Course of BK Virus Infection in Renal Transplant Recipients Treated with Cidofovir
The Methodist Hospital, Houston, TX
Meeting: 2013 American Transplant Congress
Abstract number: 276
In renal transplantation, BK virus may contribute to graft dysfunction and graft loss. While reduction in immunosuppression is considered standard therapy for infection, data has suggested a role for cidofovir (CID). The purpose of this study was to describe the course of BK infection in CID-treated patients. Kidney transplant recipients with confirmed BK viremia (BKV) or biopsy-proven nephropathy (BKN) and treated with CID (0.25 – 1 mg/kg every 2 weeks) from 01/2007 through 06/2012 were included in the analysis. Patients with <6 months follow-up after initiation were excluded. Baseline characteristics of the 68 included patients are shown below. Mean BKV at baseline was 5.2 ± 1.0 log10copies and mean time from diagnosis to CID initiation was 1.4 months. At 6 and 12 months of treatment, respectively, 44% and 64% of patients achieved negative BKV. Independent factors associated with persistent BKV at 6 months included older age, delayed graft function, higher baseline BKV, and lack of BKV reduction by 1 log10copies at 1 month of treatment. Gender, ethnicity, induction therapy, transplant type, and presence of BKN did not correlate with clearance at 6 months. Overall time to BKV clearance was 7.4 months, after a mean of 16 ± 11 CID doses. For the entire cohort, creatinine at the end of treatment increased by 39% from baseline. Patients BKV(+) at 6 months had a significantly greater rise in creatinine at the end of therapy compared to BKV(-) patients (68% vs. 1.4%; p=0.008). Repeat biopsies were performed in 20 of 44 patients with BKN and demonstrated histological clearance in 16 (80%) cases, while 3 graft losses occurred due to BK. These data provide insight into the course of BK infection in patients treated with CID. Clearance of BKV at 6 months post-treatment may be associated with maintenance of stable renal function at the end of therapy.
Age (years) | 50.3 ± 11.8 |
Male, n(%) | 46 (68%) |
Ethnicity | |
Caucasian, n(%) | 25 (37%) |
African American, n(%) | 21 (31%) |
Type of Transplant | |
Deceased donor, n(%) | 43 (63%) |
Kidney-pancreas, n(%) | 6 (9%) |
Immunosuppressive Therapy | |
Anti-thymocyte globulin, n(%) | 46 (68%) |
IL2-RA, n(%) | 22 (32%) |
Tacrolimus, n(%) | 68 (100%) |
Mycophenolate mofetil, n(%) | 68 (100%) |
Prednisone, n(%) | 56 (92%) |
BK nephropathy, n(%) | 44 (65%) |
Odds Ratio | p-value | |
Age (years) | 1.06 | 0.036 |
Baseline BKV (log10copies) | 2.94 | 0.006 |
Delayed graft function | 15.3 | 0.039 |
BKV reduction by <1 log10copies at 1 month of treatment | 29.1 | <0.0001 |
To cite this abstract in AMA style:
Kuten S, Patel S, Knight R, Gaber L, Gaber A. Course of BK Virus Infection in Renal Transplant Recipients Treated with Cidofovir [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/course-of-bk-virus-infection-in-renal-transplant-recipients-treated-with-cidofovir/. Accessed October 9, 2024.« Back to 2013 American Transplant Congress