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class="vector-toc-numb">2</span> <span>Cause</span> </div> </a> <button aria-controls="toc-Cause-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Cause subsection</span> </button> <ul id="toc-Cause-sublist" class="vector-toc-list"> <li id="toc-Transmission" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Transmission"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Transmission</span> </div> </a> <ul id="toc-Transmission-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Risk_factors" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Risk_factors"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Risk factors</span> </div> </a> <ul id="toc-Risk_factors-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Treatment</span> </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Treatment subsection</span> </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Leflunomide_in_BKVAN" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Leflunomide_in_BKVAN"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Leflunomide in BKVAN</span> </div> </a> <ul id="toc-Leflunomide_in_BKVAN-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_treatment_options" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_treatment_options"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Other treatment options</span> </div> </a> <ul id="toc-Other_treatment_options-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Virology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Virology"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Virology</span> </div> </a> <button aria-controls="toc-Virology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Virology subsection</span> </button> <ul id="toc-Virology-sublist" class="vector-toc-list"> <li id="toc-Virus_structure" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Virus_structure"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Virus structure</span> </div> </a> <ul id="toc-Virus_structure-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genome" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genome"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Genome</span> </div> </a> <ul id="toc-Genome-sublist" class="vector-toc-list"> <li id="toc-Archetype_and_rearranged_virus_forms" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Archetype_and_rearranged_virus_forms"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2.1</span> <span><i>Archetype</i> and <i>rearranged</i> virus forms</span> </div> </a> <ul id="toc-Archetype_and_rearranged_virus_forms-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genotypes_and_subtypes" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Genotypes_and_subtypes"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2.2</span> <span>Genotypes and subtypes</span> </div> </a> <ul id="toc-Genotypes_and_subtypes-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Replication_cycle" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Replication_cycle"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.3</span> <span>Replication cycle</span> </div> </a> <ul id="toc-Replication_cycle-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Tissue_tropism" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Tissue_tropism"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.4</span> <span>Tissue tropism</span> </div> </a> <ul id="toc-Tissue_tropism-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Viral_latency" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Viral_latency"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.5</span> <span>Viral latency</span> </div> </a> <ul id="toc-Viral_latency-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div 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class="mw-page-title-main">BK virus</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. 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mw-list-item"><a href="https://de.wikipedia.org/wiki/BK-Virus" title="BK-Virus – German" lang="de" hreflang="de" data-title="BK-Virus" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Virus_BK" title="Virus BK – Spanish" lang="es" hreflang="es" data-title="Virus BK" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%88%DB%8C%D8%B1%D9%88%D8%B3_%D8%A8%DB%8C%E2%80%8C%DA%A9%DB%8C" title="ویروس بی‌کی – Persian" lang="fa" hreflang="fa" data-title="ویروس بی‌کی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Virus_BK" title="Virus BK – French" lang="fr" hreflang="fr" data-title="Virus BK" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/BK%EB%B0%94%EC%9D%B4%EB%9F%AC%EC%8A%A4" title="BK바이러스 – Korean" lang="ko" hreflang="ko" data-title="BK바이러스" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AC%E0%A5%80%E0%A4%95%E0%A5%87_%E0%A4%B5%E0%A4%BE%E0%A4%87%E0%A4%B0%E0%A4%B8" title="बीके वाइरस – Hindi" lang="hi" hreflang="hi" data-title="बीके वाइरस" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Poliomavirus_BK" title="Poliomavirus BK – Italian" lang="it" hreflang="it" data-title="Poliomavirus BK" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/BK_virus" title="BK virus – Hebrew" lang="he" hreflang="he" data-title="BK virus" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D9%81%D9%8A%D8%B1%D9%88%D8%B3_%D8%A7%D9%84%D8%A8%D9%89_%D9%83%D9%8A%D9%87" title="فيروس البى كيه – Egyptian Arabic" lang="arz" hreflang="arz" data-title="فيروس البى كيه" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/BK%E3%82%A6%E3%82%A4%E3%83%AB%E3%82%B9" title="BKウイルス – Japanese" lang="ja" hreflang="ja" data-title="BKウイルス" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/V%C3%ADrus_BK" title="Vírus BK – Portuguese" lang="pt" hreflang="pt" data-title="Vírus BK" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/BK-virus" title="BK-virus – Swedish" lang="sv" hreflang="sv" data-title="BK-virus" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tr 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id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Member of the polyomavirus family</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">BK virus</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span typeof="mw:File"><a href="/wiki/File:Decoy_cell_cytology.