BK Virus Infection:A Hidden Threat for Renal Transplant Recipients

Abstract

BK virus (BKV) infection has become an important concern for renal transplant recipients, as it may cause nephropathy in transplant patients receiving immunosuppressive therapy resulting in renal dysfunction and possibly, graft loss. This crosssectional study was carried out at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2015 to June 2016, aimedto detect the incidence of BKV infection among transplant recipients from Bangladesh. A total of 30randomly selected adult renal transplant recipients and 15 healthy controls were included in this study.Their blood and urine samples were collected at 4 and 12 weeks of post transplantation, and tested for BKV DNA by quantitative real-time polymerase chain reaction. The serum creatinine levels were measured along with other routine investigations at the Department Biochemistry, BSMMU.Virological analysis showed, 8 (26.6%) patients had detectable BKV DNA at 4 weeks (1 month). Of them, 23.3% (7/30) had viruria and 3.3% (1/30) had viraemia. No BKV DNA was detected either in blood or in urine samples of healthy controls. Incidence of BKV infection found significantly higher (p<0.02) in transplant patients than healthy controls. However, their serum creatinine value was not significantly higher than that of the BKV DNA negative patients. At third month (12 weeks post transplantation), BKVviruria and/or viraemia were detected among 23.3% (7/30) patients where 13.3% (4/30) patients were newly detected who were previously ( at 4 weeks of transplant) negative; only 1 (3.3%) patient had both viraemia and viruria. There was significant variation (p<0.05) in mean serum creatinine value of BKV DNA positive and BKV DNA negative recipients at third month follow-up.Significantly higher incidence of BKV infection among transplant patients indicates thatit is very likely occurring in transplantation recipients, andBKV screening test should be included in routine postoperative follow-up investigations for early detection; and thus prevent the graft loss due to BKV nephropathy.