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Review
. 2019 Jan;28(1):65-69.
doi: 10.1097/MNH.0000000000000464.

Protective association between JC polyoma viruria and kidney disease

Jasmin Divers  1 , Carl D Langefeld  1 , Douglas S Lyles  2 , Lijun Ma  3 , Barry I Freedman  3
Affiliations
Review

Protective association between JC polyoma viruria and kidney disease

Jasmin Divers et al. Curr Opin Nephrol Hypertens. 2019 Jan.

Abstract

Purpose of review: The presence of viruses in urine (urine virome) typically reflects infection in the kidneys and urinary tract. The urinary virome is associated with HIV-associated nephropathy and chronic glomerulosclerosis. There are many associations of this microbiome with human diseases that remain to be described. This manuscript reviews emerging data on relationships between kidney disease and urinary tract infection/colonization with JC polyomavirus (JCPyV).

Recent findings: Approximately 30% of the adult population sheds JCPyV in the urine. Further, urinary tract infection with one polyomavirus strain appears to inhibit secondary infections. The presence of urinary JCPyV and BK polyomavirus (BKPyV) replication were measured with polymerase chain reaction in African Americans to assess relationships with apolipoprotein L1 gene (APOL1)-associated nephropathy. Urinary JCPyV was associated with paradoxically lower rates of nephropathy in those with APOL1 high-risk genotypes. Subsequent studies revealed African Americans with JCPyV viruria had lower rates of nondiabetic nephropathy independent from APOL1.

Summary: Urinary tract JCPyV replication is common and associates with lower rates of nephropathy. This relationship is observed in diverse settings. Results support a host immune system that fails to eradicate nonnephropathic viruses and is also less likely to manifest renal parenchymal inflammation resulting in glomerulosclerosis.

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Conflict of interest statement

Conflicts of interest

There are no conflicts of interest.

References

    1. Divers J, Nunez M, High KP, et al. JC polyoma virus interacts with APOL1 in African Americans with nondiabetic nephropathy. Kidney Int 2013; 84: 1207–1213. - PMC - PubMed
    1. Freedman BI, Kistler AL, Skewes-Cox P, et al. JC polyoma viruria associates with protection from chronic kidney disease independently from apolipoprotein L1 genotype in African Americans. Nephrol Dial Transplant 2018; doi:10.1093/ndt/gfx368. [Epub ahead of print] - DOI - PMC - PubMed

    2. This report replicated the protective relationship between JC polyoma viruria and nondiabetic CKD in African Americans. For the first time, associations were extended beyond APOL1-associated nephropathy to individuals with non-APOL1-related CKD.

    1. Kupin WL. Viral-associated GN: hepatitis B and other viral infections. Clin J Am Soc Nephrol 2017; 12:1529–1533. - PMC - PubMed

    2. A thorough review of mechanistic associations between viral infections and glomerular disease.

    1. Wyatt CM, Klotman PE. HIV-associated nephropathy in the era of antiretroviral therapy. Am J Med 2007; 120:488–492. - PubMed
    1. Kasembeli AN, Duarte R, Ramsay M, et al. APOL1 risk variants are strongly associated with HIV-associated nephropathy in Black South Africans. J Am Soc Nephrol 2015; 26:2882–2890. - PMC - PubMed

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