ArticleKidney international reports2026
Early BK Polyomavirus-Specific Immunity and Viral Clearance.
Article in Kidney international reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Introduction: BK polyomavirus (BKPyV) replication remains a frequent complication after kidney transplantation. The clinical relevance of assessing BKPyV-specific cellular immunity at the time of first detectable viremia remains incompletely defined. Methods: We retrospectively studied 50 kidney transplant recipients with a first episode of BKPyV DNAemia who underwent BKPyV-specific interferon-gamma enzyme-linked immunosorbent spot (IFN-γ ELISPOT) shortly after the first positive plasma polymerase chain reaction (PCR). Responses directed against structural (viral protein [VP]1-VP3) and regulatory (large T and small t) antigens were quantified. The primary end point was time from ELISPOT to viral clearance. Secondary end points included viral clearance within 90 days, biopsy-proven BKPyV-associated nephropathy (BKPyVAN), immunosuppression (IS) reduction, and kidney function outcomes. Results: Structural BKPyV-specific ELISPOT responses showed marked interindividual variability and correlated weakly with viral burden. Thirty-seven patients (74%) achieved viral clearance. Higher structural responses were independently associated with faster viral clearance (adjusted hazard ratio per 100 spot-forming cells [SFC]: 1.28; 95% confidence interval [CI]: 1.15-1.42; Conclusion: Early BKPyV-specific cellular immune responses measured by IFN-γ ELISPOT were consistently associated with viral clearance kinetics and clinically relevant outcomes after kidney transplantation. Structural antigen-specific responses may provide complementary information regarding antiviral immune competence and support further evaluation of immune-stratified management strategies. These findings should be considered hypothesis-generating and require prospective multicenter validation.
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