Pre- and Post-Transplant Anti-BKV IgG Responses and HLA Associations in BK Virus Reactivation Among Renal Transplant Recipients
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Recruitment
2.2. Sample Collection and Storage
- Pre-transplant: Blood samples were obtained before transplantation to assess baseline anti-BKV IgG levels and HLA typing.
- During viremia onset: In patients who developed BK viremia, additional blood samples were collected at the time of confirmed viremia detection.
- Post-transplant: A third sample was obtained at least one year post-transplant to evaluate long-term changes in anti-BKV IgG levels.
2.3. Laboratory Procedures
Detection of BK Virus DNA in Blood
2.4. Enzyme-Linked Immunosorbent Assay (ELISA) for Anti-BKV IgG
2.5. HLA Typing
2.6. Statistical Analysis
2.7. Ethical Considerations
3. Results
3.1. Patient Demographics and Clinical Characteristics
3.2. Pre- and Post-Transplant Anti-BKV IgG Levels
3.3. Longitudinal Changes in Anti-BKV IgG Levels
3.4. Association Between HLA Alleles and BK Viremia
3.5. Multivariate Analysis of Risk Factors for BK Viremia
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | Recipients = 38 | Viremia = 18 | |||||
---|---|---|---|---|---|---|---|
Non-Viremia | Viremia | Low Viral Loads | p-Value | No BKVAN | BKVAN | p-Value (p < 0.05) | |
No. patients (%) | 15 (39.5) | 18 (47.4) | 5 (13) | 15 (83.3) | 3 (16.6) | ||
Patient’s sex (male) | 8 (53.3) | 12 (66.6) | 2 (40) | 0.2 | 10 (66.6) | 2 (66.6) | NS |
Age (mean ±/− SD) | 58.17 ± 14.7 | 56 ± 13.7 | 59.6 ± 12.6 | 0.8 | 57 ± 11 | 46.6 ± 5 | NS |
First → graft (%) | 11 (73.3) | 17 (100) | 4 (80) | NS | 15 (100) | 3 (100) | NS |
Underlying condition (%) | |||||||
Obstructive urology (%) | 3 (20) | 0 | 1 (20) | NS | NS | ||
Hypertension (%) | 2 (13) | 6 (35) | 2 (40) | NS | 6 (40) | 0 | NS |
Polycystic kidney (%) | 4 (26.6) | 1 (5.8) | 0 | NS | 1 (6.6) | 0 | NS |
Other (%) | 6 (40.0) | 11 (58.8) | 2 | NS | 8 (60) | 3 | NS |
Induction of Immune Suppression (%) | |||||||
Campath | 70.9 | 71.5 | 40 | NS | 12 (80) | 3 (100) | |
Simulect | 29.1 | 28.5 | 60 | NS | 3 (20) | 0 | |
Maintenance suppression (%) | |||||||
MMF + Advagraf | 4 (16) | 2 (28) | 1 (20) | NS | 1 (6.6) | 1 (30) | |
Azathioprine | 4 (16) | 4 (22) | 0 | NS | 3 (20) | 1 (30) | |
MMF + prograf | 3 (12.5) | 2 (11) | 1 (20) | NS | 2 (13) | 0 | |
Advagraf (%) | 2 (8.3) | 2 (28) | 1 (20) | NS | 5 (30) | 1 (30) | |
MMF | 6 (25) | 3 (42) | 2 (40) | NS | 3 (20) | 0 | |
MMF + TAC (%) | 5 (20) | 1 (5) | 0 | 1 (6.6) | 0 | ||
