High Incidence of Malignancy in Polyomavirus-Associated Nephropathy in Renal Transplant Recipients

Polyomavirus Infections JC Virus Kidney Transplantation Medical Records 3. Good health Tumor Virus Infections 03 medical and health sciences 0302 clinical medicine BK Virus Neoplasms Prevalence Animals Humans Kidney Diseases Retrospective Studies
DOI: 10.1016/j.transproceed.2010.02.068 Publication Date: 2010-04-28T13:03:01Z
ABSTRACT
Human polyomaviruses (PV), including JC and BK virus, have been reported to cause polyomavirus-associated nephropathy (PVAN), in renal transplant patients. PV infection has been demonstrated to be associated with malignancies in animals; however, the association between malignancy and viral infections in humans is not clear. We retrospectively reviewed our 864 (M:F=502:362) kidney transplant patients over the past 25 years. We identified PVAN in 6 patients (0.69%), including BK nephropathy (n=5) and JC nephropathy (n=1). Three patients (50%) improved after reducing the immunosuppression, but 3 (50%) progressed to graft loss despite this reduction. Malignancy occurred in 5 out of the 6 patients (83%; P<.0001 compared with patients without PVAN), including transitional cell carcinoma (n=2), renal cell carcinoma (n=1), squamous cell carcinoma of skin (n=1) and Kaposi sarcoma (n=1). We concluded that kidney transplant patients with PVAN are at a significantly greater risk to develop malignancy. Whether this is due to a direct effect of PV infection or the result of overimmunosuppression remains to be determined in a future study.
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