Role of urinary viral haufen in diagnosis of polyomavirus nephropathy: A systematic review

Abstract

Renal biopsy is a gold standard method for diagnosis of BK polyomavirus nephropathy (PVN); however, it is an invasive procedure, and it can be false negative due to sampling error. Many noninvasive screening strategies such as decoy cell in urine and viral load assessments using polymerase chain reaction in urine and in plasma have a limited role in diagnose of PVN. Recently, urinary viral Haufen (UVH) is found to be very useful for diagnosis of PVN. The aim of this study was to evaluate the efficacy of UVH in the diagnosis of PVN in all transplant patients. In this systematic review, we included studies where UVH was used for diagnosis of PVN. We searched PubMed, EMBASE, Google Scholar, and Cochrane database of systematic reviews. Two authors independently selected studies and extracted data for review. Five studies were included in this study. One study reported sensitivity, specificity, positive predictive value, and negative predictive values of UVH against kidney biopsy as 100%, 99%, 97%, and 100%, respectively, for diagnosis of PVN in all type of transplant patients. Second study described technique of UVH estimation. Two studies correlated UVH with severity of PVN. Fifth study demonstrated that UVH formation occurs in the setting of high concentration of Tamm–Horsfall protein in urine and also reported UVH as a marker of PVN in mice. Data were not appropriate for meta-analysis. A limited number of studies showed that UVH may be a novel noninvasive biomarker to diagnosis and to predict the severity of PVN in transplant patients.