Prevalence of cytomegalovirus and BK polyoma virus infection in post-renal transplant patients in a tertiary care centre in South India

Abstract

Background: Viral infections are a significant cause of graft loss and dysfunction in kidney transplant recipients. Cytomegalovirus and BK polyomavirus have often been explained as the most common viral etiological agents. Objectives: The current study was undertaken to assess the prevalence of cytomegalovirus and BK polyomavirus infection in post-renal transplant individuals in a tertiary care centre in South India and also to study the histopathological changes of such infections in the kidney allograft biopsies. Patients and Methods: We conducted a retrospective investigation of 100 cases using archival renal biopsy specimens which were subjected to immunohistochemical stains to detect cytomegalovirus and BK polyoma virus. These findings were then correlated with the histopathological alterations detected in H&E sections. Results: We detected the prevalence of cytomegalovirus in 7% and BK polyoma virus in 3%. Cytomegalovirus was statistically associated with pre- and post-transplant infections along with diabetic status. We noted that, out of the seven patients who were immunohistochemically cytomegalovirus positive, only five had positive cytomegalovirus IgM status. With BK polyoma virus, we noted a statistical significance with pre- and posttransplant infections. However, we did not find evidence of cytomegalovirus and BK polyoma virus co-infection in any of the renal allograft biopsies. Conclusions: Routine immunohistochemical evaluation of cytomegalovirus and BK polyoma viral infections in kidney allograft recipients must be done, especially in those with preand post-transplant infections and diabetes.

Keywords

• bk polyomavirus
• cytomegalovirus
• immunohistochemistry
• renal transplantation