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- Title
JC polyomavirus replication and associated disease in pediatric renal transplantation: an international CERTAIN Registry study.
- Authors
Höcker, Britta; Tabatabai, Julia; Schneble, Lukas; Oh, Jun; Thiel, Florian; Pape, Lars; Rusai, Krisztina; Topaloglu, Rezan; Kranz, Birgitta; Klaus, Günter; Printza, Nikoleta; Yavascan, Onder; Fichtner, Alexander; Krupka, Kai; Bruckner, Thomas; Waldherr, Rüdiger; Pawlita, Michael; Schnitzler, Paul; Hirsch, Hans H.; Tönshoff, Burkhard
- Abstract
Background: JC polyomavirus (JCPyV)-associated nephropathy (JCPyVAN) is a severe, but rare complication in adult renal transplant (RTx) recipients. Related data in pediatric patients are scarce.Methods: Based on the CERTAIN Registry, we therefore performed a multi-center, retrospective study on the JCPyV antibody status, prevalence of JCPyV replication, and its associated disease in 139 pediatric RTx recipients (mean age, 8.5 ± 5.3 years). JCPyV DNA in plasma and/or urine was measured by quantitative PCR at a median time of 3.2 (IQR, 0.3-8.1) years post-transplant.Results: 53.2% of patients were JCPyV-seronegative prior to transplantation; younger age was associated with JCPyV seronegativity. 34/139 (24.5%) patients post-transplant showed active JCPyV replication in either urine (22.0%), plasma (13.4%), or both (7.6%). JCPyV viremia occurred significantly (p < 0.001) more often in patients with viruria (34.6%) than in those without (7.6%), but 7/118 (5.9%) had isolated viremia. High-level viruria (> 107 copies/mL) was found in 29.6% of viruric patients. A higher net state of immunosuppression constituted an independent risk factor for JCPyV replication both in urine and plasma (OR 1.2, p < 0.02). Male patients tended to have a higher risk of JCPyV viremia than females (OR 4.3, p = 0.057). There was one male patient (0.7%) with JCPyVAN 7 years post-transplant, which resolved after reduction of immunosuppressive therapy. No patient exhibited progressive multifocal leukoencephalopathy.Conclusions: This first multi-center study on JCPyV in pediatric renal transplant recipients shows that JCPyV replication is common (24.5%), with strong immunosuppression being a significant risk factor, but associated nephropathy is rare.
- Subjects
AGE distribution; REPORTING of diseases; IMMUNOSUPPRESSION; KIDNEY diseases; KIDNEY transplantation; MEDICAL cooperation; PEDIATRICS; RESEARCH; SEX distribution; POLYOMAVIRUS diseases; DISEASE prevalence; RETROSPECTIVE studies; VIREMIA; DESCRIPTIVE statistics; DISEASE complications
- Publication
Pediatric Nephrology, 2018, Vol 33, Issue 12, p2343
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-018-4029-9