Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany; Institute for Virology, University Hospital Essen, University of Duisburg-Essen Virchowstr. 179, 45147, Essen, Germany.
Department of Gastroenterology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
J Clin Virol. 2019 Apr;113:14-19. doi: 10.1016/j.jcv.2019.02.002. Epub 2019 Feb 10.
After reactivation the BK-polyomavirus (BKPyV) associated nephropathy (PyVAN) is observed in 1-10% of renal transplant recipients, of which up to 80% undergo graft failure. BKPyV reactivation after renal transplantation was associated with donor-derived serotypes against which the recipient has no immunological protection. However, PyVAN risk assessment seroactivity testing is a time-consuming and cost intensive process.
Since BKPyV serotypes can be attributed to distinct genotypes I to IV, in the present study we retrospectively analyzed whether a simple PCR-based BKPyV genotyping assay might be a fast and inexpensive method to assess the risk for PyVAN and transplant outcome already at early stages of BKPyV reactivation.
56 patients who were renal transplanted and tested positive for BKPyV viremia were included into the study. The BKPyV-VP1-coding sequences were PCR-amplified, sequenced, and subjected to genotyping. For group specific analysis patients were grouped in genotype I (n = 46) and a second group including genotype II and IV (n = 10) and associated with their clinical outcomes.
The most abundant genotype I was detected in 46 of 56 (82%) patients, however, in the genotype II and IV group PyVAN was twice as frequent as compared to the genotype I group 24 months after transplantation (8 of 10 (80%) vs. 17 of 46 (37%); p = 0.001). Accordingly, graft failure was significantly more frequent in the genotype II and IV group (3 of 10 (30%) vs. 2 of 46 (4%); p = 0.007).
PCR-based BKPyV genotyping might represent a fast and inexpensive method to assess the risk for PyVAN and transplant outcome already at early stages of BKPyV reactivation even if matched samples of the donor are not available.
BK 多瘤病毒（BKPyV）再激活后，1-10%的肾移植受者会发生相关肾病（PyVAN），其中多达 80%的受者会发生移植物失功。肾移植后 BKPyV 再激活与供体来源的血清型有关，而受者对此没有免疫保护。然而，PyVAN 风险评估血清学检测是一个耗时且昂贵的过程。
由于 BKPyV 血清型可归因于不同的基因型 I 至 IV，因此在本研究中，我们回顾性分析了一种简单的基于 PCR 的 BKPyV 基因分型检测是否可能是一种快速且经济的方法，用于在 BKPyV 再激活的早期阶段评估 PyVAN 和移植结局的风险。
本研究纳入了 56 例肾移植后 BKPyV 血症检测阳性的患者。PCR 扩增 BKPyV VP1 编码序列，测序并进行基因分型。为了进行组特异性分析，将患者分为基因型 I（n=46）和包括基因型 II 和 IV 的第二组（n=10），并与他们的临床结局相关联。
在 56 例患者中，最常见的基因型 I 检测到 46 例（82%），然而，在基因型 II 和 IV 组中，24 个月后，PyVAN 的发生率是基因型 I 组的两倍（8 例[80%]比 17 例[37%]；p=0.001）。相应地，基因型 II 和 IV 组的移植物失功明显更频繁（3 例[30%]比 2 例[4%]；p=0.007）。
基于 PCR 的 BKPyV 基因分型可能是一种快速且经济的方法，用于在 BKPyV 再激活的早期阶段评估 PyVAN 和移植结局的风险，即使没有供体的匹配样本。
