BK Virus Infection and Its Management in Renal Transplantation: An Update

Abstract

BK virus (BKV) is a common opportunistic pathogen in kidney transplant recipients and one of the most challenging causes of allograft dysfunction and loss. Although over-immunosuppression remains the primary risk factor for BKV infection after transplantation, male gender, older recipient age, prior rejection episodes, degree of human leukocyte antigen mismatching, prolonged cold ischemia time, BK virus serostatus and ureteral stent placement have all been implicated as risk factors. Routine screening post-renal transplant is important to prevent allograft loss in patients with BK viruria or viremia. Reduction of immunosuppression remains the mainstay of BKV nephropathy treatment and is the most studied intervention. In this review, we are going to discuss the epidemiology of BK virus infection, screening strategies, treatment options and new studies or evidence in the future.