Cidofovir: A method of treatment for BK virus-associated transplant nephropathy

The incidence of polyomavirus infections, particularly that of BK virus (BKV), in kidney transplant recipients has been increasing steadily. The diagnosis of this disease has been made more difficult because of the pathological similarities between BK viral nephropathy and acute cellular rejection. Despite reduced immunosuppression, the authors have seen persistence of BKV, which can result in gradual loss of kidney function. Cidofovir, an antiviral agent with known nephrotoxic effects, has been used, in very low doses, to treat patients with BKV while monitoring blood and urine with DNA-PCR assays. The authors report the outcome of 16 renal transplant patients treated with cidofovir for BKV-associated nephropathy.