Polyoma BK Viremia Incidence in Kidney Transplant Patients with Belatacept or Tacrolimus-based Immunosuppression Regimens Geoffrey Zettel, Erika Meredith Emory University Hospital - Atlanta, GA
Background/Purpose: Polyoma virus, BK type, is a ubiquitous, small, double-stranded DNA virus which commonly causes primary infection during childhood and has a sero-prevalence of 80-90% in the human population. Polyoma BK virus reactivation is ordinarily eliminated in immunocompetent individuals. However, with immunosuppressed individuals, such as kidney transplant patients, Polyoma BK virus is particularly burdensome. Immunosuppression induction agents as well as immunosuppression maintenance regimens are known risk factors for Polyoma BK viremia. However, the risk of Polyoma BK viremia in the setting of immunosuppression maintenance with belatacept, a novel co-stimulatory CTLA4-inhibitor, has not been well established. The objective of this study is to evaluate the incidence of Polyoma BK viremia in patients who were administered either a tacrolimus-based immunosuppression regimen or a belatacept-based immunosuppression regimen after kidney transplant. Our primary endpoint is the incidence of BK viremia on either immunosuppression regimens. Secondary endpoints include the following for positive Polyoma BK viremia patients: time until viremia after transplant, rates of biopsy confirmed BK virus associated nephropathy, mean dose of immunosuppression during viremia treatment, time until clearance of viremia, rate of graft loss, rejection rates, and renal function during viremia treatment.
Methodology: This is a single center, retrospective chart review including Emory University Hospital kidney transplant patients who were transplanted between January 1, 2010 to December 1, 2015. Patients were included if they were a kidney recipient at Emory University Hospital, 18 years of age or greater, had induction immunosuppression with basiliximab, and had either Belatacept or tacrolimus immunosuppression maintenance regimens. Exclusion criteria included patients who were HIV positive or had multiple organ transplants.
Presentation Objective: Describe the incidence of BK viremia in kidney transplant patients with either Tacrolimus or Belatacept immunosuppression regimens.
Self-Assessment: How does the incidence of BK viremia in Belatacept-based immunosuppression compare to that of Tacrolimus-based immunosuppression regimens.