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Decoy_cell_cytology.png/200px-Decoy_cell_cytology.png" decoding="async" width="200" height="115" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Decoy_cell_cytology.png/300px-Decoy_cell_cytology.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Decoy_cell_cytology.png/400px-Decoy_cell_cytology.png 2x" data-file-width="939" data-file-height="541" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Cytology" class="mw-redirect" title="Cytology">Cytology</a> of a polyomavirus infected cell, using <a href="/wiki/Papanicolaou_stain" title="Papanicolaou stain">Papanicolaou stain</a>. The high nuclear to cytoplasmic ratio makes it resemble <a href="/wiki/Cancer" title="Cancer">cancer</a> (thus the name "<a href="/wiki/Decoy_cell" class="mw-redirect" title="Decoy cell">decoy cell</a>") but the inclusion body reveals its viral pathophysiology.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_speciality)" class="mw-redirect" title="Infectious disease (medical speciality)">Infectious disease</a></td></tr></tbody></table> <p>The <b>BK virus</b>, also known as <b>Human polyomavirus 1</b>, is a member of the <a href="/wiki/Polyomavirus" class="mw-redirect" title="Polyomavirus">polyomavirus</a> family. Past infection with the BK virus is widespread,<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> but significant consequences of infection are uncommon, with the exception of the <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immunocompromised</a> and the <a href="/wiki/Immunosuppression" title="Immunosuppression">immunosuppressed</a>. BK virus is an abbreviation of the name of the first patient, from whom the virus was isolated in 1971. This patient - a male - was then 39 years old, who had developed constriction of the ureter after a renal transplant.<sup id="cite_ref-Pahari_2003_2-0" class="reference"><a href="#cite_note-Pahari_2003-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The BK virus rarely causes disease but is typically associated with patients who have had a kidney transplant; many people who are infected with this virus are <a href="/wiki/Asymptomatic" title="Asymptomatic">asymptomatic</a>. If symptoms do appear, they tend to be mild: respiratory infection or fever. These are known as primary BK infections. Although without any clinical symptoms, footprints of BK virus have been detected in specimens from females affected by spontaneous abortion.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Serum antibodies against BK virus have also been found in spontaneous abortion affected women as well as in women who underwent voluntary interruption of pregnancy.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>The virus then disseminates to the kidneys and urinary tract where it persists for the life of the individual. It is thought that up to 80% of the population contains a latent form of this virus, which remains latent until the body undergoes some form of immunosuppression. Typically, this is in the setting of <a href="/wiki/Kidney_transplantation" title="Kidney transplantation">kidney transplantation</a> or multi-organ transplantation.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Presentation in these immunocompromised individuals is much more severe. Clinical manifestations include renal dysfunction (seen by a progressive rise in serum creatinine), and an abnormal urinalysis revealing renal tubular cells and inflammatory cells.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=2" title="Edit section: Cause"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <table class="infobox biota" style="text-align: left; width: 200px; font-size: 100%"> <tbody><tr> <th colspan="2" style="color:inherit; text-align: center; background-color: rgb(250,250,190)"><i>Human polyomavirus 1</i> </th></tr> <tr> <th colspan="2" style="color:inherit; min-width:15em; text-align: center; background-color: rgb(250,250,190)"><a href="/wiki/Virus_classification" title="Virus classification">Virus classification</a> <span class="plainlinks taxobox-edit-taxonomy skin-invert" style="font-size:smaller; float:right; padding-right:0.4em; margin-left:-3em;"><span typeof="mw:File"><a href="/wiki/Template:Taxonomy/Betapolyomavirus" title="Edit this classification"><img alt="Edit this classification" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/OOjs_UI_icon_edit-ltr.svg/15px-OOjs_UI_icon_edit-ltr.svg.png" decoding="async" width="15" height="15" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/8a/OOjs_UI_icon_edit-ltr.svg/23px-OOjs_UI_icon_edit-ltr.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/8a/OOjs_UI_icon_edit-ltr.svg/30px-OOjs_UI_icon_edit-ltr.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span> </th></tr> <tr> <td>(unranked): </td> <td><a href="/wiki/Virus" title="Virus">Virus</a> </td></tr> <tr> <td><i>Realm</i>: </td> <td><a href="/wiki/Monodnaviria" title="Monodnaviria"><i>Monodnaviria</i></a> </td></tr> <tr> <td>Kingdom: </td> <td><a href="/wiki/Shotokuvirae" title="Shotokuvirae"><i>Shotokuvirae</i></a> </td></tr> <tr> <td>Phylum: </td> <td><a href="/wiki/Cossaviricota" title="Cossaviricota"><i>Cossaviricota</i></a> </td></tr> <tr> <td>Class: </td> <td><a href="/wiki/Papovaviricetes" title="Papovaviricetes"><i>Papovaviricetes</i></a> </td></tr> <tr> <td>Order: </td> <td><a href="/wiki/Polyomaviridae" title="Polyomaviridae"><i>Sepolyvirales</i></a> </td></tr> <tr> <td>Family: </td> <td><a href="/wiki/Polyomaviridae" title="Polyomaviridae"><i>Polyomaviridae</i></a> </td></tr> <tr> <td>Genus: </td> <td><a href="/w/index.php?title=Betapolyomavirus&action=edit&redlink=1" class="new" title="Betapolyomavirus (page does not exist)"><i>Betapolyomavirus</i></a> </td></tr> <tr> <td>Species: </td> <td><div style="display:inline" class="species"><i><b>Human polyomavirus 1</b></i></div> </td></tr> <tr> <th colspan="2" style="color:inherit; text-align: center; background-color: rgb(250,250,190)"><a