Successful Treatment of BK Viremia Using Reduction in Immunosuppression Without Antiviral Therapy

• DOI: 10.1097/tp.0b013e318166cba8
• Publication Date: 2009-03-04T00:36:47Z
• Authors: Ehab R. Saad; Barbara A. Bresnahan; Eric P. Cohen; Na Lu; Rimas J. Orentas; Brahm Vasudev; Sundaram Hariharan
• Keywords: Viremia; Immunosuppression; Antiviral Therapy

Treatment of BK virus (BKV) infection in renal transplant recipients remains controversial. This retrospective analysis evaluated efficacy and safety reducing immunosuppression without antiviral therapy.This single center included 24 patients diagnosed with viremia between September 2001 December 2003. Sixteen (66%) presented BKV nephritis eight (34%) evidence on biopsy.At time diagnosis, mean plasma DNA (copies/mL) was 460,409 (range 10,205-1,920,691). Mean doses reduction mycophenolate mofetil tacrolimus were 44% 41%, respectively, from diagnosis to complete resolution viremia. A decline viral load noticed within 15 30 days, successful elimination over a period 5.8 months (range, 1-9.5). serum creatinine at 1.8 mg/dL 1.2-2.8). follow-up is 30.9 postdiagnosis. At the most recent visit, 2.0 1.0-3.6) (P=0.14). With immunosuppressive therapy, three (13%) developed acute cellular rejection treated successfully intravenous bolus steroids. During follow-up, one patient had relapse during pregnancy lost her graft. After 43.5 posttransplantation, all are alive 23 have functioning Seventeen (71%) stable or improved graft function.Our shows that therapy alone results clearance good long-term outcome.