Background. Human Polyomaviruses (HPyVs) are able to establish latent infection in the kidney of the host. Immunosuppression is recognized risk factor for HPyVs reactivation. Besides the well studied BK virus (BKPyV), JC virus (JCPyV), Merkel Cell Polyomavirus (MCPyV), and HPyV9 have been also detected in kidney transplant (KTx) recipients. Origin and natural history of these HPyVs remain unclear. Methods. Urine, blood, and kidney samples from 39 donor-recipient pairs were collected immediately before and periodically (from 1 to 180 days) after KTx. Samples were tested for BKPyV, JCPyV, MCPyV, HPyV7, and HPyV9 genome using Real Time PCR and automatic sequencing to define viral genotypes and rearrangements. Results. No HPyVs viremia was observed whereas HPyVs viruria was detected in 21/39 (54%) donors and 24/39 (61.5%) recipients. Overall, 14/39 (36%) donor-recipient pairs were positive for HPyVs. JCPyV DNA was detected in 13/39 (33%) donor-recipient pairs with both donors and recipients positive for identical JCPyV strains. JCPyV was consistently positive in the urine of the recipients at any time point of the study. BKPyV was detected in 2 donors and sporadically in 5 recipients (1 donor-recipient pair). MCPyV was detected in 2 donors and sporadically in 10 recipients (1 donor-recipient pair). Median time from KTx to first viruria for JCPyV, BKPyV, and MCPyV was 1 (range 1-301), 76 (range 24-180), and 14 (range 1-267) days post KTx, respectively. Two cases of concomitant JCPyV and BKPyV, and 1 case of concomitant JCPyV and MCPyV infections were observed. No relationships between HPyVs replication and KTx outcomes were identified during the follow up. Conclusions. Our data confirm that JCPyV replication is frequently observed in organ donors. They also show that JCPyV replication in KTx recipients generally occurs very early. Moreover, post transplant JCPyV infections are due to viral strains transmitted by the donor. Post KTx BKPyV and MCPyV replication is less frequent, mostly occurs at a later stage, and it is likely due to viral reactivation of recipient's strains or new infections. Extended follow up is needed to rule out clinical impact of early JCPyV infection after KTx.

CITATION INFORMATION: Favi E., Delbue S., Colico C., Ferrante P., Villani S., Perna I., Mondoni N., Giussani A., Clementoni L., Messa P., Ferraresso M. Origin and Pattern of Human Polyomaviruses Replication after Kidney Transplantation: A Prospective Study Am J Transplant. 2017;17 (suppl 3).

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