BK Virus in Kidney Transplant Recipients The Influence of Immunosuppression英文文献资料.docVIP

HindawiPublishingCorporation JournalofTransplantation Volume2011,ArticleID750836,9pages doi:10.1155/2011/750836 ClinicalStudy BKVirusinKidneyTransplantRecipients: TheIn?uenceofImmunosuppression KatherineA.Barraclough, NicoleM.Isbel, ChristineE.Staatz, andDavidW.Johnson 1 1 2 1 1 2 DepartmentofNephrology,UniversityofQueenslandatthePrincessAlexandraHospital,Brisbane,QLD4102,Australia SchoolofPharmacy,UniversityofQueensland,StLucia,Brisbane,QLD4072,Australia CorrespondenceshouldbeaddressedtoKatherineA.Barraclough,katherinebarraclough@.au Received14January2011;Revised5March2011;Accepted27March2011 AcademicEditor:BernhardK.Kr¨amer Copyright?2011KatherineA.Barracloughetal. This is an open access article distributed under the Creative Commons AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis properlycited. TheincidenceofBKvirusinfectioninkidneytransplantrecipientshasincreasedoverrecentdecades,coincidentwiththeuseof morepotentimmunosuppression.Moreimportantly,posttransplantBKvirusreplicationhasemergedasanimportantcauseof graftdamageandsubsequentgraftloss.ImmunosuppressionhasbeenacceptedasamajorriskforBKvirusreplication.However, thespeci?ccontributionofindividualimmunosuppressivemedicationstothisriskhasnotbeenwellestablished.Thepurposeof thispaperistoprovideanoverviewoftherecentliteratureonthein?uenceofthevariousimmunosuppressantdrugsanddrug combinationsonposttransplantBKvirusreplication.Evidencesupportingthevariousimmunosuppressionreductionstrategies utilisedinthemanagementofBKviruswillalsobebrie?ydiscussed. 1.Introduction Serological studies indicate that BKV infection has a worldwideadultseroprevalencerateofaround75%(range of46–94%dependingontheregionstudied)[6,7].Primary infection is usually asymptomatic, but BKV establishes latencyinurinaryepithelium[6–8].Whilereactivationand urinary shedding occurs in 10% to 60% of immunocom- petent individual