ACTA MEDICA, Vol 65 No 4 (2022), 119–124
Current Status, Prevention and Treatment of BK Virus Nephropathy
Ester Kurašová, Jakub Štěpán, Karel Krejčí, František Mrázek, Pavel Sauer, Jana Janečková, Tomáš Tichý
zveřejněno: 16. 03. 2023
All renal transplant recipients should undergo a regular screening for BK viral (BKV) viremia. Gradual reduction of immunosuppression is recommended in patients with persistent plasma BKV viremia for 3 weeks after the first detection, reflecting the presence of probable or suspected BKV-associated nephropathy. Reduction of immunosuppression is also a primary intervention in biopsy proven nephropathy associated with BKV (BKVN). Thus, allograft biopsy is not required to treat patients with BKV viremia with stabilized graft function. There is a lack of proper randomised clinical trials recommending treatment in the form of switching from tacrolimus to cyclosporin-A, from mycophenolate to mTOR inhibitors or leflunomide, or the additive use of intravenous immunoglobulins, leflunomide or cidofovir. Fluoroquinolones are not recommended for prophylaxis or therapy. There are on-going studies to evaluate the possibility of using a multi-epitope anti-BKV vaccine, administration of BKV-specific T cell immunotherapy, BKV-specific human monoclonal antibody and RNA antisense oligonucleotides. Retransplantation after allograft loss due to BKVN can be successful if BKV viremia is definitively removed, regardless of allograft nephrectomy.
klíčová slova: BK virus nephropathy; BK virus-specific T-cell immunotherapy; monoclonal anti-BK virus antibodies; BK virus vaccine; immunosuppressive therapy; RNA antisense oligonucleotides; kidney transplantation
Current Status, Prevention and Treatment of BK Virus Nephropathy is licensed under a Creative Commons Attribution 4.0 International License.
210 x 297 mm
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cena tištěného čísla: 150 Kč