J Korean Med Sci.  2008 Oct;23(5):814-818. 10.3346/jkms.2008.23.5.814.

Quantitation of BK Virus DNA for Diagnosis of BK Virus-Associated Nephropathy in Renal Transplant Recipients

• Sung H
• Choi BH
• Pyo YJ
• Kim MN
• Han DJ

• KMID: 1783066
• DOI: http://doi.org/10.3346/jkms.2008.23.5.814

Abstract

Quantitative measurement of BK virus DNA (Q-BKDNA) has been used for the early diagnosis and monitoring of BK virus-associated nephropathy (BKVAN). This study was designed to determine the BKDNA cutoff for the diagnosis of BKVAN. Between June 2005 and February 2007, 64 renal transplant recipients taken renal biopsies due to renal impairment submitted plasma and urine for Q-BKDNA. Eight BKVAN patients (12.5%) had median viral loads of 6.0 log(10) copies/mL in plasma and 7.3 log(10) copies/mL in urine. Among 56 non-BKVAN patients, 45 were negative for Q-BKDNA; 4 were positive in plasma with a median viral load of 4.8 log(10) copies/ mL, and 10 were positive in urine with a median viral load of 4.8 log(10) copies/mL. Receiver operating characteristic curve analysis showed that a cutoff of 4.5 log(10) copies/mL in plasma and a cutoff of 5.9 log(10) copies/mL in urine had a sensitivity of 100% and a specificity of 96.4%, respectively. A combined cutoffs of 4 log(10) copies/ mL in plasma and 6 log(10) copies/mL in urine had better performance with a sensitivity of 100% and a specificity of 98.2% than each cutoff of urine or plasma. QBKDNA with the combined cutoffs could reliably diagnose BKVAN in renal transplant recipients.

Keyword

BK Virus; Nephropathy; Quantitative; Polymerase Chain Reaction; Cutoff

MeSH Terms

Adolescent
Adult
BK Virus/*genetics
Biopsy
Calibration
DNA, Viral/*genetics
Female
Humans
Kidney Diseases/*virology
Kidney Transplantation/*methods
Male
Middle Aged
Polymerase Chain Reaction
Polyomavirus Infections/diagnosis
Treatment Outcome

Figure

• 

  Fig. 1 Distribution of BK virus DNA loads in BK virus-associated nephropathy (BKVAN) and non-BKVAN patients. Data are expressed as log10 viral copies/mL. Dashed lines indicate the suggested viral load cutoffs for diagnosis of BKVAN.

• 

  Fig. 2 Receiver operating characteristics curve for diagnosis of BKVAN and (A) plasma BKV DNA levels, and (B) urine BKV DNA levels, respectively. A cutoff of 4.5 log10 copies/mL in plasma and a cutoff of 5.9 log10 copies/mL in urine showed the best performance, respectively.

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