The Noninvasive Urinary Polyomavirus Haufen Test Predicts BK Virus Nephropathy in Children After Hematopoietic Cell Transplantation: A Pilot Study

Transplantation
Benjamin L LaskinVolker Nickeleit

Abstract

After hematopoietic cell transplantation (HCT), polyoma-BK virus is associated with hemorrhagic cystitis and also with polyomavirus nephropathy (PVN). However, the true burden of post-HCT PVN is unknown because kidney biopsies are avoided due to their bleeding risk. The novel, noninvasive urinary PV-Haufen test detects PVN in kidney transplant recipients with greater than 95% positive/negative predictive values. We hypothesized that the detection of PV-Haufen in voided urine samples-a positive PV-Haufen test-was also clinically significant after HCT. We examined 21 suitable urine samples from 14 patients (median age, 15 years; 71.4% male) who were selected from repositories for having varying degrees of BK viremia (range, 0-1.0 × 10 copies/mL), hemorrhagic cystitis (present/absent), and data on kidney function. Urine samples were obtained at a median of 88 days post-HCT. The PV-Haufen were detected in 5 of 14 patients (35.7%) and 7 of 21 (33.3%) urine samples, with histologic confirmation of PVN in 1 autopsy specimen. After a median of 285 days post-HCT, patients with PV-Haufen had an increased risk of dialysis-dependent renal failure (P < 0.05). All 3 dialysis-dependent patients had PV-Haufen and died. The presence of urinary ...Continue Reading

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Citations

Mar 16, 2017·Transplant International : Official Journal of the European Society for Organ Transplantation·Neerja AgrawalMichelle A Josephson
May 17, 2018·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Karel KrejciJosef Zadrazil
Sep 30, 2016·World Journal of Transplantation·Darlene VigilAntonios H Tzamaloukas
Mar 5, 2020·Reviews in Medical Virology·Jason T BlackardBenjamin L Laskin

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