Epidemiology of Parvovirus B19 and Anemia Among Kidney Transplant Recipients

Purpose: Persistent anemia has been described in kidney transplant (KTX) recipients with Parvovirus B19 virus infection. However, epidemiology of Parvovirus B19 and Parvovirus B19-related anemia after KTx remains unclear. The study\u27s aims were 1) to investigate the frequency of Parvovirus B19 infection and 2) to assess the incidence of Parvovirus B19-related anemia in KTx recipients. Methods: Aliterature search for studies that reported the occurrence rate of Parvo-virus B19 infection and/or seroprevalence of Parvovirus B19 inKTx recipientswas conducted using Medline, Embase, and Cochrane Database from inception through October 2018. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. Results: 15 observational studies with a total of 1, 757 KTx patients were enrolled. Overall, the pooled estimated seroprevalence of Parvovirus B19 IgG was 87. 4% (950/oCI: 64. 4°/\u3c, 96. 4%). The pooled estimated occurrence rate of positive Parvovirus B19 DNA in the first year after KTx was 9. 7% (95%CI: 4. 7°/\u3c, 18. 9%). Sensitivity analysis excluding a study (that solely included KTx patients with anemia) was performed, and showed the pooled estimated occurrence rate of positive Parvovirus B19DNAafterKTxof8. 6%(95%CI: 4. 0%-17. 6%). Meta-regression analysis demonstrated no significant correlations between the year of study and occurrence rate of positive Parvovirus B19 DNA (P = 0. 93). Among KTx recipients with positive Parvovirus B19 DNA, the pooled estimated incidence rates of anemia and severe anemiawere37. 6o/o(95o/oCL25. 8o/o-51. 1o/o)and22. 3o/o(7. 1o/\u3c, 51. 9o/o), respectively. Egger\u27s regression asymmetry test was perforated and showed no publication bias in all analyses. Conclusions: Parvovirus B19 infection occurs mostly within the first year post-transplant. The overall estimated occurrence of positive Parvovirus Bl 9 DNA after KTX is 9. 70/0. The estimated incidence of anemia among KTx recipients with positive Parvovirus B19 DNA is 21. 6%. Parvovirus B 19 should be ruled out in cases of persistent anemia after transplant. [Figure Presented]

Polyomavirus Genotypes in Renal Transplant Recipients in the United States

Purpose: BK Polyomavirus (BKV) subtypes and subgroups present uneven geo-graphical distribution, suggesting a potential relationship with ethnicity. In the United States where there is a definite racial and ethnic diversity, the epidemiology of BKV genotypes remains unclear. This meta-analysis was conducted with the aim to assess BKV genotypes among kidney transplant (KTX) recipients. Methods: A comprehensive literature review was conducted utilizing MEDLINE. Embase and Cochrane Database through October 2018 to identify all studies that reported BKV subtypes and/or subgroups in KTx recipients in the United States. Effect estimates from each individual study were extracted and combined using random-effect, generic inverse variance method of DerSimoman and Laird. Results: 8 observational studies with a total of 193 samples (urine, blood, and kidney tissues) from 188 BKV-mfected KTx recipients in the United States were enrolled. The study years ranged from 2001 to 2016. Overall, the pooled estimated percentages of BKV subtypes were 72. 2% (95%CI: 62. 7%-80. 0%) for subtype I, 6. 8%(95%CI: 2. 5%-16. 9%)forsubtypeII, 8. 3% (95%CI: 4. 4%-15. 1%)for subtype III, and 16. 1% (95%CI: 10. 4%-24. 2%) for subtype IV, respectively. While meta-regression analysis demonstrated a significant positive correlation between year of study and the percentage of BKV subtype I (slopes =+0. 1023, P =0. 01), there were no significant correlations between year of study and percentages of BKV subtype II-IV (P \u3e0. 05). Among KTx recipients with BKV subtype I, the pooled estimated percentages of BKV subgroups were 22. 4% (95%CI: 13. 7%-34. 5%) for subgroup la, 30. 6% (95%CI: 17. 7%-47. 5%)for subgroup Ibl, 47. 7% (95%CI: 35. 8%-59. 9%) for subgroup Ib2, and 4. 1% (95%CI: 1. 2%-13. 3%) for subgroup Ic, respectively. Conclusions: BKV subtype I is the most prevalent subtype among KTx recipients in the United States and its percentage seems to increase overtime. Subgroup Ib2 is the most common among BKV subtype I. Further analysis is needed to assess the effect of BKV genotype on the clinical course of BK viremia in KTx