Modeling BK Virus Infection in Renal Transplant Recipients

Viruses. 2024 Dec 31;17(1):50. doi: 10.3390/v17010050.

Abstract

Kidney transplant recipients require a lifelong protocol of immunosuppressive therapy to prevent graft rejection. However, these same medications leave them susceptible to opportunistic infections. One pathogen of particular concern is human polyomavirus 1, also known as BK virus (BKPyV). This virus attacks kidney tubule epithelial cells and is a direct threat to the health of the graft. Current standard of care in BK virus-infected transplant recipients is reduction in immunosuppressant therapy, to allow the patient's immune system to control the virus. This requires a delicate balance; immune suppression must be strong enough to prevent rejection, yet weak enough to allow viral clearance. We seek to model viral and immune dynamics with the ultimate goal of applying optimal control methods to this problem. In this paper, we begin with a previously published model and make simplifying assumptions that reduce the number of parameters from 20 to 14. We calibrate our model using newly available patient data and a detailed sensitivity analysis. Numerical results for multiple patients are given to show that the newer model reflects observed dynamics well.

Keywords: BKPyV; immunosuppression; kidney; model calibration; modeling; renal; sensitivity; transplant.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • BK Virus* / immunology
  • BK Virus* / physiology
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation* / adverse effects
  • Polyomavirus Infections* / immunology
  • Polyomavirus Infections* / virology
  • Transplant Recipients*
  • Tumor Virus Infections* / immunology
  • Tumor Virus Infections* / virology

Substances

  • Immunosuppressive Agents