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Association of donor hepatitis C virus infection status and risk of BK polyomavirus viremia after kidney transplantation.

Miklos Z MolnarVishnu S PotluriDouglas E SchaubelMeghan E SiseBeatrice P ConcepcionRachael C ForbesEmily A BlumbergRoy D BloomDavid ShafferRaymond T ChungIan A StrohbehnNahel EliasAmbreen AzharMital ShahDeirdre L SawinskiLaura A BinariManish TalwarVasanthi BalaramanAnshul BhallaJames D EasonBehdad BesharatianJennifer Trofe-ClarkDavid S GoldbergPeter Philip Reese
Published in: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2021)
Kidney transplantation (KT) from deceased donors with hepatitis C virus (HCV) into HCV-negative recipients has become more common. However, the risk of complications such as BK polyomavirus (BKPyV) remains unknown. We assembled a retrospective cohort at four centers. We matched recipients of HCV-viremic kidneys to highly similar recipients of HCV-aviremic kidneys on established risk factors for BKPyV. To limit bias, matches were within the same center. The primary outcome was BKPyV viremia ≥1000 copies/ml or biopsy-proven BKPyV nephropathy; a secondary outcome was BKPyV viremia ≥10 000 copies/ml or nephropathy. Outcomes were analyzed using weighted and stratified Cox regression. The median days to peak BKPyV viremia level was 119 (IQR 87-182). HCV-viremic KT was not associated with increased risk of the primary BKPyV outcome (HR 1.26, p = .22), but was significantly associated with the secondary outcome of BKPyV ≥10 000 copies/ml (HR 1.69, p = .03). One-year eGFR was similar between the matched groups. Only one HCV-viremic kidney recipient had primary graft loss. In summary, HCV-viremic KT was not significantly associated with the primary outcome of BKPyV viremia, but the data suggested that donor HCV might elevate the risk of more severe BKPyV viremia ≥10 000 copies/ml. Nonetheless, one-year graft function for HCV-viremic recipients was reassuring.
Keyphrases
  • hepatitis c virus
  • kidney transplantation
  • human immunodeficiency virus
  • small cell lung cancer
  • magnetic resonance
  • magnetic resonance imaging
  • computed tomography
  • hepatitis c virus infection
  • insulin resistance