href="/wiki/Synonym_(taxonomy)" title="Synonym (taxonomy)">Synonyms</a> </th></tr> <tr> <td colspan="2" style="text-align: left"> <ul><li>BK polyomavirus</li> <li>BK virus</li></ul> </td></tr> </tbody></table><style data-mw-deduplicate="TemplateStyles:r1238732961">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox.biota tr{background:transparent!important}html.skin-theme-clientpref-night .mw-parser-output .infobox.biota img{background:transparent}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox.biota tr{background:transparent!important}html.skin-theme-clientpref-os .mw-parser-output .infobox.biota img{background:white}}.mw-parser-output .infobox.biota .taxobox-edit-taxonomy img{background:transparent!important}body.skin-vector .mw-parser-output table.biota.infobox{margin-top:0.5em}body.skin--responsive .mw-parser-output table.biota.infobox tr.taxonrow td{padding:2px 10px}</style> <div class="mw-heading mw-heading3"><h3 id="Transmission">Transmission</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=3" title="Edit section: Transmission"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It is not known how this virus is transmitted, except that it spreads from person to person, and not from an animal source. It has been suggested that this virus may be transmitted through respiratory fluids or urine, since infected individuals periodically excrete virus in the urine. A survey of 400 healthy <a href="/wiki/Blood_donor" class="mw-redirect" title="Blood donor">blood donors</a> was reported as showing that 82% were positive for <a href="/wiki/Immunoglobulin_G" title="Immunoglobulin G">IgG</a> against BK virus.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Risk_factors">Risk factors</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=4" title="Edit section: Risk factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In some <a href="/wiki/Renal_transplant" class="mw-redirect" title="Renal transplant">renal transplant</a> patients, the necessary use of <a href="/wiki/Immunosuppressive_drug" title="Immunosuppressive drug">immunosuppressive drugs</a> has the side-effect of allowing the virus to replicate within the graft, a disease called BK <a href="/wiki/Nephropathy" class="mw-redirect" title="Nephropathy">nephropathy</a>.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> From 1–10% of renal transplant patients progress to BK virus associated nephropathy (BKVAN) and up to 80% of these patients lose their grafts. The onset of nephritis can occur as early as several days post-transplant to as late as 5 years.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2022)">citation needed</span></a></i>]</sup> </p><p>It is also associated with <a href="/wiki/Ureteral_stenosis" class="mw-redirect" title="Ureteral stenosis">ureteral stenosis</a> and interstitial <a href="/wiki/Nephritis" title="Nephritis">nephritis</a>. In <a href="/wiki/Bone_marrow_transplant" class="mw-redirect" title="Bone marrow transplant">bone marrow transplant</a> recipients it is notable as a cause for <a href="/wiki/Hemorrhagic_cystitis" title="Hemorrhagic cystitis">hemorrhagic cystitis</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2022)">citation needed</span></a></i>]</sup> </p><p>BK viremia load > 185 000 copies/ml at the time of first positive BKV diagnosis – to be the strongest predictor for BKVAN (97% specificity and 75% sensitivity). In addition the BKV peak viral loads in blood reaching 223 000 copies/ml at any time was found to be predictive for BKVAN (91% specificity and 88% sensitivity) .<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The monitoring for BK viremia and BK virurea should be started immediately after transplantation. This helps in reduction of <a href="/wiki/Immunosuppression" title="Immunosuppression">immunosuppression</a> at the earliest possible time - a good preventive measure for BKVAN.<sup id="cite_ref-Wajih2024_9-0" class="reference"><a href="#cite_note-Wajih2024-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=5" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Polyomavirus.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/33/Polyomavirus.jpg/170px-Polyomavirus.jpg" decoding="async" width="170" height="122" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/33/Polyomavirus.jpg/255px-Polyomavirus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/33/Polyomavirus.jpg/340px-Polyomavirus.jpg 2x" data-file-width="2419" data-file-height="1738" /></a><figcaption><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> showing a polyomavirus infected cell – large (blue) cell below-center-left. Urine cytology specimen.</figcaption></figure> <p>This virus can be diagnosed by a BKV blood test or a urine test for <a href="/wiki/Decoy_cells" title="Decoy cells">decoy cells</a>, in addition to carrying out a biopsy in the kidneys. PCR techniques are often carried out to identify the virus.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=6" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The cornerstone of therapy is reduction in immunosuppression. A recent surge in BKVAN correlates with use of potent <a href="/wiki/Immunosuppressant_drug" class="mw-redirect" title="Immunosuppressant drug">immunosuppressant drugs</a>, such as <a href="/wiki/Tacrolimus" title="Tacrolimus">tacrolimus</a> and <a href="/wiki/Mycophenolate_mofetil" class="mw-redirect" title="Mycophenolate mofetil">mycophenolate mofetil</a> (MMF). Studies have not shown any correlation between BKVAN and a single immunosuppressive agent but rather the overall immunosuppressive load.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2022)">citation needed</span></a></i>]</sup> </p> <ul><li>No guidelines or drug levels and doses exist for proper reduction of immunosuppressants in BKVAN</li> <li>Most common methods:</li></ul> <ol><li>Withdrawal of MMF or tacrolimus</li> <li>Replacement of tacrolimus by cyclosporine</li> <li>Overall reduction of immunosuppressive load</li> <li>Some cyclosporine trough levels reported to be reduced to 100–150 ng/ml and tacrolimus levels reduced to 3–5 ng/ml</li></ol> <ul><li>Retrospective analysis of 67 patients concluded graft survival was similar between reduction and discontinuation of agents.