Ghotbi Maryam, Keshavarz Mohsen, Parhizgari Najmeh, Mokhtari-Azad Talat, Shafiei-Jandaghi Nazanin Zahra, Rezaei Farhad
Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
Viral Immunol. 2025 Jul-Aug;38(6):203-211. doi: 10.1089/vim.2024.0077. Epub 2025 Jun 5.
BK virus is a childhood virus that can reactivate in immunocompromised individuals, particularly organ transplant recipients, causing transplant rejection due to BK virus-associated nephropathy. The study aimed to assess the prevalence of BK virus infection in kidney transplant recipients, examine the relationship between demographic and laboratory factors and active infection, evaluate the impact of reducing immunosuppressive drug doses on BK virus reactivation, and explore the genotyping of BK virus strains in this population. This cross-sectional study utilized 245 serum samples from kidney transplant recipients. Viral DNA was extracted from these samples, and initially, Nested PCR was employed for screening to ensure accuracy, with primers targeting a segment of the VP1 gene used to detect the BK virus genome. Real-Time PCR was subsequently performed on positive samples to measure viral load more precisely. The prevalence of BK virus infection among kidney transplant recipients was 5.3%. Out of 245 kidney transplant recipients, 13 individuals were diagnosed with active BK virus infection. Genotype I was the most prevalent, accounting for 90% of the cases. The relationship between demographic factors (gender and age) and laboratory parameters (fasting blood glucose, creatinine, hemoglobin, and platelet count) was examined in both kidney transplant recipients with and without active BK virus infection. The results revealed that a reduction in immunosuppressive drug dosages, particularly tacrolimus, was associated with a decrease in BK viral load, potentially contributing to a lower incidence of active BK virus infections. Additionally, hematological analysis showed a significant decrease in hemoglobin levels in kidney transplant recipients with active BK virus infection, accompanied by a significant increase in serum creatinine levels. Balancing immunosuppressive therapy, especially reducing tacrolimus, helps control BK virus reactivation and preserve graft function. Regular monitoring of hematological parameters and viral load is crucial for optimal management in kidney transplant recipients.
BK病毒是一种儿童期病毒，可在免疫功能低下的个体中重新激活，尤其是器官移植受者，会因BK病毒相关性肾病导致移植排斥反应。该研究旨在评估肾移植受者中BK病毒感染的患病率，研究人口统计学和实验室因素与活动性感染之间的关系，评估降低免疫抑制药物剂量对BK病毒重新激活的影响，并探索该人群中BK病毒株的基因分型。这项横断面研究使用了245份肾移植受者的血清样本。从这些样本中提取病毒DNA，最初采用巢式PCR进行筛查以确保准确性，使用靶向VP1基因片段的引物来检测BK病毒基因组。随后对阳性样本进行实时PCR以更精确地测量病毒载量。肾移植受者中BK病毒感染的患病率为5.3%。在245名肾移植受者中，有13人被诊断为活动性BK病毒感染。I型基因型最为常见，占病例的90%。在有和没有活动性BK病毒感染的肾移植受者中，都研究了人口统计学因素（性别和年龄）与实验室参数（空腹血糖、肌酐、血红蛋白和血小板计数）之间的关系。结果显示，免疫抑制药物剂量的减少，尤其是他克莫司，与BK病毒载量的降低有关，这可能有助于降低活动性BK病毒感染的发生率。此外，血液学分析显示，活动性BK病毒感染的肾移植受者血红蛋白水平显著降低，同时血清肌酐水平显著升高。平衡免疫抑制治疗，尤其是减少他克莫司的使用，有助于控制BK病毒的重新激活并保留移植肾功能。定期监测血液学参数和病毒载量对于肾移植受者的最佳管理至关重要。
