BK polyomavirus (BKV) is a ubiquitous virus in humans that remains latent in the urogenital tract after a primary infection during childhood. The virus, which is reactivated frequently and excreted in urine, can cause nephropathy in renal transplant recipients. BKV sequences are classified into four subtypes (I-IV). Subtype I and IV are divided further into four and six subgroups, respectively. To characterize the subtypes of BKV prevalent in Tunisia, the presence of the virus was investigated by real-time PCR in urine samples from 77 renal transplant recipients. For subtype identification, a DNA fragment in the VP1 coding region, amplified by nested PCR from positive samples, was sequenced and a phylogenetic analysis was performed. In the studied population, subtype I (75.5%), II (14.5%), and IV (2.5%) were identified with a clear predominance of subtype Ib-2 (73%) as observed in European population. This study suggests that in North Africa, the BKV genotype distribution is similar to that of Europe and different from that of sub-Saharan Africa.

The polyomavirus JC (JCPyV) is a ubiquitous virus in humans, causing progressive multifocal leukoencephalopathy, a fatal demyelinating disease. JCPyV propagates in the adult kidney and excretes its progeny in urine, from which its DNA can be recovered readily. JCPyV isolates worldwide can be classified into 14 subtypes or genotypes, each associated with a specific geographical region. The European genotypes EU-a-b-c are spread throughout Europe and Mediterranean areas. The major African genotype Af2 is spread not only throughout Africa but also in West and South Asia. A minor African genotype (Af1) occurs in Central and West Africa. Partially overlapping domains in Asia were occupied by various genotypes (e.g., B1-a, -b, -d, B2, CY, MY, and SC). To characterize the subtypes of JCPyV prevalent in Tunisia, the presence of the virus was investigated by real-time PCR in urine samples from 98 renal transplant recipients. For subtype identification, a 610 bp typing region of the JCPyV genome was amplified from each urine sample, and its DNA sequence was determined. In the patients studied, the major African subtype Af2 was the predominant (62.5%), followed by the European subtype EU (33.5%). Only one case clustering with the Asian genotype SC (4%) was identified. The presence of the European subtype with high prevalence in this population suggests that the epidemiological distribution of JCPyV virus sequences in North Africa is related partially to the epidemiological data in Europe.

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mittee approved the study (certificate 308/2020), and an online survey was designed using a REDCap database hosted at the University of Pretoria 15,16 . The survey was administered to all nephrologists registered with the South African Renal Society between May and August 2020. All patient data was entered online by the treating nephrologist. Odds ratios were calculated using mortality as the outcome, with international comparative mortality data derived from Fominskiy et. al.Results: At the completion of the study, 142 responses were received. Of these, 52 (36.62%) were removed due to incomplete data or incomplete informed consent, resulting in 90 (63.38%) responses available for analysis. No significant increase in deaths was fond when comparing our data to international COVID-19 ICU mortality data (odds ratio [OR] 1.14, 95% confidence interval (CI) 0.64 -2.06, P = 0.6532), but a significant increase in mortality was seen when compared to international COVID-19 in-hospital mortality (OR 2.05, 95% CI 1.13 -3.72, P = 0.0176). Our data revealed that mortality was significantly increased in patients who were treated in the state sector (OR 2.15, 95% CI 1,00 -4,63, P = 0,0497) or were diagnosed with shock (OR 2.73, 95% CI 1.11 -6.71, P = 0.028). Similarly, mortality was significantly increased in patients who required ventilation (OR 2.24, 95% CI 1.10 -4.56, P = 0.026), inotropes (OR 2.78, 95% CI 1.26 -6.16, P = 0.0115) or continuous dialysis therapy (OR 3.11, 95% CI 1.33 -7.26, P = 0.0087). In contrast, mortality was significantly decreased in patients diagnosed with ischemic heart disease (OR 0.19, 95% CI 0.04 -0.95, P = 0.0431) and patients who received intermittent hemodialysis during their admission (OR 0.28, 95% CI 0.11 -0.72, P = 0.0081). Conclusions: 1) Our findings from a developing country are similar to developed countries.2) Significant predictors of mortality were continuous dialysis therapy, ventilation, inotropes, shock and treatment in the state sector.3) Significant predictors of survival were intermittent hemodialysis and ischemic heart disease.No conflict of interest