Diagnosis and treatment of BK virus-associated transplant nephropathy

Advances in Experimental Medicine and Biology
Abhay VatsRon Shapiro

Abstract

The incidence of polyoma virus infection, particularly that of BK virus (BKV) in kidney transplant recipients has been increasing steadily since early 1990s. The diagnosis is generally made by a renal allograft biopsy. However the diagnosis can sometimes be difficult because of the pathological similarities between BKV associated nephropathy (BKVAN) and acute cellular rejection. In addition to the difficulties in making a diagnosis, the treatment of BKVAN can also be very complex. Reduction in immunosuppression is generally advocated as the initial therapeutic option for the management of BKVAN. Despite reduced immunosuppression, BKV can persist in the renal allograft and lead to gradual loss of kidney function. Hence, new therapeutic options are being evaluated for treatment of BKVAN. Cidofovir, an anti-viral agent with known nephrotoxic effects, has been successfully used in very low doses to treat patients with BKVAN, with serial measurement of the blood and urine BKV load with PCR assays. More recently several other agents have also been utilized to treat BKVAN, with variable success. This chapter summarizes the current diagnostic modalities and therapeutic options for BKVAN.

Citations

Dec 21, 2007·The New England Journal of Medicine·Jay A Fishman
Jun 4, 2008·Pediatric Transplantation·Abhay Vats
Nov 28, 2008·Journal of Virology·Mengxi JiangMichael J Imperiale
Jul 25, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Aishwarya RavindranSanjeev Sethi
Feb 7, 2018·Transplantation Proceedings·P Yooprasert, P Rotjanapan
Jul 10, 2007·Seminars in Nephrology·Jay A Fishman
Mar 1, 2007·Diabetes Care·Paturi V RaoSrinivasa R Nagalla

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BK virus infection is a significant complication of modern immunosuppression used in kidney transplantation. Discover the latest research on BK virus infection here.