Humans ; Polyomavirus ; classification ; Polyomavirus Infections ; virology

PURPOSE: To find the incidence and risk factors for polyomavirus (PV) infection, we monitored urine decoy cell (UDC) after renal transplantation. METHODS: From March 2003 to September 2004, 142 de novo renal recipients were prospectively monitored for UDC at post-transplant 1, 3, 6, 9, 12 months. According to the number of UDC in Cytospin, patients were divided into 3 groups: A (0), B (1~9) and C (> or =10). We decreased immunosuppression (IS) when group C status persisted for more than 1 month or more than 4 UDC was continuously detected for more than 3 months. Differences in demographics and clinical characteristics among the groups were compared. RESULTS: Forty four (31%) patients were found to have positive UDC at least at one examination (30 in group B and 14 in C). The number of patients with positive UDC at postoperative 1, 3, 6, 9, 12 months were 10 (22.7%), 14 (31.8%), 17 (38.6%), 27 (61.3%), 20 (45.4%) respectively with a highest at 9 months. One PV nephropathy was documented by renal biopsy. During the period from January 2001 to December 2002 when we did not prospectively monitor UDC, 7 PV nephropathy cases were documented among 116 recipients. Tacrolimus (Tac) and episode of acute rejection (AR) were significant risk factor for positive UDC (P=0.036, 0.010, respectively). Cumulative incidence of PV infection was significantly different by the use of Tac and episode of AR (P=0.03, 0.013, respectively). CONCLUSION: Use of Tac and episode of AR were risk factor for positive UDC and PV infection. Modulation of IS by the result of UDC monitoring could decrease the development of PV nephropathy after renal transplantation.
Biopsy ; Demography ; Humans ; Immunosuppression ; Incidence ; Kidney Transplantation* ; Kidney* ; Polyomavirus ; Polyomavirus Infections ; Prospective Studies* ; Risk Factors ; Tacrolimus

OBJECTIVETo investigate the relationship of KI polyomavirus (KIPyV) and WU polyomavirus (WUPyV) with acute respiratory infection in children in Tianjin, China.

METHODSA total of 3 730 nasopharyngeal secretions were collected from hospitalized children with acute respiratory infection in Tianjin Children's Hospital from January 2011 to December 2013. Viral nucleic acid was extracted, and virus infection (KIPyV and WUPyV) was determined by PCR. Some KIPyV-positive and WUPyV-positive PCR products were subjected to sequencing. Sequencing results were aligned with the known gene sequences of KIPyV and WUPyV to construct a phylogenetic tree. Amplified VP1 fragments of KIPyV were inserted into the cloning vector (PUCm-T) transformed into E. coli competent cells. Positive clones were identified by PCR and sequencing. The nucleotide sequences were submitted to GenBank. In addition, another seven common respiratory viruses in all samples were detected by direct immunofluorescence assay.

RESULTSIn the 3 730 specimens, the KIPyV-positive rate was 12.14% (453/3 730) and the WUPyV-positive rate was 1.69% (63/3 730). The mean infection rate of KIPyV was significantly higher in June and July, while the mean infection rate of WUPyV peaked in February and March. Most of the KIPyV-positive or WUPyV-positive children were <3 years. The co-infections with KIPyV, WUPyV, and other respiratory viruses were observed in the children. The co-infection rate was 2.31% (86/3 730) and there were nine cases of co-infections with WUPyV and KIPyV. Thirty-five KIPyV-positive and twelve WUPyV-positive PCR products were sequenced and the alignment analysis showed that they had high homology with the known sequences (94%-100% vs 95%-100%). The VP1 gene sequences obtained from two KIPyV strains in this study were recorded in GenBank with the accession numbers of KY465925 and KY465926.

CONCLUSIONSFor some children with acute respiratory infection in Tianjin, China, the acute respiratory infection may be associated with KIPyV and WUPyV infections. KIPyV infection is common in summer, and WUPyV infection in spring. The epidemic strains in Tianjin have a high homology with those in other regions.

Acute Disease ; Adolescent ; Child ; Female ; Humans ; Male ; Molecular Epidemiology ; Polyomavirus ; genetics ; isolation & purification ; Polyomavirus Infections ; epidemiology ; Respiratory Tract Infections ; virology

BK virus infection is one of the common complications after hematopoietic stem cell transplantation(HSCT), which is also one of the reasons of the hemorrhagic cystitis．In recent years, although there are more studies of the risk factors related with human BK virus infection after hematopoietic stem cell transplantation, the risk factors related with BKV-associated hemorrhagio cystitis(BKV-HC) remain to be elucidated. Diagnosis of BK virus infection is mainly based on quantitative PCR of blood or urine. An effective strategy for treatment of these patients is the adoptive transfer of T lymphocytes specific to virus-associated antigens. In this review, the progressis of diagnosis and treatment of BK virus infection after hematopoietic stem cell transplantation are briefly summarized.
BK Virus ; Cystitis ; Hematopoietic Stem Cell Transplantation ; Humans ; Polyomavirus Infections ; Tumor Virus Infections

OBJECTIVEWU polyomavirus (WUPyV), a new member of the genus Polyomavirus in the family Polyomaviridae, has been found to be associated with respiratory tract infections recently. But the role of the WUPyV as agents of human disease remains uncertain. We sought to describe the detection and clinical characterization of WUPyV in acute respiratory tract infection in children.

