Is antibody-mediated rejection in kidney transplant recipients a risk factor for developing cytomegalovirus or BK virus infection? Results from a case-control study

Ibai Los-Arcos, Oscar Len, Manel Perello, Irina B. Torres, Gemma Codina, Juliana Esperalba, Joana Sellarés, Francesc Moreso, Daniel Seron, Joan Gavaldà

    Research output: Contribution to journalArticleResearch

    Abstract

    © 2018 Elsevier B.V. Background: Data are scarce on cytomegalovirus (CMV) and BK virus (BKV) infection after antibody-mediated rejection (ABMR). Objectives: We hypothesized that the immunological response in patients with ABMR or the immune modulation associated with its treatment could predispose to CMV and BKV infection. Our objective was to investigate this hypothesis. Study design: We conducted a single-center, matched case-control study (1:2 ratio) to analyze CMV and BKV replication during the first year after the ABMR diagnosis in kidney transplant recipients. Adult recipients with a histopathological diagnosis of ABMR between 2007–2015 were included as cases. Controls were kidney recipients who underwent transplantation immediately before and after the index case. Results: Fifty-eight patients diagnosed with ABMR (33 chronic active ABMR and 25 acute ABMR), with their matched controls (116) were included. Forty-four cases received treatment for ABMR, including plasmapheresis (41), immunoglobulins (40), and rituximab (31). Within 1 year after ABMR, cases showed CMV replication more often than controls (9/58, 15.5% vs 7/116, 6%, OR = 4.21, CI 1.10–16.16, p = 0.04). Over the study period, CMV PCR determinations were requested more frequently in cases than controls (46/58, 79.3% vs 63/116, 54.3%, OR = 4.58, CI 1.92–10.9, p = 0.001). On multivariate analysis adjusted for CMV PCR determinations, retransplantation, antithymocyte globulin treatment and methylprednisolone treatment for acute rejection, CMV replication remained more common in cases than in controls (OR = 2.41, CI 0.49–11.73, p = 0.28). There were no differences in BKV replication in either urine or blood. Conclusions: ABMR may be a risk factor for CMV but not for BKV replication in kidney transplant recipients.
    Original languageEnglish
    Pages (from-to)45-50
    JournalJournal of Clinical Virology
    Volume110
    DOIs
    Publication statusPublished - 1 Jan 2019

    Keywords

    • Acute rejection
    • BK virus
    • Cytomegalovirus
    • Kidney transplantation
    • Plasmapheresis
    • Rituximab

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    Los-Arcos, I., Len, O., Perello, M., Torres, I. B., Codina, G., Esperalba, J., Sellarés, J., Moreso, F., Seron, D., & Gavaldà, J. (2019). Is antibody-mediated rejection in kidney transplant recipients a risk factor for developing cytomegalovirus or BK virus infection? Results from a case-control study. Journal of Clinical Virology, 110, 45-50. https://doi.org/10.1016/j.jcv.2018.11.010