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2010)">citation needed</span></a></i>]</sup></li> <li>Single center study showed renal allografts were preserved in 8/8 individuals managed with reduction in immunosuppression while graft loss occurred in 8/12 patients treated with an increase in therapy for what was thought to be organ rejection.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2010)">citation needed</span></a></i>]</sup></li></ul> <p>Other therapeutic options include <a href="/wiki/Leflunomide" title="Leflunomide">Leflunomide</a>, <a href="/wiki/Cidofovir" title="Cidofovir">Cidofovir</a>, <a href="/wiki/Intravenous_immunoglobulin" class="mw-redirect" title="Intravenous immunoglobulin">IVIG</a>, and the <a href="/wiki/Fluoroquinolone" class="mw-redirect" title="Fluoroquinolone">fluoroquinolones</a>. Leflunomide, a <a href="/wiki/Pyrimidine_synthesis_inhibitor" class="mw-redirect" title="Pyrimidine synthesis inhibitor">pyrimidine synthesis inhibitor</a> is now generally accepted as the second treatment option behind reduction of immunosuppression.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Leflunomide_in_BKVAN">Leflunomide in BKVAN</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=7" title="Edit section: Leflunomide in BKVAN"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The rationale behind using <a href="/wiki/Leflunomide" title="Leflunomide">leflunomide</a> in BKVAN comes from its combined immunosuppressive and antiviral properties. Two studies consisting of 26 and 17 patients who developed BKVAN on a three-drug regimen of tacrolimus, MMF, and steroids had their MMF replaced with leflunomide 20–60 mg daily. 84 and 88% of patients, respectively had clearance or a progressive reduction in viral load and a stabilization or improvement of graft function (7).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2010)">citation needed</span></a></i>]</sup> In a study conducted by Teschner et al. in 2009, 12/13 patients who had their MMF exchanged with leflunomide cleared the virus by 109 days. In a case series, there was improvement or stabilization in 23/26 patients with BKVAN after switching MMF to leflunomide.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2010)">citation needed</span></a></i>]</sup> </p><p>There are no dosing guidelines for leflunomide in BKVAN. Patient to patient variability has made dosing and monitoring of leflunomide extremely difficult. </p> <ul><li>Study of 26 and 17 patients were dosed between 20 mg/day and 60 mg/day with trough levels of 50—100 μg/ml. Failure was seen in patients with leflunomide plasma levels < 40 μg/ml.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2010)">citation needed</span></a></i>]</sup></li> <li>One study of 21 patients found that low levels (< 40 μg/ml) and high levels (> 40 μg/ml) had similar effects on the rate of viral clearance. Those with higher levels had more adverse events (hematologic, hepatic).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2010)">citation needed</span></a></i>]</sup></li> <li>In the study by Teschner et al., dosages and drug concentration showed no correlation with substantial variation from person to person.</li> <li>In the Teschner study, low drug concentrations were associated with decrease in viral load. This makes it difficult to determine whether or not reduction of viral load or addition of leflunomide was the cause for viral clearance.</li></ul> <div class="mw-heading mw-heading3"><h3 id="Other_treatment_options">Other treatment options</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=8" title="Edit section: Other treatment options"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Quinolone_antibiotic" title="Quinolone antibiotic">Quinolone antibiotics</a>: Ciprofloxacin (Cipro) was shown to significantly lower viral loads but no data on survival and graft loss exist.</li> <li><a href="/wiki/Intravenous_immunoglobulin" class="mw-redirect" title="Intravenous immunoglobulin">Intravenous immunoglobulin</a> (IVIG) has use in the treatment of infection and allograft rejection – hard to distinguish<sup class="noprint Inline-Template" style="margin-left:0.1em; white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Please_clarify" title="Wikipedia:Please clarify"><span title="The text near this tag may need clarification or removal of jargon. (November 2010)">clarification needed</span></a></i>]</sup></li> <li><a href="/wiki/Cidofovir" title="Cidofovir">Cidofovir</a> has limited data and is highly nephrotoxic.</li></ul> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=9" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The BK virus was first isolated in 1971 from the urine of a renal transplant patient, initials B.K.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> The BK virus is similar to another virus called the <a href="/wiki/JC_virus" class="mw-redirect" title="JC virus">JC virus</a> (JCV), since their genomes share 75% sequence similarity. Both of these viruses can be identified and differentiated from each other by carrying out serological tests using specific antibodies or by using a <a href="/wiki/Polymerase_chain_reaction" title="Polymerase chain reaction">PCR</a>-based genotyping approach.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Virology">Virology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=10" title="Edit section: Virology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Virus_structure">Virus structure</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=11" title="Edit section: Virus structure"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Similarly to <a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">JC virus</a> and <a href="/wiki/SV40" title="SV40">SV40</a>, BK virus has a small, non-<a href="/wiki/Viral_envelope" title="Viral envelope">enveloped</a>, icosahedral <a href="/wiki/Capsid" title="Capsid">capsid</a> with a diameter of 45–50 nm.