BK Virus

Shmuel Shoham, M.D., Paul G. Auwaerter, M.D.
BK Virus is a topic covered in the Johns Hopkins ABX Guide.

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MICROBIOLOGY

  • DNA polyomavirus, first isolated in 1971 from the urine of a renal transplant patient with ureteral stenosis whose initials were B.K.
  • Other members of the polyoma virus family:
    • JC virus, ~75% information shared genomically, KI polyomavirus, WU polyomavirus and trichodysplasia spinulosa-associated polyomavirus and Merkel cell polyomavirus.
  • Important viral components are large tumor antigen (T antigen), small tumor antigen (t antigen) and capsid proteins (VP1, VP2, VP3 and agnoprotein)
  • Subtypes: Subtype 1 is most common followed by subtype 4. Subtypes 3 and 4 are much less common. Serostatus of donor and recipient may impact risk for viral reactivation in kidney transplant.
  • Sequence of events:
    • Primary infection: Usually respiratory tract infection.
      • Most transmission is via exposure to the virus in respiratory, urine, fecal secretions.
      • Transmission is also possible via transplacental trnasfer, blood transfusions and organ transplant.
    • Latent phase most commonly in uroepithelial cells: Asymptomatic.
    • Reactivation with immunosuppression leading to organ disease (BK nephropathy, ureteral stenosis, hemorrhagic cystitis and respiratory tract infection).

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MICROBIOLOGY

  • DNA polyomavirus, first isolated in 1971 from the urine of a renal transplant patient with ureteral stenosis whose initials were B.K.
  • Other members of the polyoma virus family:
    • JC virus, ~75% information shared genomically, KI polyomavirus, WU polyomavirus and trichodysplasia spinulosa-associated polyomavirus and Merkel cell polyomavirus.
  • Important viral components are large tumor antigen (T antigen), small tumor antigen (t antigen) and capsid proteins (VP1, VP2, VP3 and agnoprotein)
  • Subtypes: Subtype 1 is most common followed by subtype 4. Subtypes 3 and 4 are much less common. Serostatus of donor and recipient may impact risk for viral reactivation in kidney transplant.
  • Sequence of events:
    • Primary infection: Usually respiratory tract infection.
      • Most transmission is via exposure to the virus in respiratory, urine, fecal secretions.
      • Transmission is also possible via transplacental trnasfer, blood transfusions and organ transplant.
    • Latent phase most commonly in uroepithelial cells: Asymptomatic.
    • Reactivation with immunosuppression leading to organ disease (BK nephropathy, ureteral stenosis, hemorrhagic cystitis and respiratory tract infection).

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Last updated: December 3, 2019