The effects of valacyclovir on polyomavirus infection (BKV) in kidney transplant recipients

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Abstract

Polyomavirus-associated nephropathy (PVAN) is one of the most serious infectious complications in allograft recipients, with the BK virus (BKV) being the primary etiologic agent. This study was conducted to investigate the efficacy of valacyclovir on BK virus (BKV) infection and viremia control in infected patients in Iran. This quasi-experimental study involved 21 Iranian patients. All kidney transplant recipients with a confirmed diagnosis of BKV infection based on renal biopsy and PCR were administered standard therapy (reduced doses of immunosuppressive drugs) with or without valacyclovir at a one-gram dose twice daily for one month. After collecting the data, the data was analyzed using SPSS 23. The K-S test confirmed the normality of the quantitative data. Chi-square for trend, independent-t, and Fisher’s exact tests were used to examine group homogeneity in terms of socio-demographic characteristics. Before the intervention, a t-test was used to compare mean scores among the groups; and repeated measures independent sample test, pair sample test, chi square test and ANOVA. The significance level of p < 0.05 was considered for all tests. The mean creatinine level, mean GFR (Glomerular Filtration Rate) level, and median viral load in the serum were not significantly different between the two groups at the time of graft rejection diagnosis. One month after treatment, the serum viral load decreased in 90.9% of patients in the intervention group and 50% of patients in the control group, with the difference being statistically significant (p = 0.038). Also, in the two-month review, the results showed that the reduction of the virus serum load level was observed in 81.8% of patients in the intervention group and 40% of patients in the control group, and this difference was statistically significant (p = 0.049). Mean age, body mass index, and transplant duration were comparable between the two groups. Neither creatinine nor GFR levels differed significantly between the two groups after the intervention (p = 0.557 and p = 0.387). Valacyclovir can effectively reduce the serum viral load in BKV-infected kidney transplant recipients. This reduction, however, is not accompanied by an improvement in renal function or prevention of rejection.

About the authors

K. Samadi

Sabzevar University of Medical Sciences

Email: jalambadaniz@gmail.com

Assistant Professor of Nephrology, Department of Internal Medicine, Faculty of Medicine

Iran, Islamic Republic of, Sabzevar

M. Ghorbansabbagh

Mashhad University of Medical Sciences

Email: jalambadaniz@gmail.com

Associate Professor of Nephrology, Department of Internal Medicine, Faculty of Medicine

Iran, Islamic Republic of, Mashhad

V. Raesi

Birjand University of Medical Sciences

Email: jalambadaniz@gmail.com

Assistant Professor of Nephrology, Department of Internal Medicine, Faculty of Medicine

Iran, Islamic Republic of, Birjand

P. Marouzi

Mashhad University of Medical Sciences

Email: jalambadaniz@gmail.com

Assistant Professor of Biostatistics, Department of Health Information Technology and Medical Records, School of Paramedical Sciences

Iran, Islamic Republic of, Mashhad

F. Sharifipour

Mashhad University of Medical Sciences

Email: sharifipourf@mums.ac.ir

Associate Professor of Nephrology, Department of Internal Medicine, Faculty of Medicine

Iran, Islamic Republic of, Mashhad

Zeinab Jalambadani

Sabzevar University of Medical Sciences

Author for correspondence.
Email: jalambadaniz@gmail.com

Assistant Professor of Health Education and Promotion, Department of Community Medicine, Faculty of Medicine; Assistant Professor of Health Education and Promotion, Non-Communicable Diseases Research Center, Faculty of Medicine

Iran, Islamic Republic of, Sabzevar

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