Incidence, risk factors and the effect of polyomavirus infection in hematopoietic stem cell transplant recipients

J Int Med Res. 2017 Apr;45(2):762-770. doi: 10.1177/0300060517691795. Epub 2017 Mar 7.

Abstract

Objective The effect of polyomavirus infection in HSCT recipients is poorly understood. Methods We evaluated 38 HSCT recipients. Polyomavirus was detected by nested qualitative polymerase chain reaction (PCR) assays of urine. The risk factors for BK virus and JC virus were analysed. The kidney and liver functions of infected and uninfected patients were compared. Results BK virus, JC virus, and simian virus 40 were detected in 21%, 42%, and 0% of HSCT recipients respectively. HCMV infection was found to be an independent risk factor for JC virus infection (odds ratio (OR): 8.528), while transplants with mismatched HLA are more susceptible to BK virus infection (OR: 12.000). Liver function of JC virus-infected subjects was worse than that of uninfected subjects. Conclusion We must be vigilant for opportunistic polyomavirus infections in HSCT recipients, especially those with HCMV co-infection or a mismatched HLA transplant. When unexplained liver function deterioration is observed, JC virus infection should be considered.

Keywords: BK virus; Haematopoietic stem cell transplantation; JC virus; haemorrhagic cystitis; polyomavirus; risk factors.

MeSH terms

  • Adolescent
  • Adult
  • BK Virus / genetics
  • BK Virus / isolation & purification*
  • Child
  • DNA, Viral / genetics
  • Female
  • Hematologic Neoplasms / immunology
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation*
  • Histocompatibility Testing
  • Humans
  • JC Virus / genetics
  • JC Virus / isolation & purification*
  • Kidney / immunology
  • Kidney / physiopathology
  • Kidney / virology
  • Kidney Function Tests
  • Liver / immunology
  • Liver / physiopathology
  • Liver / virology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Polyomavirus Infections / diagnosis*
  • Polyomavirus Infections / immunology
  • Polyomavirus Infections / physiopathology
  • Polyomavirus Infections / virology
  • Prospective Studies
  • Risk Factors
  • Siblings
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Tumor Virus Infections / diagnosis*
  • Tumor Virus Infections / immunology
  • Tumor Virus Infections / physiopathology
  • Tumor Virus Infections / virology
  • Unrelated Donors

Substances

  • DNA, Viral