METHODFrom July 2008 through June 2009, nasopharyngeal aspirates were collected from 771 children who were hospitalized with acute respiratory tract infection in Second Affiliated Hospital of Shantou University Medical College, and from 82 asymptomatic children who visited the health checkup clinic. WUPyV was detected by using PCR technology and was identified by using DNA sequencing. All WUPyV-positive specimens were screened for 9 common viruses [influenza A and B, respiratory syncytial virus (RSV), parainfluenza virus (PIV) 1 and 3, human metapneumovirus, human bocavirus, adenovirus and rhinovirus] by using PCR or RT-PCR. The clinical data of WUPyV infection were collected and analyzed.

RESULTIn this study, fifteen of the 771 tested specimens with acute respiratory tract infection were positive for WUPyV, the positive rate was 1.95% and all of the asymptomatic children who visited the health checkup clinic were negative. Of the 15 cases who were positive for the virus, the age range was 2 to 48 (mean 18.8) months, 9 (60%) were male and 6 (40%) were female. WUPyV was the sole virus detected in 9 specimens (60%) from patients with acute respiratory tract infection. WUPyV was associated with the co-infection with another respiratory virus in 6 of 15 (40%) cases, most frequently with RSV (n = 4), followed by adenovirus (n = 1) and rhinovirus (n = 1). The most common clinical findings in the patients with WUPyV were cough, fever and wheezing. The most frequent diagnoses were pneumonia (n = 8), bronchiolitis (n = 4), upper respiratory tract infections (n = 2) and bronchitis (n = 1). A severe case was complicated with viral encephalitis.

CONCLUSIONWUPyV may be a respiratory pathogen because it was the sole virus detected in 9 specimens from patients with respiratory illness and all of the asymptomatic controls were negative. The most common clinical findings are cough and wheezing. Young children may be susceptible to infection with this virus and occasionally the infection with this virus may cause severe disease. More comprehensive and in-depth studies are required to prove the pathogenicity of these viruses.

Child ; Child, Preschool ; Female ; Genes, Viral ; Humans ; Infant ; Infant, Newborn ; Male ; Polymerase Chain Reaction ; Polyomavirus ; genetics ; isolation & purification ; Polyomavirus Infections ; physiopathology ; virology ; Respiratory Tract Infections ; virology

KI polyomavirus, which was firstly discovered in 2007, is a new human polyomavirus belonging to Polyomaviridae and containing circular double-strand genomic DNA. This study was based on identification assay of KI polyomavirus reported. Total 2293 clinical sputum specimens from children under 3-years-old were collected and screened from Wenzhou Medical College affiliated Wenling Hospital, Zhejiang Province. A KI polyomavirus was detected and identified, the positive rate was 0.04%. The sequences of PCR products was identical to that of the viral capsid protein (VP1) gene derived from KI polyomavirus. The results strongly suggested that the KI polyomavirus was found firstly in Chinese children with acute lower respiratory tract infections from Zhejiang region. This study provided new information for further investigation of etiopathogenisis and diagnosis in children with lower respiratory tract infections.
Child, Preschool ; China ; Humans ; Infant ; Polymerase Chain Reaction ; Polyomavirus ; isolation & purification ; Respiratory Tract Infections ; virology

Purpose: The purposes of this study were to compare the relative efficacy of urine decoy cell (UDC) and polymerase chain reaction (PCR) for the polyomavirus infection (PVI), and to search the efficacy of preemptive immunologic control for PVI in earlier stage before irreversible graft injury. Methods: Between Mar. 2003 to Sep. 2005, 265 patients were monitored for the PVI after kidney transplantation. Of the 265 patients, the results of preemptive immunologic modifications were searched among 222 recipients who had the complete data. Results: Of the total 222 patients, 75 patients (33.8%) were positive for UDCs in at least one examination. Overall cumulative incidence of PVI was 32.9%. According to the episode of acute rejection, the one year incidences of PVI were 51.4% and 29.5% in recipients with and without the episode of acute rejection, respectively (P=0.0047). Using decoy cells as a marker of PV viruria, cytology has a sensitivity of 57.1% and negative predictive value of 74.1%. The specificity and positive predictive value for viruria (not viral nephropathy) are 67.2% and 48.8%. False-negative results occurred in samples with suboptimal cellularity, and a low viral load. Three cases of PV nephropathy (PVN) were documented. From January 2001 to December 2002, when we did not prospectively monitor UDCs, 7 cases of PVN were documented among the 116 recipients. Conclusion: The combination test of UDC and PV PCR should be considered as screening test for PVI due to low positive predictive value of UDC. The modulation of net immunosuppression based on UDC values and PV viral loads may reduce the development of PVN.
Humans ; Immunosuppression ; Incidence ; Kidney Transplantation* ; Kidney* ; Mass Screening ; Polymerase Chain Reaction ; Polyomavirus Infections* ; Polyomavirus* ; Prospective Studies ; Sensitivity and Specificity ; Transplants ; Viral Load

