IMPACT OF BK POLYOMAVIRUS INFECTION IN CHILDREN AFTER KIDNEY TRANSPLANT IN A REFERENCE CENTER IN SALVADOR – BAHIA, BRAZIL

ABSTRACT Introduction BK Polyomavirus infection has a high incidence in the post-renal transplant phase and is considered a significant cause of premature graft failure after transplantation. Pediatric renal patients undergo relatively more potent immunosuppression; however, despite the large number of studies conducted in adult renal recipients, there is limited information on BKPyV infection in the pediatric population. Objective To estimate the incidence of BK Polyomavirus infection after kidney transplantation in pediatric patients undergoing immunosuppressive therapy at a referral center. Methodology Observational descriptive study, with data collection based on medical records of children undergoing kidney transplantation at Hospital Ana Nery, Salvador-BA, from 2009 to 2017. Results Forty-one children were evaluated, of which 21 (51.2%) were female. The mean age of the sample was 11 ± 3, with a higher frequency of patients in the age range of 13-17 years (43.9%). Regarding the presence of BKPyV infection, most patients were not infected (56.1%). Regarding the type of antiproliferative and calcineurin inhibitor, Mycophenolate Mofetil was used in 37 (90.2%) patients and Tacrolimus in 40 (97.6%). When comparing the groups with the presence or absence of BKPyV infection, there was no statistically significant difference between the variables: sex (p = 0.890), age (p = 0.829) and type of antiproliferative used (p = 0.187). In the analysis of renal function, an increase in creatinine was observed in 38.9% of infected patients, while among the uninfected patients, only 13% presented an increase in the period of one year. The difference between these two groups (p = 0.05) therefore demonstrated an association between worsening renal function and the presence of BKPyV infection. Conclusion The incidence of BK Polyomavirus infection in pediatric patients undergoing kidney transplantation, in the period of one year after the surgical procedure, is almost 50%. No differences could be demonstrated between the groups with and without BKPyV infection and established risk factors, such as sex, age and immunosuppressive therapy used. Furthermore, a worsening of renal function was evidenced among infected patients, when compared to the uninfected group, in this period of one year.