Journal of Transplantation

Clinical Study

BK Virus in Kidney Transplant Recipients: The Influence of Immunosuppression

Table 3

Clinical studies examining the relationship between BKV replication and drug exposure.


Study number	Number of participants	Study design	Immunosuppression exposure measures	Manifestation of BKV	Results	Reference

1	38 pancreas Tx recipients	Retrospective	Tac C₀ concentrations, MMF, and pred dose	4 with viruria	Tac C₀ higher in those with viruria at 1, 3 and 12 months post-tx (22 ± 3.1 versus 16 ± 0.9 ng/mL, ; 26 ± 4.8 versus 14 ± 1.0 ng/mL, ; 19 ± 0.6 versus 12 ± 0.7 ng/mL ); no influence of MMF or pred dose	[65]

2	33 KTxRs with BKVAN, 66 matched controls	Retrospective	Tac C₀ concentrations, MMF, and pred dose	33 with BKVAN	Higher Tac C₀ and prednisolone dose associated with increased risk of BKVAN (OR 1.3. 95% CI 1.02–1.7; ; and OR 1.22, 95% CI 1.04–1.4; , resp.); no influence of MMF dose	[66]

3	575 KTxRs	Retrospective	Tac C₀ concentrations	32 with BKVAN	Higher Tac C₀ associated with higher incidence of BKVAN (10.5% versus 2.5%, )	[64]

4	7 KTxRs with BKVAN, 42 matched controls^#	Retrospective	Tac C₀ concentrations, MMF, and pred dose	7 with BKVAN	No influence of Tac C₀, MMF, or pred dose on BKVAN	[20]

5	32 KTxRs	Prospective observational	CyA and Tac C₀ concentrations	20 with viruria*; 23 with viraemia	No influence of CyA or Tac C₀ on viruria, viraemia or BKVAN	[62]

6	120 KTxRs	Prospective observational	Tac C₀ concentrations, tac, and pred dose	37 with viruria	No influence of Tac C₀ or tac or pred dose on viruria	[67],

*Includes recipients in whom viruria and viraemia were simultaneously detected.
^#Matched for transplant date and baseline immunosuppression.
BKV: BK virus; BKVAN: BKV associated nephropathy; CI: confidence interval; CyA: cyclosporine; KTxRs: kidney transplant recipients; MMF: mycophenolate mofetil; OR: odds ratio; pred: prednisolone; Tac: tacrolimus.