BK Virus‐Specific Antibodies and BKV DNA in Renal Transplant Recipients with BKV Nephritis

• Published in: American journal of transplantation Vol. 5; no. 11; pp. 2719 - 2724
• Main Authors: Hariharan, Sundaram, Cohen, Eric P., Vasudev, Brahm, Orentas, Rimas, Viscidi, Raphael P., Kakela, Justin, DuChateau, Brian
• Format: Journal Article
• Language: English
• Published: Oxford UK Munksgaard International Publishers 01.11.2005; Blackwell
• Subjects: Adult; Aged; Antibodies, Viral - blood; Biological and medical sciences; BK virus; BK Virus - genetics; BK Virus - immunology; BK Virus - isolation & purification; BK virus nephritis; BKV DNA; BKV‐specific antibody; Creatinine - blood; Cross-Sectional Studies; DNA, Viral - blood; DNA, Viral - isolation & purification; Female; Humans; Immunoglobulin G - blood; Immunoglobulin M - blood; kidney transplantation; Kidney Transplantation - adverse effects; Male; Medical sciences; Middle Aged; Nephritis - virology; Pancreas Transplantation - adverse effects; Polyomavirus Infections - immunology; Polyomavirus Infections - transmission; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Tumor Virus Infections - immunology; Tumor Virus Infections - transmission; Viremia - blood; Viremia - drug therapy; Kidney disease; Opportunistic infection; Urinary system disease; Antibody; BKV DNA; Polyomavirus; BK virus; Papovaviridae; Homotransplantation; BK virus nephritis; BKV-specific antibody; Infection; Virus; Nephropathy; Treatment; Urinary system; Surgery; DNA; Viral disease; Graft; DNA virus; Kidney transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2005.01080.x

We evaluated twenty renal transplant subjects at various stages of BKV nephritis (BKVN) for BKV‐specific IgG and IgM antibodies using ELISA technique and BKV‐DNA using PCR. They were divided as early onset (n = 7), stabilizing (n = 3), resolved (n = 8) and late onset (n = 2) BKVN. BKV‐specific antibodies and BKV‐DNA were simultaneously determined. The mean BKV‐specific IgG level in early onset and stabilizing BKVN were 64 and 39 EIA units, and were significantly lower than 138 EIA units seen in resolved BKVN, P = 0.007, P = 0.008. The mean BKV‐specific IgM levels in stabilizing BKVN was higher than resolved BKVN (130 vs 51 EIA units), P = 0.006. Mean plasma BKV loads for each group were 955 925, 5642 and 42 copies/mL of plasma, respectively. Prospective study in six BKVN cases revealed mean IgG, IgM levels and BKV‐DNA at the time of diagnosis of BKVN as 39, 110 EIA units and 586 758 copies/mL of plasma, respectively. After a mean period of 5.2 months, IgG level increased to 120 EIA units (p = 0.0058) and had no detectable viral copies in circulation. Recovery from BKVN and elimination of BKV is associated with the development of BKV‐specific IgG antibodies and this provides insight into the role of humoral immunity to BKV in the pathogenesis of BKVN.