Investigators have identified independent risk factors for post-kidney transplant BK virus (BKV) infection, which is associated with worse patient and graft survival, a study found. These factors include male sex, increasing age, and use of maintenance steroids.

Omar Malik, MD, and colleagues at the University of Kentucky in Lexington retrospectively analyzed data from 649 recipients of kidney transplant at their institution. Of these, 122 (19%) had BKV infection and 527 did not. Male sex was associated with 1.8-fold increased odds of BKV infection compared with female sex, the investigators reported in Transplantation Proceedings. Each 10-year increment in age at the time of transplantation was associated with 1.2-fold increased odds of BKV infection. Maintenance steroid use was associated with nearly 2.9-fold increased odds compared with no steroid use. In addition, compared with thymoglobulin induction, alemtuzumab induction was associated with almost 2.3-fold increased odds. BKV infection developed after a median 115 days following kidney transplantation.

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The 1-, 5-, and 10-year patient survival rates were 98%, 84%, and 52%, respectively, in the BKV group compared with 98%, 92%, and 84%, respectively, in the BKV negative group, the investigators reported. The 1-, 5-, and 10-year graft survival rates were 97%, 75%, and 33% in the BKV group compared with 96%, 85%, and 71% in the BKV negative group.

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Malik O, Saleh S, Suleiman B, et al. Prevalence, risk factors, freatment, and overall impact of BK viremia on kidney transplantation. Transplant Proc. 2019;51:1801-1809. doi: 10.1016/j.transproceed.2019.03.035