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Post-Transplant Events

High frequency of polyoma BK virus shedding in the gastrointestinal tract after hematopoietic stem cell transplantation: a prospective and quantitative analysis

Bone Marrow Transplantation volume 43, pages 43–47 (2009)Cite this article

Abstract

The polyoma BK virus (BKV) remains latent after primary infection and may reactivate during immunosuppression. The uroepithelium is the main latency site defined. This study addressed whether the gastrointestinal tract might be another latency site. To test this hypothesis, we prospectively quantified fecal BKV by quantitative PCR reaction in 40 patients undergoing hematopoietic SCT (HSCT). Urinary BKV was similarly quantified. Fecal BKV excretion was positive in 16/40 patients, of whom 10 were transient (<3 consecutively positive samples), six were persistent (⩾3 consecutively positive samples) and three were persistent with peaking (⩾103-fold increase in viral load over baseline, reaching 5.11 × 106, 4.68 × 107 and 2.75 × 108 copies/sample at 14, 14 and 21 days post-HSCT, respectively). Urinary BKV excretion was positive in 25/40 patients. Fecal BKV excretion was significantly correlated with that of the urine (P=0.036) and was significantly associated with allogeneic HSCT (P=0.037) and persistent and peaking of urinary BKV excretion (P<0.001). Binary logistic regression showed that BKV viruria was the only significant risk factor for fecal BKV excretion (P=0.021). Fecal BKV excretion occurred in 40% patients undergoing HSCT, implicating the gastrointestinal tract as a BKV latency site.

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Acknowledgements

We thank Dr Albert KW Lie, Professor Raymond Liang and the nursing staff of the Bone Marrow Transplantation in Queen Mary Hospital, Hong Kong, for their expert management of patients recruited in this study. We are also grateful to Dr Daniel YT Fong, assistant professor, Department of Nursing Studies, University of Hong Kong, for his expert advice in statistical analysis.

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Authors and Affiliations

  1. Department of Medicine, University of Hong Kong, Hongkong

    A S Y Wong, Y-L Kwong & A Y H Leung

  2. Department of Microbiology, University of Hong Kong, Hongkong

    V C C Cheng & K-Y Yuen

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  1. A S Y Wong
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  2. V C C Cheng
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  3. K-Y Yuen
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  4. Y-L Kwong
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  5. A Y H Leung
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Correspondence to Y-L Kwong or A Y H Leung.

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Wong, A., Cheng, V., Yuen, KY. et al. High frequency of polyoma BK virus shedding in the gastrointestinal tract after hematopoietic stem cell transplantation: a prospective and quantitative analysis. Bone Marrow Transplant 43, 43–47 (2009). https://doi.org/10.1038/bmt.2008.266

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