Department of Virology, CHU Amiens-Picardie, Amiens, France.
AGIR Laboratory UR4294, Université Picardie Jules Verne, Amiens, France.
J Med Virol. 2024 Jun;96(6):e29742. doi: 10.1002/jmv.29742.
Polyomaviruses 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.
多瘤病毒 BK（BKPyV）和 JC（JCPyV）属于多瘤病毒科，可导致人类发病。在肾移植受者中，BKPyV 复制可导致不可逆的肾单位损伤，而 JCPyV 复制仍无症状。同时复制很少见，并且已描述了感染之间的潜在竞争。本回顾性病例对照研究的目的是描述 BKPyV 和 JCPyV 在肾移植受者队列中的分子流行病学和相关危险因素。共对 460 名患者的 655 份尿液样本进行了 BKPyV 和 JCPyV DNA 检测。阳性样本进行了病毒株基因分型。还比较了人口统计学和临床特征。分别在 16.5%和 23.3%的患者中发现了孤立的 JCPyV 和 BKPyV；共同复制很少见（3.9%）。BKPyV 株 Ib-2、Ib-1 和 IVc-2 最为常见。JCPyV 株主要属于基因型 4 和 1B。在随访期间，JCPyV 脱落显著降低了 BKPyV 尿 DNA 阳性的风险，比值比为 0.57（95%置信区间：0.35-0.99），与 BKPyV 复制相比，基于估计的肾小球滤过率，预后更好。我们地区 BKPyV 和 JCPyV 株的分子流行病学与之前的研究相似。本研究表明 JCPyV 是良性的，似乎限制了对 BKPyV 复制的损害。因此，JCPyV 尿 DNA 筛查可能是预测 BKPyV 相关结局的一种有用策略。
