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High Incidence of Malignancy in Polyomavirus-Associated Nephropathy in Renal Transplant Recipients |
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| Authors: | C.-H. Chen M.-C. Wen J.-D. Lian M.-J. Wu T.-M. Yu D. Chang |
| Affiliation: | a Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan b Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan c Department of Life Science, Tunghai University, Taichung, Taiwan d Division of Nephrology, Chung Shan Medical University Hospital, Taichung, Taiwan e Department of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan f School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan g Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan |
| Abstract: | Human polyomaviruses (PV), including JC and BK virus, have been reported to cause polyomavirus-associated nephropathy (PVAN), in renal transplant patients. PV infection has been demonstrated to be associated with malignancies in animals; however, the association between malignancy and viral infections in humans is not clear. We retrospectively reviewed our 864 (M:F = 502:362) kidney transplant patients over the past 25 years. We identified PVAN in 6 patients (0.69%), including BK nephropathy (n = 5) and JC nephropathy (n = 1). Three patients (50%) improved after reducing the immunosuppression, but 3 (50%) progressed to graft loss despite this reduction. Malignancy occurred in 5 out of the 6 patients (83%; P < .0001 compared with patients without PVAN), including transitional cell carcinoma (n = 2), renal cell carcinoma (n = 1), squamous cell carcinoma of skin (n = 1) and Kaposi sarcoma (n = 1). We concluded that kidney transplant patients with PVAN are at a significantly greater risk to develop malignancy. Whether this is due to a direct effect of PV infection or the result of overimmunosuppression remains to be determined in a future study. |
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