Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients
Background. BK virus (BKV) infection is a common complication following kidney transplantation. Immunosuppression reduction is the cornerstone of treatment while adjuvant drugs have been tried in small uncontrolled studies. We sought to examine our center’s experience with the use of ciprofloxacin i...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2014/107459 |
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| author | David Arroyo Sindhu Chandran Parsia A. Vagefi David Wojciechowski |
| author_facet | David Arroyo Sindhu Chandran Parsia A. Vagefi David Wojciechowski |
| author_sort | David Arroyo |
| collection | DOAJ |
| description | Background. BK virus (BKV) infection is a common complication following kidney transplantation. Immunosuppression reduction is the cornerstone of treatment while adjuvant drugs have been tried in small uncontrolled studies. We sought to examine our center’s experience with the use of ciprofloxacin in patients with persistent BKV infection. Methods. Retrospective evaluation of the effect of a 30-day ciprofloxacin course (250 mg twice daily) on BKV infection in kidney transplant recipients who had been diagnosed with BK viruria
≥106 copies/mL and viremia
≥500 copies/mL and in whom the infection did not resolve after immunosuppression reduction and/or treatment with other adjuvant agents. BKV in plasma and urine was evaluated after 3 months following treatment with ciprofloxacin. Results. Nine kidney transplant recipients received ciprofloxacin at a median of 130 days following the initial reduction in immunosuppression. Three patients showed complete viral clearance and another 3 had a
≥50% decrease in plasma viral load. No serious adverse events secondary to ciprofloxacin were reported and no grafts were lost due to BKV up to 1 year after treatment. Conclusion. Ciprofloxacin may be a useful therapy for persistent BKV infection despite conventional treatment. Randomized trials are required to evaluate the potential benefit of this adjuvant therapy. |
| format | Article |
| id | doaj-art-1f4524839ca44e0eab6f7410f4b9041f |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-1f4524839ca44e0eab6f7410f4b9041f2025-02-03T06:44:15ZengWileyJournal of Transplantation2090-00072090-00152014-01-01201410.1155/2014/107459107459Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant RecipientsDavid Arroyo0Sindhu Chandran1Parsia A. Vagefi2David Wojciechowski3Nephrology Department, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo 46, 28007 Madrid, SpainKidney Transplant Service, Division of Nephrology, Department of Medicine, University of California, San Francisco, 400 Parnassus Avenue, Suite A701, San Francisco, CA 94143, USATransplant Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, White 544, Boston, MA 02114, USAKidney Transplant Service, Division of Nephrology, Department of Medicine, University of California, San Francisco, 400 Parnassus Avenue, Suite A701, San Francisco, CA 94143, USABackground. BK virus (BKV) infection is a common complication following kidney transplantation. Immunosuppression reduction is the cornerstone of treatment while adjuvant drugs have been tried in small uncontrolled studies. We sought to examine our center’s experience with the use of ciprofloxacin in patients with persistent BKV infection. Methods. Retrospective evaluation of the effect of a 30-day ciprofloxacin course (250 mg twice daily) on BKV infection in kidney transplant recipients who had been diagnosed with BK viruria ≥106 copies/mL and viremia ≥500 copies/mL and in whom the infection did not resolve after immunosuppression reduction and/or treatment with other adjuvant agents. BKV in plasma and urine was evaluated after 3 months following treatment with ciprofloxacin. Results. Nine kidney transplant recipients received ciprofloxacin at a median of 130 days following the initial reduction in immunosuppression. Three patients showed complete viral clearance and another 3 had a ≥50% decrease in plasma viral load. No serious adverse events secondary to ciprofloxacin were reported and no grafts were lost due to BKV up to 1 year after treatment. Conclusion. Ciprofloxacin may be a useful therapy for persistent BKV infection despite conventional treatment. Randomized trials are required to evaluate the potential benefit of this adjuvant therapy.http://dx.doi.org/10.1155/2014/107459 |
| spellingShingle | David Arroyo Sindhu Chandran Parsia A. Vagefi David Wojciechowski Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients Journal of Transplantation |
| title | Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients |
| title_full | Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients |
| title_fullStr | Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients |
| title_full_unstemmed | Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients |
| title_short | Adjuvant Ciprofloxacin for Persistent BK Polyomavirus Infection in Kidney Transplant Recipients |
| title_sort | adjuvant ciprofloxacin for persistent bk polyomavirus infection in kidney transplant recipients |
| url | http://dx.doi.org/10.1155/2014/107459 |
| work_keys_str_mv | AT davidarroyo adjuvantciprofloxacinforpersistentbkpolyomavirusinfectioninkidneytransplantrecipients AT sindhuchandran adjuvantciprofloxacinforpersistentbkpolyomavirusinfectioninkidneytransplantrecipients AT parsiaavagefi adjuvantciprofloxacinforpersistentbkpolyomavirusinfectioninkidneytransplantrecipients AT davidwojciechowski adjuvantciprofloxacinforpersistentbkpolyomavirusinfectioninkidneytransplantrecipients |