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Review
. 2022 Jul 25;14(8):1616.
doi: 10.3390/v14081616.

BK Virus Nephropathy in Kidney Transplantation: A State-of-the-Art Review

Sam Kant  1   2 , Alana Dasgupta  3 , Serena Bagnasco  3 , Daniel C Brennan  1   2
Affiliations
Review

BK Virus Nephropathy in Kidney Transplantation: A State-of-the-Art Review

Sam Kant et al. Viruses. .

Abstract

BK virus maintains a latent infection that is ubiquitous in humans. It has a propensity for reactivation in the setting of a dysfunctional cellular immune response and is frequently encountered in kidney transplant recipients. Screening for the virus has been effective in preventing progression to nephropathy and graft loss. However, it can be a diagnostic and therapeutic challenge. In this in-depth state-of-the-art review, we will discuss the history of the virus, virology, epidemiology, cellular response, pathogenesis, methods of screening and diagnosis, evidence-based treatment strategies, and upcoming therapeutics, along with the issue of re-transplantation in patients.

Keywords: BK virus; kidney injury; kidney transplantation; nephropathy; viremia.

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Conflict of interest statement

SK, AG, and SB declare no relevant conflict of interest. COI for DCB below: Grants/research support: Allovir, Amplyx, CareDx, Natera. Consultant: CareDx, Hansa, Medeor, Sanofi, Vera Therapeutics. Honoraria/speakers bureau: None. Stock: None. Board position: None. Other: Editorial Board Transplantation and UpToDate.

Figures

Figure 1
Figure 1
A “decoy cell” with an enlarged nucleus and clumped chromatin, mimicking high-grade urothelial atypia. PAP smear 600×. Courtesy of Zareema Mangaru, DO.
Figure 2
Figure 2
A tubular epithelial cell with a “ground glass” nuclear inclusion. H&E 600×.
Figure 3
Figure 3
A tubular lumen containing sloughed epithelial cells with a viral intranuclear inclusion. H&E 600×.
Figure 4
Figure 4
Lymphoplasmacytic interstitial inflammation surrounding a tubule containing an epithelial cell with a viral inclusion (arrow). H&E 400×.
Figure 5
Figure 5
SV40 IHC staining highlighting infected tubular epithelial cells (600×).
Figure 6
Figure 6
In situ hybridization for BK virus RNA (600×).
See this image and copyright information in PMC

References

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