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> The capsid is made up of viral <a href="/wiki/Protein" title="Protein">proteins</a> VP1, VP2, and VP3. The capsid proteins have T=7 arrangement. The icosahedral structure contains 72 pentamers of the major capsid protein VP1, 360 molecules in total. Each penton is bound the <a href="/wiki/Minor_capsid_proteins_VP2_and_VP3" title="Minor capsid proteins VP2 and VP3">minor capsid proteins VP2 or VP3</a> on the inside of the virus while VP1 protein shell is on the outside.<sup id="cite_ref-:0_13-0" class="reference"><a href="#cite_note-:0-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Genome">Genome</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=12" title="Edit section: Genome"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>BKV <a href="/wiki/Genome" title="Genome">genome</a> is approximately 5,000bp long and can vary depending on non-coding control region.The genome is compacted by cellular <a href="/wiki/Histone" title="Histone">histone</a> proteins H2A, H2B, H3 and H4, forming a structure termed "minichromosome" due to being <a href="/wiki/Chromatin" title="Chromatin">chromatin</a>-like. </p><p>The genome is divided into <a href="/wiki/Viral_replication" title="Viral replication">early coding region</a>, late coding region and non-coding control region (NCCR). Transcription from <a href="/wiki/Origin_of_replication" title="Origin of replication">ORI</a> site produces mRNA coding the early, functional proteins, known as small and large <a href="/wiki/SV40_large_T_antigen" title="SV40 large T antigen">T antigens</a>, (sTAg and LTAg). These proteins function in viral DNA replication and cell cycle progression, by promoting <a href="/wiki/S_phase" title="S phase">S phase</a> in the host cell. The late transcript codes for structural proteins VP1, VP2, and VP3 and functional protein known as <a href="/wiki/Agnoprotein" title="Agnoprotein">agnoprotein</a>.<sup id="cite_ref-:0_13-1" class="reference"><a href="#cite_note-:0-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Archetype_and_rearranged_virus_forms"><i>Archetype</i> and <i>rearranged</i> virus forms</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=13" title="Edit section: Archetype and rearranged virus forms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Non-coding_control_region_blocks_of_BK_polyomavirus.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f9/Non-coding_control_region_blocks_of_BK_polyomavirus.png/220px-Non-coding_control_region_blocks_of_BK_polyomavirus.png" decoding="async" width="220" height="73" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f9/Non-coding_control_region_blocks_of_BK_polyomavirus.png/330px-Non-coding_control_region_blocks_of_BK_polyomavirus.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f9/Non-coding_control_region_blocks_of_BK_polyomavirus.png/440px-Non-coding_control_region_blocks_of_BK_polyomavirus.png 2x" data-file-width="4206" data-file-height="1396" /></a><figcaption>Different viral forms based on NCCR sequence variant (archetype or rearranged). The NCCR contains O,P,Q,R,S blocks and their variations.</figcaption></figure> <p>Non-coding control region (NCCR) is prone to variation by <a href="/wiki/Mutation" title="Mutation">DNA rearrangements</a>. The most common and transmissible (<a href="/wiki/Wild_type" title="Wild type">wild-type</a>) form based on NCCR region is called <i>Archetype</i> and has five sequence blocks (O-P-Q-R-S). <i>Rearranged</i> virus can have <a href="/wiki/Deletion_(genetics)" title="Deletion (genetics)">deletions</a>, <a href="/wiki/Insertion_(genetics)" title="Insertion (genetics)">insertions</a> or other types of <a href="/wiki/Mutation" title="Mutation">mutations</a> that lead to variation in the P-Q-R-S blocks.<sup id="cite_ref-:1_14-0" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Some viruses can have deletions and insertions of several blocks, as is the case with the Dunlop strain (O-P-P-P-S).<sup id="cite_ref-:0_13-2" class="reference"><a href="#cite_note-:0-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Rearrangement of <i>archetype</i> frequently arises in cell cultures and in patients. Certain rearranged variants can lead to much higher viral replication compared to <i>archetype.</i><sup id="cite_ref-:2_15-0" class="reference"><a href="#cite_note-:2-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> This is thought to be due to enhanced promoter activity and high levels of early mRNA expression.<sup id="cite_ref-:3_16-0" class="reference"><a href="#cite_note-:3-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Genotypes_and_subtypes">Genotypes and subtypes</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=14" title="Edit section: Genotypes and subtypes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Based on <a href="/wiki/Nucleic_acid_sequence" title="Nucleic acid sequence">DNA sequence</a> variation, BKV is categorized into four genotypes (I, II, III, IV) which are further divided into subtypes (Ia, Ib1, Ib2, Ic, and IVa1, IVa2, IVb1, IVb2, IVc1, IVc2).<sup id="cite_ref-:1_14-1" class="reference"><a href="#cite_note-:1-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Genotype I is found wordwide, while other genotypes are geographically distributed.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Replication_cycle">Replication cycle</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=15" title="Edit section: Replication cycle"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>BK virus enters the <a href="/wiki/Host_(biology)" title="Host (biology)">host</a> cells by <a href="/wiki/Caveolae" title="Caveolae">caveolae</a>-mediated <a href="/wiki/Endocytosis" title="Endocytosis">endocytic</a> pathway.