New Medscape article - BK Virus Common After Solid Organ Transplants

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BK Virus Common After Solid Organ Transplants

Reuters Health Information 2005. © 2005 Reuters Ltd. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

By Will Boggs, MD

NEW YORK (Reuters Health) Dec 26 - The BK species of human polyomavirus is frequently found in patients who have received solid organ transplants, according to a report in the December 15th Clinical Infectious Diseases.

"BK virus is common in all types of solid organ transplant recipients, particularly in heart and kidney transplant recipients, and it may predispose to end-stage renal failure in more patients than previously thought," Dr. Muoz from Hospital General Universitario "Gregorio Maranon," Madrid, Spain told Reuters Health.

Dr. Muoz and colleagues investigated the prevalence of BK virus among recipients of liver, heart, or kidney transplants at their medical center and examined the relationship between BK virus replication and renal function.

The investigators identified BK viremia in 6% and BK viruria in 19% of solid organ transplant recipients. Both viremia and viruria were significantly more common among recipients of kidney and heart transplants than among recipients of liver transplants.

Mean creatinine levels were highest for patients with BK viremia (3.5 mg/dL), intermediate for patients with BK viruria (1.9 mg/dL), and lowest for patients without BK virus (1.3 mg/dL), the authors report.

BK virus replication (viremia or viruria), renal transplantation, and mycophenolate use were independently related to impaired renal function, the results indicate.

"The role of mycophenolate as independent predictor of renal impairment in our study population is not clear," the researchers write. "It may reflect differences in the use of mycophenolate for different types of transplantation or even its use in patients with higher risk of renal function impairment."

"The systematic screening of BKV infection may be essential for early diagnosis before graft damage progression occurs," Dr. Muoz concluded. "It is becoming more important now that more therapeutic approaches are being described."

"It is not yet clear what, if any, role there is for monitoring BK virus load over time and recipients of nonrenal solid organ transplants, nor whether any pharmacotherapeutic intervention should be undertaken for these patients," Dr. Robin K. Avery from the Cleveland Clinic Foundation, Ohio, writes in a related commentary. "The intriguing findings of Muoz and colleagues should prompt further research to address these unanswered questions."

Clin Infect Dis 2005;41:1720-1725,1726-1727.