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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
12
pubmed:dateCreated
2007-11-6
pubmed:abstractText
Polyoma BK virus (BKV)-associated nephropathy (PVAN) is a relevant cause of poor renal allograft survival. In a prospective analysis, we monitored BKV DNA in blood and urine samples from 62 consecutive pediatric kidney recipients. In patients with BKV replication, we analyzed the impact of reduction of maintenance immunosuppression on viral load kinetics and PVAN in patients with BKV replication. BKV-specific immunity was concomitantly evaluated on blood samples of viremic patients, by measuring the frequency of BKV-specific interferon-gamma-producing and cytotoxic T cells, and BKV IgG antibody levels. At a median follow-up of 24 months, BK viruria was observed in 39 of 62 patients, while BK viremia developed in 13 patients (21%). In all viremic patients, immunosuppression reduction resulted in the clearance of viremia, and prevented development of PVAN, without increasing the rate of acute rejection or causing graft dysfunction. As a consequence of immunosuppression adjustment, an expansion of BKV-specific cellular immunity was observed that coincided with viral clearance. We conclude that treating pediatric kidney transplant patients pre-emptively with immunosuppression reduction guided by BKV DNA in blood is safe and effective to prevent onset of PVAN. BKV-specific cellular immunity may be useful to guide this intervention.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
1600-6135
pubmed:author
pubmed:issnType
Print
pubmed:volume
7
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2727-35
pubmed:dateRevised
2008-11-21
pubmed:meshHeading
pubmed-meshheading:17908275-Adolescent, pubmed-meshheading:17908275-Adult, pubmed-meshheading:17908275-Antibodies, Viral, pubmed-meshheading:17908275-BK Virus, pubmed-meshheading:17908275-Child, pubmed-meshheading:17908275-Child, Preschool, pubmed-meshheading:17908275-DNA, Viral, pubmed-meshheading:17908275-Dose-Response Relationship, Drug, pubmed-meshheading:17908275-Female, pubmed-meshheading:17908275-Graft Rejection, pubmed-meshheading:17908275-Humans, pubmed-meshheading:17908275-Immunosuppressive Agents, pubmed-meshheading:17908275-Incidence, pubmed-meshheading:17908275-Interferon-gamma, pubmed-meshheading:17908275-Kidney Transplantation, pubmed-meshheading:17908275-Male, pubmed-meshheading:17908275-Polyomavirus Infections, pubmed-meshheading:17908275-Prospective Studies, pubmed-meshheading:17908275-Tumor Virus Infections, pubmed-meshheading:17908275-Viral Load, pubmed-meshheading:17908275-Virus Replication
pubmed:year
2007
pubmed:articleTitle
Prospective monitoring of polyomavirus BK replication and impact of pre-emptive intervention in pediatric kidney recipients.
pubmed:affiliation
Pediatric Nephrology Unit, G. Gaslini Institute, Genova, Italy. fabrizioginervri@ospedale-gaslini.ge.it
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't