{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:24:13Z","timestamp":1768523053575,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>BK polyomavirus (BKPyV)\u2010DNAemia is a common complication in kidney transplant recipients (KTRs). The significance of achieving viral clearance at different time intervals is not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All adult KTRs transplanted between January 1, 2015 and December 31, 2017 who developed BKPyV\u2010DNAemia were included. Outcomes were analyzed based on persistent clearance of BKPyV\u2010DNAemia at 3\u2010month intervals up to 2 years after initial detection, and for recipients with persistent BKPyV\u2010DNAemia at last follow\u2010up. Uncensored graft failure, death\u2010censored graft failure (DCGF), and a composite outcome of DCGF or fall in estimated glomerular filtration rate (eGFR) by \u226550% from the time of initial BKPyV\u2010DNAemia were outcomes of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 224 KTRs with BKPyV\u2010DNAemia, 58 recipients (26%) achieved viral clearance by 3 months after initial detection, 105 (47%) by 6 months, 120 (54%) by 9 months, 141 (63%) by 12 months, 155 (69%) by 15 months, 167 (75%) by 18 months, 180 (80%) by 21 months, and 193 (86%) by 24 months. Nine recipients (4%) had persistent BKPyV\u2010DNAemia at last follow\u2010up. Compared to recipients who achieved viral clearance by 3 months, those who achieved clearance by 6 months (adjusted odds ratio [aOR]: 3.15; 95% confidence interval [CI]: 1.22\u20138.12; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02) and 9 months (aOR: 3.69; 95% CI: 1.02\u201313.43; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04) had significantly increased risk for uncensored graft failure. There was no significant association between time to viral clearance and DCGF or composite outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found a trend of increased risk for uncensored graft failure among those who cleared BKPyV\u2010DNAemia more slowly. Aiming to clear viremia early, without risking rejection, may be beneficial for allograft function and patient morbidity and mortality.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14371-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14371","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T16:14:43Z","timestamp":1725380083000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early clearance of BK polyomavirus\u2010DNAemia among kidney transplant recipients may lead to better graft survival"],"prefix":"10.1111","volume":"26","author":[{"given":"Isabel","family":"Breyer","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Ptak","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Stoy","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-8583","authenticated-orcid":false,"given":"Didier","family":"Mandelbrot","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1667-7465","authenticated-orcid":false,"given":"Sandesh","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13528"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12164"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/v14081616"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2006.11.001"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13472"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13283"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28800"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08420813"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13768"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13216"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13561"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.791087"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142460"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014010119"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13508"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00767"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/00007890-201407151-01886","article-title":"Factors influencing viral clearance and graft outcomes following diagnosis of polyomavirus BK\u2010associated nephropathy after renal transplantation. 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