&lt;p&gt;BK Virus Nephropathy: Prevalence, Impact and Management Strategies&lt;/p&gt;

Sharma, Rajeev; Zachariah, Mareena

doi:10.2147/ijnrd.s236556

Cited by 15 publications

(11 citation statements)

References 63 publications

(71 reference statements)

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“…However, despite BKVN being the most common cause of kidney allograft dysfunction within the first year after transplantation, advances in the management of polyomavirusassociated diseases are limited by a lack of randomized controlled trials of different therapeutic approaches. 22 In almost all instances, the primary step in the treatment of BKVN in the absence of concurrent acute organ rejection is a reduction of therapeutic immunosuppression. This approach is thought to allow the individual's own immune system to combat the infection.…”

Section: Discussionmentioning

confidence: 99%

“…22 Other strategies involve changing the type of calcineurin inhibitor or switching to a mammalian target of rapamycin inhibitor. 22,23 A similar approach of immunosuppression reduction is used to treat another polyomavirus infection, JC virus-associated progressive multifocal leukoencephalopathy, in which the goal of treatment is also to restore immune function. 24 In our patient, despite a reduction in immunosuppression, viremia persisted, resulting in a progressive decline in kidney function.…”

Section: Discussionmentioning

confidence: 99%

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Native BK Polyomavirus Nephropathy in an Orthotopic Heart Transplant Patient

Thompson

Ajene

Kulkarni

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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BK polyomavirus nephropathy (BKVN) is a common cause of nephropathy in kidney transplant patients and is typically seen within the first year after transplantation. BK polyomavirus nephropathy can occur in the native kidneys of patients with nonrenal solid-organ transplants (NRSOT). However, this is rare, especially outside the early post-transplant period, and BKVN is not usually considered in the differential diagnosis for acute kidney injury in NRSOT patients. We present a case of a 75-year-old man who had undergone orthotopic heart transplant 13 years prior with stable allograft function who developed progressive renal dysfunction in the setting of recent unilateral obstructive nephrolithiasis requiring ureteral stenting. Kidney biopsy demonstrated evidence of polyomavirus nephritis. Serum BK viral load was elevated. Despite reducing immunosuppression and initiating leflunomide, viral clearance was never achieved. The patient experienced progressive failure to thrive before ultimately transitioning to hospice care and dying. The intensity of immunosuppression is a well-known risk factor for viral replication; ureteral stenting has also been associated with BKVN. However, since clinical manifestations of BK viral infections often include a genitourinary (GU) tract pathology, it is important for clinicians to consider BKVN in patients with NRSOT with progressive renal dysfunction, especially in the clinical context of known GU disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Native BK Polyomavirus Nephropathy in an Orthotopic Heart Transplant Patient

Thompson

Ajene

Kulkarni

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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“…It is a member of the polyomavirus (PV) family, together with John Cunningham virus (JC) and Simian virus 40 (SV40). The BKV genome (

5 kb) is divided into: (i) the early region (which codes for small (t) and large T-antigen); (ii) the late region (which codes for capsid proteins Vp1, Vp2, Vp3, agnoprotein and microRNAs) and (iii) the non-coding control region (NCCR) ( Figure 1 ) [ 1 ].…”

Section: Bk Virusmentioning

confidence: 99%

“…BKV strains are classified into six genotypes, according to polymorphisms in VP1 and NCCR [ 1 ], with genotype I frequency at around 80% and genotype IV at 15% [ 2 ]. BKV infects most of the world population in their youth, often with silent infections (i.e., without symptoms) [ 3 ].…”

Section: Bk Virusmentioning

confidence: 99%

BK Virus Infection and BK-Virus-Associated Nephropathy in Renal Transplant Recipients

Borriello

Ingrosso

Perna

et al. 2022

Genes

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Poliomavirus BK virus (BKV) is highly infective, causing asymptomatic infections during childhood. After the initial infection, a stable state of latent infection is recognized in kidney tubular cells and the uroepithelium with negligible clinical consequences. BKV is an important risk factor for BKV-associated diseases, and, in particular, for BKV-associated nephropathy (BKVN) in renal transplanted recipients (RTRs). BKVN affects up to 10% of renal transplanted recipients, and results in graft loss in up to 50% of those affected. Unfortunately, treatments for BK virus infection are restricted, and there is no efficient prophylaxis. In addition, consequent immunosuppressive therapy reduction contributes to immune rejection. Increasing surveillance and early diagnosis based upon easy and rapid analyses are resulting in more beneficial outcomes. In this report, the current status and perspectives in the diagnosis and treatment of BKV in RTRs are reviewed.

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“…Interest in the BK and JC polyomaviruses is due in part to their high prevalence. Anti-BKPyV antibodies have been detected in over 80% of individuals in analysed populations, and in the case of the JC polyomavirus, antibodies indicating contact with the pathogen have been shown in about 39% of those tested [ 27 , 28 , 29 , 30 ]. The genetic material of the virus is detected much less often.…”

Section: Introductionmentioning

confidence: 99%

BK Polyomavirus—Biology, Genomic Variation and Diagnosis

Furmaga

Kowalczyk

Zapolski

et al. 2021

Viruses

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The BK polyomavirus (BKPyV), a representative of the family Polyomaviridae, is widespread in the human population. While the virus does not cause significant clinical symptoms in immunocompetent individuals, it is activated in cases of immune deficiency, both pharmacological and pathological. Infection with the BKPyV is of particular importance in recipients of kidney transplants or HSC transplantation, in which it can lead to the loss of the transplanted kidney or to haemorrhagic cystitis, respectively. Four main genotypes of the virus are distinguished on the basis of molecular differentiation. The most common genotype worldwide is genotype I, with a frequency of about 80%, followed by genotype IV (about 15%), while genotypes II and III are isolated only sporadically. The distribution of the molecular variants of the virus is associated with the region of origin. BKPyV subtype Ia is most common in Africa, Ib-1 in Southeast Asia, and Ib-2 in Europe, while Ic is the most common variant in Northeast Asia. The development of molecular methods has enabled significant improvement not only in BKPyV diagnostics, but in monitoring the effectiveness of treatment as well. Amplification of viral DNA from urine by PCR (Polymerase Chain Reaction) and qPCR Quantitative Polymerase Chain Reaction) is a non-invasive method that can be used to confirm the presence of the genetic material of the virus and to determine the viral load. Sequencing techniques together with bioinformatics tools and databases can be used to determine variants of the virus, analyse their circulation in populations, identify relationships between them, and investigate the directions of evolution of the virus.

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<p>BK Virus Nephropathy: Prevalence, Impact and Management Strategies</p>

Cited by 15 publications

References 63 publications

Native BK Polyomavirus Nephropathy in an Orthotopic Heart Transplant Patient

Native BK Polyomavirus Nephropathy in an Orthotopic Heart Transplant Patient

BK Virus Infection and BK-Virus-Associated Nephropathy in Renal Transplant Recipients

BK Polyomavirus—Biology, Genomic Variation and Diagnosis

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