Outcome of renal transplant recipients with cytomegalovirus and BK polyomavirus co-infection nephropathy.

Reactivation of cytomegalovirus (CMV) and BK polyomavirus (BKV) can result in virus-associated tubulointerstitial nephritis in renal allografts. All those renal biopsies reported as viral cytopathic were isolated and examined by two independent renal histopathologists from our institute and classified as CMV, BKV, and CMV-BKV coinfection-associated viral cytopathic changes with confirmation through polymerase chain reaction technology in either serum or urine or both. All twenty patients were categorized as 10 in CMV, four in BKV, and six were in CMV-BKV coinfection. One patient each had received antithymocyte globulin and basiliximab as induction all patients received triple-drug immunosuppression. The mean graft survival was 69, 61, and 59 months in CMV, BKV, and CMV-BKV coinfection group, respectively. At the end of the study period, 10 (50%) patients died. 1-, 3-and 5-year patient survival was 94%, 88% and 76% among CMV group, 75%, 75% and 50% in BKV group, and 96%, 83% and 62%, in CMV-BKV coinfection group (P = 0.157). CMV and BK virus are not so common infections in postrenal transplant patients yet an important cause of graft dysfunction. Coinfection did not pose an increased risk for acute rejection or patients and death-censored and uncensored graft survival among compared groups.