<sup id="cite_ref-:0_13-3" class="reference"><a href="#cite_note-:0-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> The viral protein VP1 binds to α2-8-linked disialic acid motifs on <a href="/wiki/Ganglioside" title="Ganglioside">gangliosides</a> GD1b and GT1b on cell membranes. After caveola-mediated endocytosis, the virus capsid is uncoated while VP2 and VP3 mediate the entry of BKV into the nucleus. BKV genome is episomal and does not integrate into host DNA under normal conditions. </p><p>The early coding region is transcribed first to make functional proteins LTAg and sTAg. These proteins accumulate in the nucleus and facilitate the replication of viral DNA. LTAg binds to the late coding region, acting as a <a href="/wiki/Helicase" title="Helicase">helicase</a> to facilitate the transcription of proteins coded on the late region. The capsid proteins VP1-3 are produced in the cytoplasm and later recruited to the nucleus in order to assemble new virus particles. </p><p>One additional transmission and uptake route between cells is via <a href="/wiki/Extracellular_vesicle" title="Extracellular vesicle">extracellular vesicles</a>. The virus can transfer viral components or even infectious particles between cells using cellular secretory system by utilizing extracellular vesicles.<sup id="cite_ref-:2_15-1" class="reference"><a href="#cite_note-:2-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Tissue_tropism">Tissue tropism</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=16" title="Edit section: Tissue tropism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>BK virus has a wide spectrum of tissue and cell type tropism. The virus is detected in urinary tract system, salivary gland cells, peripheral blood leukocytes, pancreatic cells, vascular endothelial cells.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> BKV has been identified in upper respiratory tract and tonsils as well as in fetus cells.<sup id="cite_ref-:0_13-4" class="reference"><a href="#cite_note-:0-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Viral_latency">Viral latency</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=17" title="Edit section: Viral latency"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>BK virus infection is self-limiting and is known to establish lifelong <a href="/wiki/Virus_latency" title="Virus latency">latent</a> infection in the <a href="/wiki/Urinary_system" title="Urinary system">urinary system</a>. The mechanism of how the virus establishes latency is not fully understood. Therefore, it is not known if BKV stays latent in the cells or maintains low level replication with persistent infection. The viral ability to establish latency in <a href="/wiki/Nephron" title="Nephron">renal tubule</a> or urothelium cells in healthy <a href="/wiki/Host_(biology)" title="Host (biology)">hosts</a> can be detrimental in <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immunocompromised</a> host due to viral reactivation. Viral reactivation is common in <a href="/wiki/Kidney_transplantation" title="Kidney transplantation">kidney transplant</a> recipients, <a href="/wiki/Hematopoietic_stem_cell_transplantation" title="Hematopoietic stem cell transplantation">hematopoietic stem cell transplantation recipients</a> and <a href="/wiki/HIV/AIDS" title="HIV/AIDS">HIV/AIDS</a> patients.<sup id="cite_ref-:0_13-5" class="reference"><a href="#cite_note-:0-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Most often, the persistent infection is explained by innate and adaptive immune regulation. Another mechanism on how the virus can be self-limiting is by using <a href="/wiki/MicroRNA" title="MicroRNA">microRNA</a> and targeting the DNA sequence of the functional protein Large T antigen. This miRNA is transcribed during the late viral phase and is believed to effectively limit the <i>archetype</i> virus form.<sup id="cite_ref-:2_15-2" class="reference"><a href="#cite_note-:2-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> Additionally, both <a href="/wiki/Agnoprotein" title="Agnoprotein">agnoprotein</a> and <a href="/wiki/Small_tumor_antigen" title="Small tumor antigen">small T antigen</a> can have a role in latency by impairing the innate immune signalling. Specifically, agnoprotein is known to impair IRF3 nuclear translocation and induce mitochondrial fragementation. Small T antigen can interact with a cellular enzyme <a href="/wiki/Protein_phosphatase_2A" title="Protein phosphatase 2A">protein phosphatase 2A</a> which interferes with cell cycle progression.<sup id="cite_ref-:3_16-1" class="reference"><a href="#cite_note-:3-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=18" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/w/index.php?title=BK_polyomavirus-associated_diseases&action=edit&redlink=1" class="new" title="BK polyomavirus-associated diseases (page does not exist)">BK polyomavirus-associated diseases</a></li> <li><a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">JC polyomavirus</a></li> <li><a href="/wiki/Decoy_cells" title="Decoy cells">Decoy cells</a></li> <li><a href="/wiki/Low-dose_naltrexone" title="Low-dose naltrexone">Low-dose naltrexone</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=19" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFTagliapietraRotondoBononiMazzoni2019" class="citation journal cs1">Tagliapietra A, Rotondo JC, Bononi I, Mazzoni E, Magagnoli F, Maritati M, Contini C, Vesce F, Tognon M, Martini F (2019). <a rel="nofollow" class="external text" href="https://academic.oup.com/humrep/article-abstract/34/3/433/5259177?redirectedFrom=fulltext">"Footprints of BK and JC polyomaviruses in specimens from females affected by spontaneous abortion"</a>. <i>Hum Reprod</i>. <b>34</b> (3): 433–440. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fhumrep%2Fdey375">10.1093/humrep/dey375</a>. <a href="/wiki/Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/11392%2F2397214">11392/2397214</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30590693">30590693</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:58621197">58621197</a>.