Korean J Transplant.  2023 Nov;37(Suppl 1):S133. 10.4285/ATW2023.F-7160.

Pre- and posttransplant BK virus-specific ELISPOT assay for predicting the outcome of BK virus infection in kidney transplant recip

• Na D
• Bae H
• Lee H
• Ko EJ
• Yang CW
• Chung BH
• Oh EJ

• KMID: 2551753
• DOI: http://doi.org/10.4285/ATW2023.F-7160

Abstract

Background
It is needed to plan optimal therapeutic strategies for controlling BK viremia. Our previous study showed that BK virus (BKV)-specific T cell immunity measured by an interferon enzyme-linked immunospot (ELISPOT) are related to outcome of BKV infections. However, there was limitations about difference of time and viremia status.
Methods
We included 84 kidney transplant recipients (KTRs) who experienced at least one BK viremia at RQ-PCR of BKV-DNA. BKV-ELISPOT were measured in all included recipients at the time of pretransplant, 4 weeks posttransplant, 12 weeks posttransplant, and when viremia were detected. We divided into two groups, controller and noncontroller, according to sustained duration of BKV infection. We compared BKV-ELISPOT results at each time.
Results
We reduced or stop mycophenolic acid in 88.6% of BK viremia patients and used leflunomide for 48% patients (38.6% and 70% for each group). BKV-ELISPOT results were higher in controller groups at the time of pretransplant, 4 weeks posttransplant, 12 weeks posttransplant, first viremia detected. When first viremia detected, we analyzed BKV ELISPOT including five BKV peptide mixes. Controller group had higher LT, ST, VP1, VP2 ELISPOT results. Also, those who had no biopsy proven BKV-associated nephropathy (BKVAN) had higher LT, ST, VP1, VP3 ELOSPT results.
Conclusions
Pre- and post-BKV-ELISPOT assay may help to distinguish patients with well controlling BK viremia from those who have persisting BK Viremia who need more intensive therapy to prevent BKVAN.