Polyomavirus disease is a re-emerging infectious complication in renal transplantation. It manifests as symptomless renal dysfunction and progresses to graft loss unless the prompt diagnosis and intervention are initiated. A gold standard for diagnosis is the renal biopsy. Recently, the molecular diagnosis can be made using plasma PCR technique before histologic confirmation. Reduction of immunosuppression is a mainstay of treatment. Leflunomide and other antiviral agents could be used successfully in selected cases. The screening using urine decoy cell and subsequent plasma PCR may detect the BK viral replication, and preemptive intervention will prevent development of overt nephropathy without risk of rejection. This review will cover the recent advances and clinical issues in diagnosis and management of polyomavirus disease, mainly BK virus associated nephropathy.
Antiviral Agents ; Biopsy ; BK Virus ; Immunosuppression ; Isoxazoles ; Kidney ; Kidney Transplantation ; Mass Screening ; Plasma ; Polymerase Chain Reaction ; Polyomavirus ; Polyomavirus Infections ; Rejection (Psychology) ; Transplants

PURPOSE: This study was conducted to identify risk factors for new onset diabetes after transplantation (NODAT) among renal transplant recipients treated with tacrolimus-based immunosuppressant. METHODS: We selected renal transplant recipients who underwent surgery at Samsung Seoul Hospital between May 2001 and July 2009. Exclusion criteria were as follows: recipients <18 years old, history of diabetes mellitus (DM) or impaired glucose tolerance. Analysis of possible risk factors for NODAT included age, gender, body mass index, co-morbid diseases, family history of DM, infection of hepatitis B or polyomavirus, type of donors (cadaver or living) and acute rejection. Overall incidence and median value of NODAT onset day were analyzed with Kaplan-Meier curve. We calculated crude incidence rate and relative risk (RR) and 95% confidence interval (CI) for independent risk factors of NODAT using Cox proportional hazard analysis. RESULTS: A total of 278 patients were included and the incidence of NODAT was 13.3% (5.6/100 person-year) and the median duration of NODAT onset was 28 days. In Cox analysis, risk factors for NODAT were age (45-59 years: RR=1.41, 95% CI 1.09-1.83, 60> years: RR=4.36, 95% CI 2.00-9.49), family history of DM (RR=1.62, 95% CI 1.12-2.34) and polyomavirus infection (RR=1.40, 95% CI 1.08-1.81). CONCLUSION: The risk factors for NODAT among renal transplant recipients treated with tacrolimus-based regimen were age (>45 years old), family history of DM and polyomavirus infection.
Body Mass Index ; Diabetes Mellitus ; Glucose ; Hepatitis B ; Humans ; Incidence ; Kidney Transplantation ; Polyomavirus ; Polyomavirus Infections ; Rejection (Psychology) ; Risk Factors ; Tacrolimus ; Tissue Donors ; Transplants

The principal significance of the urothelial changes caused by polyomavirus activation is in an erroneous diagnosis of urothelial cancer; however, the clue to their benign nature is the smooth structureless nuclear configuration and the relative paucity of affected cells. Though virologic studies and electron microscopy are usually needed to firmly establish the diagnosis, cytology is the most readily available and rapid means of establishing a presumptive diagnosis of human polyomavirus infection. A urine specimen of a 24-year-old man with hemorrhagic cystitis beginning two months after bone marrow transplantation for acute myeloblastic leukemia(M2) was submitted for cytologic evaluation. Cytologic findings revealed a few inclusion-bearing epithelial cells intermingled with erythrocytes, neutrophils, lymphocytes, and macrophages. Most of the inclusion-bearing -cells had large, round to ovoid nuclei almost completely filed with homogeneous dark, basophilic inclusion. The chromatin was clumped along the periphery and the cytoplasm was mostly degenerated. The other cells exhibited irregular inclusions attached to the nuclear membrane surrounded by an indistinct halo. These findings were consistent with polyomavirus infection.
Basophils ; Bone Marrow Transplantation ; Chromatin ; Cystitis ; Cytoplasm ; Diagnosis ; Epithelial Cells ; Erythrocytes ; Granulocyte Precursor Cells ; Humans ; Lymphocytes ; Macrophages ; Microscopy, Electron ; Neutrophils ; Nuclear Envelope ; Polyomavirus Infections* ; Polyomavirus* ; Young Adult