</cite><span 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</li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=BK_virus&action=edit&section=20" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output 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margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q582873" class="extiw" title="d:Q582873">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D027601">D027601</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb32797.htm">32797</a></li></ul></div></div></td></tr></tbody></table></div> <ul><li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20070127170936/http://www.viracor.com/diagnostic-virals-bk_overview.htm">Overview of the BK virus</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20070218145058/http://www.microbiologybytes.com/virology/Polyomaviruses.html">MicrobiologyBytes: Polyomaviruses</a></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFReploegStorchClifford2001" class="citation journal cs1">Reploeg MD, Storch GA, Clifford DB (July 2001). <a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F321813">"Bk virus: a clinical review"</a>. <i>Clin. Infect. Dis</i>. <b>33</b> (2): 191–202. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1086%2F321813">10.1086/321813</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11418879">11418879</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clin.+Infect.+Dis.&rft.atitle=Bk+virus%3A+a+clinical+review&rft.volume=33&rft.issue=2&rft.pages=191-202&rft.date=2001-07&rft_id=info%3Adoi%2F10.1086%2F321813&rft_id=info%3Apmid%2F11418879&rft.aulast=Reploeg&rft.aufirst=MD&rft.au=Storch%2C+GA&rft.au=Clifford%2C+DB&rft_id=https%3A%2F%2Fdoi.org%2F10.1086%252F321813&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABK+virus" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1600-6135.2004.00730.x">"BK virus"</a>. <i>Am. J. Transplant</i>. <b>4</b> (Suppl 10): 89–91. November 2004. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1600-6135.2004.00730.x">10.1111/j.1600-6135.2004.00730.x</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15504220">15504220</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:30891138">30891138</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Am.+J.+Transplant.&rft.atitle=BK+virus&rft.volume=4&rft.issue=Suppl+10&rft.pages=89-91&rft.date=2004-11&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A30891138%23id-name%3DS2CID&rft_id=info%3Apmid%2F15504220&rft_id=info%3Adoi%2F10.1111%2Fj.1600-6135.2004.00730.x&rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fj.1600-6135.2004.00730.x&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABK+virus" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBlanckaertDe_Vriese2006" class="citation journal cs1">Blanckaert K, De Vriese AS (December 2006). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fndt%2Fgfl404">"Current recommendations for diagnosis and management of polyoma BK virus nephropathy in renal transplant recipients"</a>. <i>Nephrol. Dial. Transplant</i>. <b>21</b> (12): 3364–7. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fndt%2Fgfl404">10.1093/ndt/gfl404</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16998219">16998219</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nephrol.+Dial.+Transplant.&rft.atitle=Current+recommendations+for+diagnosis+and+management+of+polyoma+BK+virus+nephropathy+in+renal+transplant+recipients&rft.volume=21&rft.issue=12&rft.pages=3364-7&rft.date=2006-12&rft_id=info%3Adoi%2F10.1093%2Fndt%2Fgfl404&rft_id=info%3Apmid%2F16998219&rft.aulast=Blanckaert&rft.aufirst=K&rft.au=De+Vriese%2C+AS&rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Fndt%252Fgfl404&rfr_id=info%3Asid%2Fen.wikipedia.org%3ABK+virus" class="Z3988"></span></li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Human_polyomaviruses" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" 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id="Human_polyomaviruses" style="font-size:114%;margin:0 4em">Human <a href="/wiki/Polyomavirus" class="mw-redirect" title="Polyomavirus">polyomaviruses</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/BK_polyomavirus" class="mw-redirect" title="BK polyomavirus">BK polyomavirus</a></li> <li><a href="/wiki/JC_polyomavirus" class="mw-redirect" title="JC polyomavirus">JC polyomavirus</a></li> <li><a href="/wiki/KI_polyomavirus" title="KI polyomavirus">KI polyomavirus</a></li> <li><a href="/wiki/WU_polyomavirus" title="WU polyomavirus">WU polyomavirus</a></li> <li><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">Merkel cell polyomavirus</a></li> <li><a href="/wiki/Human_polyomavirus_6" title="Human polyomavirus 6">Human polyomavirus 6</a></li> <li><a href="/wiki/Human_polyomavirus_7" title="Human polyomavirus 7">Human polyomavirus 7</a></li> <li><a href="/wiki/Trichodysplasia_spinulosa_polyomavirus" title="Trichodysplasia spinulosa polyomavirus">Trichodysplasia spinulosa polyomavirus</a></li> <li><a href="/wiki/Human_polyomavirus_9" title="Human polyomavirus 9">Human polyomavirus 9</a></li> <li><a href="/wiki/MW_polyomavirus" title="MW polyomavirus">MW polyomavirus</a></li> <li><a href="/wiki/STL_polyomavirus" title="STL polyomavirus">STL polyomavirus</a></li> <li><a href="/wiki/Human_polyomavirus_12" class="mw-redirect" title="Human polyomavirus 12">Human polyomavirus 12</a></li> <li><a href="/wiki/New_Jersey_polyomavirus" title="New Jersey polyomavirus">New Jersey polyomavirus</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Infectious_diseases_–_viral_systemic_diseases" 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id="Infectious_diseases_–_viral_systemic_diseases" style="font-size:114%;margin:0 4em"><a href="/wiki/Infection" title="Infection">Infectious diseases</a> – <a href="/wiki/Viral_disease" title="Viral disease">viral systemic diseases</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oncovirus" title="Oncovirus">Oncovirus</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a></i> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd></dl></dd> <dd><i><a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV</a></i> <dl><dd><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></dd> <dd><a href="/wiki/Anal_cancer" title="Anal cancer">Anal cancer</a></dd> <dd><a href="/wiki/Penile_cancer" title="Penile cancer">Penile cancer</a></dd> <dd><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar cancer</a></dd> <dd><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal