSD ; Oxford University Press -
- article publié en mars 2022 avec un ordre des auteurs erroné (Catherine François, Claire Tinez, Etienne Brochot, Gilles Duverlie, Sandrine Castelain, François Helle, Toni Fiore, Virginie Morel, Antoine Touzé, Fadi Abdel Sater, Fatima Dakroub, Haidar Akl, Claire Presne, Gabriel Choukroun, Nicolas Guillaume), - rectifié en avril https://doi.org/10.1093/ndt/gfac146. International audience. Abstract Objectives BK polyomavirus associated nephropathy, is a troublesome disease induced by BK polyomavirus (BKPyV) infection in immunocompromised renal graft recipients with no effective available treatment, making immunosuppression reduction the only management option. Thus, pre-graft predictive BKPyV replication markers are needed for high-risk viremia patient identification. Methods we conducted a retrospective study to assess the correlation between the BKPyV pre-transplant serostatus and post-transplant BKPyV infection incidence. Sera from 329 recipients and 222 matched donors were tested for anti-BKV antibodies against BKPyV serotypes I and IV by a VLPs-based IgG ELISA, and BKPyV DNA load was monitored for at least 1 year post transplantation. Results 80 recipients were viruric and 59 recipients were viremic post transplantation. In the post-transplant period, the probability of developing viremia for serotype I was increasing from 4.3% for the D-/R + group to 12.1% for the D+/R + group and climbing to 37.5% for the D+/R- group (p < 0.05). When calculating the recipient mean titers for serotypes I and IV, we observed a clear difference in the proportions of viremia passing from 50% for mean titers < 400 to 13.5% for titers ≥ 400 (p < 0.001) with also a higher proportion of presumptive nephropathy (50% vs 23.1%, p < 0.05). In univariate analysis this parameter has an odds ratio of 6.41 for the risk of developing post-transplant BKPyV viremia (95% CI: 3.16–13.07; p < 0.0001). Conclusions Both donor and recipient BKPyV seropositivity determination before transplantation and antibody titer may serve as a predictive tool to manage clinical BKPyV infection by identification of patients at high risk.
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