HLA mismatch mean ± SD | |||||||
A | 0.88 ± 0.58 | 0.88 ± 0.78 | 1 ± 0.7 | NS | 0.92 ± 0.37 | 1 | |
B | 0.77 ± 0.54 | 0.77 ± 0.83 | 0.4 ± 0.54 | NS | 0.84 ± 0.3 | 0.66 ± 0.033 | |
DR | 0.66 ± 0.68 | 0.44 ± 0.72 | 0.6 ± 0.54 | NS | 0.92 ± 0.57 | 0.66 ± 33 | 0.4 |
A + B + DR | 2.2 ± 1.4 | 2.1 ± 1.9 | 2.4 ± 1.5 | NS | 2.7 ± 1.9 | 2.3 ± 1.33 | |
Acute rejection episode (%) | 3 (12.5) | 3 (16.6) | 1 (33) | ||||
Post-operation period (months) | 3.5 | 10 |
BKV Status | Pre-Transplant Seroprevalence (%) | Pre- Transplant Ab Titre | Post Operation > 1 Year | p- Value |
---|---|---|---|---|
Never BKV | 66.6 | 7.704 ± 0.31 | 4.627 ± 2.9 | 0.7 |
BKV viremia | 94.4 | 6.87± 0.32 | 10.21 ± 0.5 | <0.05 |
BVPyAN | 100 | 7.5 ± 0.94 | 10.50 ± 0.23 | <0.04 |
p = 0.14 |
BKV Viremia N = 23 (%) | No Viremia N = 15 (%) | p Value (p < 0.05) | |
---|---|---|---|
HLA-A1 (%) | 6 (26) | 6 (40) | 0.7 |
A2 | 6 (26) | 5 (33) | 0.8 |
HLA-B8 | 2 (8.6) | 5 (33) | 0.2 |
B44 | 14 (60) | 3 (20) | 0.02 * |
B51 | 1 (4.3) | 1 (6.6) | 1 |
HLA-DR1 | 6 (26) | 2 (13) | 0.6 |
DR3 | 2 (8.6) | 2 (13) | 1 |
DR4 | 7 (30) | 2 (13) | 0.3 |
DR7 | 2 (8.6) | 4 (26) | 0.37 |
DR11 | 1 (4.3) | 2 (13) | 0.5 |
DR13 | 1 (4.3) | 4 (26) | 0.15 |
DR15 | 11 (47) | 1 (6.6) | 0.01 * |
HR | 95% CI | p-Value | |
---|---|---|---|
Age | 0.46 | 0.009–0.15 | 0.6 |
Gender | 0.42 | 0.63–1.12 | 0.08 |
HLA-B44 | 0.296 | 0.11–0.73 | 0.009 |
HLA-DR15 | 0.44 | 0.18–1.08 | 0.07 |
HLA-A2 | 0.51–3.20 | 0.59 | |
HLA-mismatch | 0.28 | ||
A | 2.9 | 0.6–13.7 | 0.177 |
B | 2.3 | 0.06–27 | 0.489 |
DR | 0.18 | 0.22–1.5 | 0.115 |
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Fallatah, D.I.; Christmas, S. Pre- and Post-Transplant Anti-BKV IgG Responses and HLA Associations in BK Virus Reactivation Among Renal Transplant Recipients. Immuno 2025, 5, 16. https://doi.org/10.3390/immuno5020016
Fallatah DI, Christmas S. Pre- and Post-Transplant Anti-BKV IgG Responses and HLA Associations in BK Virus Reactivation Among Renal Transplant Recipients. Immuno. 2025; 5(2):16. https://doi.org/10.3390/immuno5020016
Chicago/Turabian StyleFallatah, Deema Ibrahim, and Steve Christmas. 2025. "Pre- and Post-Transplant Anti-BKV IgG Responses and HLA Associations in BK Virus Reactivation Among Renal Transplant Recipients" Immuno 5, no. 2: 16. https://doi.org/10.3390/immuno5020016
APA StyleFallatah, D. I., & Christmas, S. (2025). Pre- and Post-Transplant Anti-BKV IgG Responses and HLA Associations in BK Virus Reactivation Among Renal Transplant Recipients. Immuno, 5(2), 16. https://doi.org/10.3390/immuno5020016