JC polyomavirus replication and associated disease in pediatric renal transplantation: an international CERTAIN Registry study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-07-30

AUTHORS

Britta Höcker, Julia Tabatabai, Lukas Schneble, Jun Oh, Florian Thiel, Lars Pape, Krisztina Rusai, Rezan Topaloglu, Birgitta Kranz, Günter Klaus, Nikoleta Printza, Onder Yavascan, Alexander Fichtner, Kai Krupka, Thomas Bruckner, Rüdiger Waldherr, Michael Pawlita, Paul Schnitzler, Hans H. Hirsch, Burkhard Tönshoff

ABSTRACT

BackgroundJC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) is a severe, but rare complication in adult renal transplant (RTx) recipients. Related data in pediatric patients are scarce.MethodsBased on the CERTAIN Registry, we therefore performed a multi-center, retrospective study on the JCPyV antibody status, prevalence of JCPyV replication, and its associated disease in 139 pediatric RTx recipients (mean age, 8.5 ± 5.3 years). JCPyV DNA in plasma and/or urine was measured by quantitative PCR at a median time of 3.2 (IQR, 0.3–8.1) years post-transplant.Results53.2% of patients were JCPyV-seronegative prior to transplantation; younger age was associated with JCPyV seronegativity. 34/139 (24.5%) patients post-transplant showed active JCPyV replication in either urine (22.0%), plasma (13.4%), or both (7.6%). JCPyV viremia occurred significantly (p < 0.001) more often in patients with viruria (34.6%) than in those without (7.6%), but 7/118 (5.9%) had isolated viremia. High-level viruria (> 107 copies/mL) was found in 29.6% of viruric patients. A higher net state of immunosuppression constituted an independent risk factor for JCPyV replication both in urine and plasma (OR 1.2, p < 0.02). Male patients tended to have a higher risk of JCPyV viremia than females (OR 4.3, p = 0.057). There was one male patient (0.7%) with JCPyVAN 7 years post-transplant, which resolved after reduction of immunosuppressive therapy. No patient exhibited progressive multifocal leukoencephalopathy.ConclusionsThis first multi-center study on JCPyV in pediatric renal transplant recipients shows that JCPyV replication is common (24.5%), with strong immunosuppression being a significant risk factor, but associated nephropathy is rare. More... »

PAGES

2343-2352

Journal

TITLE

Pediatric Nephrology

ISSUE

12

VOLUME

33

Author Affiliations

  • Department of Pediatrics I, University Children’s Hospital, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
  • Department of Infectious Diseases, Virology, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
  • Department of Pediatric Nephrology, University Children’s Hospital, Martinistr. 52, 20246, Hamburg, Germany
  • Hanover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany
  • Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
  • Faculty of Medicine, Department of Pediatric Nephrology, Hacettepe University, Ankara, Turkey
  • Department of General Pediatrics, University Children’s Hospital Münster, Waldeyerstraße 22, 48149, Münster, Germany
  • Department of Pediatric Nephrology, University Children’s Hospital Marburg, Baldingerstraße, 35043, Marburg, Germany
  • 1st Pediatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Department of Pediatric Nephrology, Tepecik Teaching and Research Hospital, 1140/1 Sk No: 1, 35180 Yenisehir, İzmir, Turkey
  • Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany
  • Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
  • Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
  • Infectious Diseases & Hospital Epidemiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00467-018-4029-9

    DOI

    http://dx.doi.org/10.1007/s00467-018-4029-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1105899930

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30058047


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