Publication

BK Polyomavirus (BKPyV) Serotype-Specific Antibody Responses in Blood Donors and Kidney Transplant Recipients with and without new-onset BKPyV-DNAemia: A Swiss Transplant Cohort Study.

Journal Paper/Review - Nov 21, 2024

Units
PubMed
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Citation
Hillenbrand C, Bani D, Follonier O, Kaur A, Weissbach F, Wernli M, Wilhelm M, Leuzinger K, Binet F, Bochud P, Golshayan D, Hirzel C, Manuel O, Müller N, Schaub S, Schachtner T, Van Delden C, Hirsch H, Swiss Transplant Cohort Study. BK Polyomavirus (BKPyV) Serotype-Specific Antibody Responses in Blood Donors and Kidney Transplant Recipients with and without new-onset BKPyV-DNAemia: A Swiss Transplant Cohort Study. Am J Transplant 2024
Type
Journal Paper/Review (English)
Journal
Am J Transplant 2024
Publication Date
Nov 21, 2024
Issn Electronic
1600-6143
Brief description/objective

BK polyomavirus (BKPyV) causes premature renal failure in 10%-30% of kidney transplant recipients (KTRs). Current guidelines recommend screening for new-onset BKPyV-DNAemia/nephropathy and reducing immunosuppression to regain BKPyV-specific immune control. Since BKPyV encompasses 4 major genotype(gt)-encoded serotypes (st1,-2,-3,-4), st-specific antibodies may inform risk and course of BKPyV-DNAemia/nephropathy. Using BKPyV st-virus-like particle (VLP) ELISA, we analyzed plasma from 399 blood donors (BDs) and 428 KTRs (134 KTR-cases with BKPyV-DNAemia, 294 KTR-controls). BDs were anti-BKPyV-VLP IgG-seropositive in 85% compared to 93% of KTRs at T0 (p<0.001). Anti-st1 were predominant in both groups followed by anti-st4, anti-st2, and anti-st3. Antibody levels and quadruple sero-reactivity at T0 were higher in KTR-controls than in KTR-cases (p=0.026) or in BDs (p<0.001). In KTR-cases, anti-st increased post-transplant (p<0.0001) and independently of ongoing or cleared BKPyV-DNAemia. However, anti-st levels were significantly higher at T0 in KTR-cases able to clear at T6 or T12. In 34 KTR-cases with deep genome sequencing, BKPyV-gtI was predominant, and anti-st1 and st1-neutralizing antibodies were significantly lower at T0 than in KTR-controls. Thus, BKPyV st-specific antibody levels at transplantation might reflect gt/st-BKPyV-specific immunity clearing or preventing BKPyV-DNAemia in KTR-cases or KTR-controls, respectively. Accordingly, active or passive immunization may be most efficient pretransplant or early post-transplant.