Neutralization Serotyping of BK Polyomavirus Infection in Kidney Transplant Recipients.
Pastrana DV, Brennan DC, et al.PLoS Pathogens 2012; 8(4): e1002650.
Aims
1) To investigate whether BK polyomavirus (BKV) genotypes can be divided into distinct neutralization serotypes by developing high-throughput serological assays to monitor antibody mediated neutralization of the infectivity of BKV-I and BKV-IV reporter vectors. 2) To monitor the development of BKV-I and BKV-IV seroresponsiveness in kidney transplant recipients using neutralization assay methodology.
Interventions
Cyclosporine versus tacrolimus.
Participants
108 adult renal transplant recipients.
Outcomes
BKV type–specific neutralizing antibody response in VLPs vaccinated mice and healthy human sera; sequence analysis used to map BKV-I and BKV-IV subtypes; BKV-type-specific seroconversion analysis in renal transplant recipients.
Follow-up
52 weeks
CET Conclusions
This is an important study showing that there are at least two BKV genotypes which are distinct serotypes, namely BKV-I and BKV-IV. Thus this provides an explanation for BKV nephropathy that occurs in kidney transplant recipients with high levels of anti BKV antibodies in that there still may be an infection with BKV-IV. They also present a case for vaccination with a multivalent VLP-based vaccine against all BKV serotypes in potential kidney transplant recipients.
Data analysis
Strict intention-to-treat analysis
Quality notes
The quality assessment is based on a previous report of the same trial: “Brennan DC, Agha I, et al. Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction. American Journal of Transplantation, 5(3): 582-94, 2005â€.
Trial registration
Not reported