BK virus viral load: analysis of the requests received by the microbiology laboratory and clinical involvement of the issued results

  • Irene Muñoz-GallegoEmail author
  • Noelia Moral
  • Consuelo Pascual
  • Yolanda Alonso
  • Lola Folgueira
Original Article


Automation of viral diagnosis has led to an increase of BK virus (BKV) viral load (VL) requests. The aim of this study was to assess the suitability of serum creatinine (SCr) for controlling the demand and to study the clinical characteristics of BKV infection. This is a retrospective study including patients with BKV VL request during April–July 2017. Clinical records and SCr were analyzed. Five hundred samples from 333 patients were included; 61.4% of samples were from males (55.5 ± 14.8 years), and all belonged to transplant recipients (86.4% renal). BKV VL was detectable in 40 samples (8.0%) from 23 patients (6.9%), who presented high SCr (100% vs. 90.9%, P = 0.038). Most of detectable VLs (62.5%) belonged to patients in their first year post-transplant. Six patients with detectable VL (26.1%) developed clinical manifestations, most of them (83.3%) had a first BKV VL greater than 10,000 copies/mL (P = 0.001). In conclusion, SCr would be useful to identify suitable specimens for BKV VL testing without missing cases.


BK virus Viral load Serum creatinine Transplantation 



This research did not receive any specific grant from funding agencies from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Vigil D, Konstantinov NK, Barry M, Harford AM, Servilla KS, Kim YH, Sun Y, Ganta K, Tzamaloukas AH (2016) BK nephropathy in the native kidneys of patients with organ transplants: clinical spectrum of BK infection. World J Transplant 6:472–504CrossRefGoogle Scholar
  2. 2.
    Ambalathingal GR, Francis RS, Smyth MJ, Smith C, Khanna R (2017) BK polyomavirus: clinical aspects, immune regulation, and emerging therapies. Clin Microbiol Rev 30:503–528CrossRefGoogle Scholar
  3. 3.
    Hirsch HH, Randhawa P, AST Infectious Diseases Community of Practice (2013) BK polyomavirus in solid organ transplantation. Am J Transplant 4:179–188CrossRefGoogle Scholar
  4. 4.
    Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group (2009) KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant 9(Suppl 3):S1–S155Google Scholar
  5. 5.
    Hirsch HH, Babel N, Comoli P, Friman V, Ginevri F, Jardine A, Lautenschlager I, Legendre C, Midtvedt K, Muñoz P, Randhawa P, Rinaldo CH, Wieszek A, ESCMID Study Group of Infection in Compromised Hosts (2014) European perspective on human polyomavirus infection, replication and disease in solid organ transplantation. Clin Microbiol Infect 20:74–88CrossRefGoogle Scholar
  6. 6.
    Simko JP, Caliendo AM, Hogle K, Versalovic J (2002) Differences in laboratory findings for cerebrospinal fluid specimens obtained from patients with meningitis or encephalitis due to herpes simplex virus (HSV) documented by detection of HSV DNA. Clin Infect Dis 35:414–419CrossRefGoogle Scholar
  7. 7.
    Hanson KE, Alexander BD, Woods C, Petti C, Reller LB (2007) Validation of laboratory screening criteria for herpes simplex virus testing of cerebrospinal fluid. J Clin Microbiol 45:721–724CrossRefGoogle Scholar
  8. 8.
    Balba GP, Javaid B, Timpone JG (2013) BK polyomavirus infection in the renal transplant recipient. Infect Dis Clin N Am 27:271–283CrossRefGoogle Scholar
  9. 9.
    Bechert CJ, Schnadig VJ, Payne DA, Dong J (2010) Monitoring of BK viral load in renal allograft recipients by real-time PCR assays. Am J Clin Pathol 133:242–250CrossRefGoogle Scholar
  10. 10.
    Mohamed M, Parajuli S, Muth B, Astor BC, Panzer SE, Mandelbrot D, Zhong W, Djamali A (2016) In kidney transplant recipients with BK polyomavirus infection, early BK nephropathy, microvascular inflammation, and serum creatinine are risk factors for graft loss. Transpl Infect Dis 18:361–371CrossRefGoogle Scholar
  11. 11.
    Hirsch HH, Knowles W, Dickenmann M, Passweg J, Klimkait T, Mihatsch MJ, Steiger J (2002) Prospective study of polyomavirus type BK replication and nephropathy in renal-transplant recipients. N Engl J Med 347:488–496CrossRefGoogle Scholar
  12. 12.
    Hassan S, Mittal C, Amer S, Khalid F, Patel A, Delbusto R, Samuel L, Alangaden G, Ramesh M (2014) Currently recommended BK virus (BKV) plasma viral load cutoff of ≥ 4 log10/mL underestimates the diagnosis of BKV-associated nephropathy: a single transplant center experience. Transpl Infect Dis 16:55–60CrossRefGoogle Scholar
  13. 13.
    Randhawa P, Kant J, Shapiro R, Tan H, Basu A, Luo C (2011) Impact of genomic sequence variability on quantitative PCR assays for diagnosis of polyomavirus BK infection. J Clin Microbiol 49:4072–4076CrossRefGoogle Scholar
  14. 14.
    Sawinski D, Goral S (2015) BK virus infection: an update on diagnosis and treatment. Nephrol Dial Transplant 30:209–217CrossRefGoogle Scholar
  15. 15.
    Huang G, Wu LW, Yang SC, Fei JG, Deng SX, Li J, Chen GD, Fu Q, Deng RH, Qiu J, Wang CX, Chen LZ (2015) Factors influencing graft outcomes following diagnosis of polyomavirus - associated nephropathy after renal transplantation. PLoS One 10:e0142460CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Laboratory of Virology, Microbiology DepartmentHospital Universitario 12 de OctubreMadridSpain
  2. 2.Biomedical Research Institute imas12Hospital Universitario 12 de OctubreMadridSpain
  3. 3.Department of Medicine, School of MedicineUniversidad ComplutenseMadridSpain

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