| Summary: | Although much is known about human polyomaviruses, there is a paucity of knowledge of polyomavirus infections in renal transplant recipients (RTPs), particularly those given steroid sparing regimens and transmission of polyomaviruses. BK polyomavirus associated nephropathy (PVAN) is an uncommon complication causing graft failure post transplantation. The role of other polyomaviruses JC, Simian Virus 40, WU, KI and Merkel cell (MCV) is unclear. A prospective longitudinal study was carried out of 112 RTPs given steroid sparing regimens to investigate the presence of polyomaviruses. A second prospective study was undertaken of respiratory samples (n = 1640) submitted for the investigation of respiratory infection. The prevalence and dynamics of polyomavirus infections was studied using real-time multiplex PCR assays, antibody assays using recombinant virus-like particles and sequencing for virus typing and investigation of viral variation. There was no significant difference in prevalence for BKV and JCV infections in RTPs between the control and study treatment groups. Overall, 33% of RTPs were positive for BK viruria, of which 10.7% developed viraemia and 1.8% of these progressed to PVAN; 13.3% were positive for JCV infection and 2.7% for MCV. All samples were negative for SV40, WUV and KIV. No dual BKV and JCV infections were observed, although 8% of RTPs had dual BKV and CMV infection and 3.6% had dual JCV and CMV. There were no variations observed in the NCCR of RTPs with PVAN but duplications were observed during a BKV and JCV infection. Both BKV and JCV infections were acquired early post transplantation, molecular epidemiological studies suggested these were of donor origin. In the second study of children and adults with respiratory symptoms 3.6% were positive for WUV infection, 2.74% for KIV, 0.91 % for MCV and 0.18% for BKV infection. Epidemiology suggests a causative role for WUV but not KIV in respiratory disease.
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