Intravenous Immunoglobulin Administration Significantly Increases BKPyV Genotype-Specific Neutralizing Antibody Titers in Kidney Transplant Recipients

Aurélie Velay; Morgane Solis; Ilies Benotmane; Pierre Gantner; Eric Soulier; Bruno Moulin; Sophie Caillard; Samira Fafi-Kremer

doi:10.1128/AAC.00393-19

DOI: 10.1128/AAC.00393-19

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FIG 1
Posterior distributions of the BKPyV NAb titers according to the genotype and commercial preparation by Bayesian modeling. The density of Pr describes the continuous probability distribution of the BKPyV NAb titers according to the genotype and commercial preparation. The BKPyV NAb titer distribution values are depicted according to the BKPyV genotype (I, II, and IV) and for each commercial preparation (Privigen, Octagam, and Clairyg). There was no overlap between genotypes, reflecting higher titers for genotype I, followed by genotype II and genotype IV, for each commercial preparation. The highest anti-BKPyV genotype I NAb titers were obtained for Privigen and Clairyg.
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FIG 2
Posterior distributions of the BKPyV NAb titers before and after i.v. Ig injection according to the genotype and type of patients by Bayesian modeling. The density of Pr describes the continuous probability distribution of BKPyV NAb titers before and after i.v. Ig injection according to the genotype and the patient group (AMR or SIDS). The BKPyV NAb titer distribution values are depicted according to the BKPyV genotype (I [A], II [B], and IV [C]) before and after i.v. Ig injection for both SIDS (blue) and AMR (red) patients. The observed NAb titer increases were not relevantly different between the two groups of patients for genotype I (probability of a 0.5 log₁₀ increase [Pr], >0.75). However, the increase was greater in the AMR group than in the SIDS group for both genotype II (Pr = 0.92 versus 0.05, respectively) and genotype IV (Pr = 0.94 versus 0, respectively).
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FIG 3
Dynamics of posterior means of NAb titers over time according to BKPyV genotype in patients receiving successive i.v. Ig administrations. The estimated means of BKPyV NAb titers are depicted according to the BKPyV genotype (I, II, and IV) for both SIDS and AMR patients. There was no cumulative effect of i.v. Ig administration for any genotype.

TABLE 1

Patients’ characteristics^a

Characteristic	Value for patients with i.v. Ig for:
Characteristic	AMR (n = 17)	SIDS (n = 16)
Median age (yr) (range)	42.2 (18.0–72.6)	58.3 (17.7–69.5)
Male [n (%)]	9 (52.9)	12 (75)
1st graft [n (%)]	15 (88)	16 (100)
Living donor [n (%)]	2 (12)	4 (25)
No. of HLA mismatches [mean (range)]	3.4 (1–5)	3.9 (0–6)
Delay (mo) between graft and first i.v. Ig injection [median (range)]	19.1 (0.8–134.7)	0.8 (0.7–1.6)