Polyomavirus BK replication in de novo kidney transplant patients receiving tacrolimus or cyclosporine: A prospective, randomized, multicenter study

Simple item page
dc.contributor.authorHirsch, H.
dc.contributor.authorVincenti, F.
dc.contributor.authorFriman, S.
dc.contributor.authorTuncer, M.
dc.contributor.authorCitterio, F.
dc.contributor.authorWiecek, A.
dc.contributor.authorScheuermann, E.
dc.contributor.authorKlinger, M.
dc.contributor.authorRuss, G.
dc.contributor.authorPescovitz, M.
dc.contributor.authorPrestele, H.
dc.date.issued2013
dc.description.abstractPolyomavirus BK (BKV)-associated nephropathy causes premature kidney transplant (KT) failure. BKV viruria and viremia are biomarkers of disease progression, but associated risk factors are controversial. A total of 682 KT patients receiving basiliximab, mycophenolic acid (MPA), corticosteroids were randomized 1:1 to cyclosporine (CsA) or tacrolimus (Tac). Risk factors were analyzed in 629 (92.2%) patients having at least 2 BKV measurements until month 12 posttransplant. Univariate analysis associated CsA-MPA with lower rates of viremia than Tac-MPA at month 6 (10.6% vs. 16.3%, p = 0.048) and 12 (4.8% vs. 12.1%, p = 0.004) and lower plasma BKV loads at month 12 (3.9 vs. 5.1 log10 copies/mL; p = 0.028). In multivariate models, CsA-MPA remained associated with less viremia than Tac-MPA at month 6 (OR 0.60; 95% CI 0.36–0.99) and month 12 (OR 0.33; 95% CI 0.16–0.68). Viremia at month 6 was also independently associated with higher steroid exposure until month 3 (OR 1.19 per 1 g), and with male gender (OR 2.49) and recipient age (OR 1.14 per 10 years) at month 12. The data suggest a dynamic risk factor evolution of BKV viremia consisting of higher corticosteroids until month 3, Tac-MPA compared to CsA-MPA at month 6 and Tac-MPA, older age, male gender at month 12 posttransplant.
dc.description.statementofresponsibilityH. H. Hirsch, F. Vincenti, S. Friman, M. Tuncer, F. Citterio, A. Wiecek, E. H. Scheuermann, M. Klinger, G. Russ, M. D. Pescovitz and H. Prestele
dc.identifier.citationAmerican Journal of Transplantation, 2013; 13(1):136-145
dc.identifier.doi10.1111/j.1600-6143.2012.04320.x
dc.identifier.issn1600-6135
dc.identifier.issn1600-6143
dc.identifier.urihttp://hdl.handle.net/2440/83048
dc.language.isoen
dc.publisherBlackwell Munksgaard
dc.rights© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons
dc.source.urihttps://doi.org/10.1111/j.1600-6143.2012.04320.x
dc.subjectBK virus
dc.subjectcyclosporine
dc.subjectimmunosuppression
dc.subjectpolyomavirus
dc.subjectrisk factor
dc.subjectsteroids
dc.subjecttacrolimus
dc.subjecttransplantation
dc.titlePolyomavirus BK replication in de novo kidney transplant patients receiving tacrolimus or cyclosporine: A prospective, randomized, multicenter study
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Medicine publications