Gorriceta JH, Lopez Otbo A, Uehara G, Posadas Salas MA. BK viral infection: A review of management and treatment. World J Transplant 2023; 13(6): 309-320 [PMID: 38174153 DOI: 10.5500/wjt.v13.i6.309]
Corresponding Author of This Article
Maria Aurora Posadas Salas, MD, Professor, Department of Medicine, Division of Nephrology, Medical University of South Carolina, No. 96 Jonathan Lucas Street, Charleston, SC 29425, United States. posadas@musc.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Dec 18, 2023; 13(6): 309-320 Published online Dec 18, 2023. doi: 10.5500/wjt.v13.i6.309
BK viral infection: A review of management and treatment
June Hayrelle Gorriceta, Amy Lopez Otbo, Genta Uehara, Maria Aurora Posadas Salas
June Hayrelle Gorriceta, Department of Medicine, St Francis Hospital-Bartlett, Bartlett, TN 38133, United States
Amy Lopez Otbo, Department of Medicine, St. Luke’s Medical Center, Quezon 1112, Philippines
Genta Uehara, Maria Aurora Posadas Salas, Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC 29425, United States
Author contributions: Gorriceta JH contributed to the manuscript, revised the manuscript; Lopez Otbo A contributed to the manuscript, revised the manuscript; Uehara G contributed to the manuscript, revised the manuscript; Posadas Salas MA conceptualized the manuscript, contributed to the manuscript, revised the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maria Aurora Posadas Salas, MD, Professor, Department of Medicine, Division of Nephrology, Medical University of South Carolina, No. 96 Jonathan Lucas Street, Charleston, SC 29425, United States. posadas@musc.edu
Received: September 8, 2023 Peer-review started: September 10, 2023 First decision: September 29, 2023 Revised: November 15, 2023 Accepted: November 30, 2023 Article in press: November 30, 2023 Published online: December 18, 2023
Abstract
BK viral infection remains to be a challenging post-transplant infection, which can result in kidney dysfunction. The mainstay approach to BK infection is reduction of immunosuppression. Alterations in immunosuppressive regimen with minimization of calcineurin inhibitors, use of mechanistic target of rapamycin inhibitors, and leflunomide have been attempted with variable outcomes. Over the past few years, investigators have explored potential therapeutic options for BK infection. Fluoroquinolone prophylaxis and treatment was found to have no benefit in kidney transplant recipients. The utility of cidofovir is limited by its nephrotoxicity. Intravenous immunoglobulin is becoming a popular option for treatment and prophylaxis for BK infection, as it increases the neutralizing antibody titers against the most common BK virus serotypes. Virus-specific T cell therapy is an emerging treatment option for BK viremia. In this review, we will explore management and therapeutic options for BK infection and recent evidence available in literature.
Core Tip: BK viral infection is a significant post-transplant infection, which can result in kidney dysfunction if left unaddressed. The mainstay approach to BK infection is reduction of immunosuppression. Data on specific therapies have remained equivocal. In this article, we will review recent evidence available in literature on treatment approaches to BK viral infection.
