Management of BK-virus infection - Swedish recommendations
| Autor: | Johan Mölne, Marie Felldin, Vanda Friman, Per Ljungman, Maria Herthelius, Britt-Marie Eriksson, Lars Wennberg, Lisa Swartling, Tina Dalianis, Anna-Lena Hammarin |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Infectious Medicine BKVAN viruses medicine.medical_treatment 030106 microbiology Infektionsmedicin Antiviral Agents Nephropathy 03 medical and health sciences Immunocompromised Host 0302 clinical medicine BK Virus Infection Medicine Humans Transplantation Homologous 030212 general & internal medicine haemorrhagic cystitis BKV Polyomavirus Infections immunosuppression General Immunology and Microbiology business.industry Diagnostic Tests Routine Hematopoietic Stem Cell Transplantation virus diseases Disease Management Immunosuppression General Medicine medicine.disease Transplantation Haematopoiesis Infectious Diseases BK Virus Immunology Stem cell business management transplantation |
| Zdroj: | Infectious diseases (London, England). 51(7) |
| ISSN: | 2374-4243 |
| Popis: | BK-virus (BKV) associated nephropathy (BKVAN) and BKV associated haemorrhagic cystitis (HC) are complications of BKV infection/reactivation in renal and allogeneic haematopoietic stem cell transplantation (HSCT) patients, respectively. The task of how to manage these diseases was given to the chair by the Swedish Reference Group for Antiviral Therapy (RAV). After individual contributions by members of the working group, consensus discussions were held in a meeting on 23 January 2018 arranged by RAV. Thereafter, the recommendations were published in Swedish on November 2018. The current translation to English has been approved by all co-authors. High BKV serum levels suggest an increased risk for BKVAN and potential graft failure. For detection of BKVAN, careful monitoring of BKV DNA levels in serum or plasma is recommended the first year after renal transplantation and when increased creatinine serum levels of unknown cause are observed. Notably, a renal biopsy is mandatory for diagnosis. To reduce the risk for progression of BKVAN, there is no specific treatment, and tailored individual decrease of immunosuppression is recommended. For BKV-HC, BKV monitoring is not recommended, since BK-viruria frequently occurs in HSCT patients and the predictive value of BKV in plasma/serum has not been determined. However, the risk for BKV-HC is higher for patients undergoing myeloablative conditioning, having an unrelated, HLA-mismatched, or a cord blood donor, and awareness of the increased risk and early intervention may benefit the patients. Also for BKV-HC, no specific therapy is available. Symptomatic treatment, e.g. forced diuresis and analgesics could be of use. |
| Databáze: | OpenAIRE |
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