cancer</a></dd> <dd><a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">Oropharyngeal cancer</a></dd></dl></dd> <dd><i><a href="/wiki/Kaposi%27s_sarcoma-associated_herpesvirus" title="Kaposi's sarcoma-associated herpesvirus">KSHV</a></i> <dl><dd><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi's sarcoma">Kaposi's sarcoma</a></dd></dl></dd> <dd><i><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">EBV</a></i> <dl><dd><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">Nasopharyngeal carcinoma</a></dd> <dd><a href="/wiki/Burkitt%27s_lymphoma" class="mw-redirect" title="Burkitt's lymphoma">Burkitt's lymphoma</a></dd> <dd><a href="/wiki/Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a></dd> <dd><a href="/wiki/Follicular_dendritic_cell_sarcoma" title="Follicular dendritic cell sarcoma">Follicular dendritic cell sarcoma</a></dd> <dd><a href="/wiki/Extranodal_NK/T-cell_lymphoma,_nasal_type" title="Extranodal NK/T-cell lymphoma, nasal type">Extranodal NK/T-cell lymphoma, nasal type</a></dd></dl></dd> <dd><i><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">MCPyV</a></i> <dl><dd><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel-cell carcinoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a></i> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd> <dd><a href="/wiki/Splenic_marginal_zone_lymphoma" title="Splenic marginal zone lymphoma">Splenic marginal zone lymphoma</a></dd></dl></dd> <dd><i><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a></i> <dl><dd><a href="/wiki/Adult_T-cell_leukemia/lymphoma" title="Adult T-cell leukemia/lymphoma">Adult T-cell leukemia/lymphoma</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immune_disorder" title="Immune disorder">Immune disorders</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/HIV" title="HIV">HIV</a></i> <ul><li><a href="/wiki/HIV/AIDS" title="HIV/AIDS">AIDS</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Central_nervous_system_viral_disease" title="Central nervous system viral disease">Central<br /> nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Encephalitis</a>/<br /><a href="/wiki/Viral_meningitis" title="Viral meningitis">meningitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">Human polyomavirus 2</a></i> <dl><dd><a href="/wiki/Progressive_multifocal_leukoencephalopathy" title="Progressive multifocal leukoencephalopathy">Progressive multifocal leukoencephalopathy</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Measles_morbillivirus" class="mw-redirect" title="Measles morbillivirus">MeV</a></i> <dl><dd><a href="/wiki/Subacute_sclerosing_panencephalitis" title="Subacute sclerosing panencephalitis">Subacute sclerosing panencephalitis</a></dd></dl></dd> <dd><i><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">LCV</a></i> <dl><dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">Lymphocytic choriomeningitis</a></dd></dl></dd> <dd><a href="/wiki/Arbovirus_encephalitis" class="mw-redirect" title="Arbovirus encephalitis">Arbovirus encephalitis</a></dd> <dd><i><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></i> (probable) <dl><dd><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></dd></dl></dd> <dd><i><a href="/wiki/Rabies_virus" title="Rabies virus">RV</a></i> <dl><dd><a href="/wiki/Rabies" title="Rabies">Rabies</a></dd></dl></dd> <dd><a href="/wiki/Chandipura_vesiculovirus" title="Chandipura vesiculovirus">Chandipura vesiculovirus</a></dd> <dd><a href="/wiki/Herpesviral_meningitis" class="mw-redirect" title="Herpesviral meningitis">Herpesviral meningitis</a></dd> <dd><a href="/wiki/Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Myelitis" title="Myelitis">Myelitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Poliovirus" title="Poliovirus">Poliovirus</a></i> <ul><li><a href="/wiki/Polio" title="Polio">Poliomyelitis</a></li> <li><a href="/wiki/Post-polio_syndrome" title="Post-polio syndrome">Post-polio syndrome</a></li></ul></li> <li><i><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a></i> <ul><li><a href="/wiki/Tropical_spastic_paraparesis" title="Tropical spastic paraparesis">Tropical spastic paraparesis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eye_disease" title="Eye disease">Eye</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i> <ul><li><a href="/wiki/Cytomegalovirus_retinitis" title="Cytomegalovirus retinitis">Cytomegalovirus retinitis</a></li></ul></li> <li><i><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV</a></i> <ul><li><a href="/wiki/Herpes_simplex_keratitis" title="Herpes simplex keratitis">Herpes of the eye</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i> <ul><li><a href="/wiki/Pericarditis" title="Pericarditis">Pericarditis</a></li> <li><a href="/wiki/Myocarditis" title="Myocarditis">Myocarditis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_system" title="Respiratory system">Respiratory system</a>/<br /><a href="/wiki/Common_cold" title="Common cold">acute viral<br />nasopharyngitis</a>/<br /><a href="/wiki/Viral_pneumonia" title="Viral pneumonia">viral pneumonia</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a></i> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus_infection" title="Epstein–Barr virus infection">EBV infection</a>/<a href="/wiki/Infectious_mononucleosis" title="Infectious mononucleosis">Infectious mononucleosis</a></li></ul></li> <li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/RNA_virus#Group_IV_–_positive-sense_ssRNA_viruses" title="RNA virus">IV</a>: <i><a href="/wiki/Human_coronavirus" class="mw-redirect" title="Human coronavirus">Human coronavirus</a> <a href="/wiki/Human_coronavirus_229E" title="Human coronavirus 229E">229E</a>/<a href="/wiki/Human_coronavirus_NL63" title="Human coronavirus NL63">NL63</a>/<a href="/wiki/Human_coronavirus_HKU1" title="Human coronavirus HKU1">HKU1</a>/<a href="/wiki/Human_coronavirus_OC43" title="Human coronavirus OC43">OC43</a></i> <ul><li><a href="/wiki/Common_cold" title="Common cold">Common cold</a></li></ul></li> <li><i><a href="/wiki/Middle_East_respiratory_syndrome%E2%80%93related_coronavirus" class="mw-redirect" title="Middle East respiratory syndrome–related coronavirus">MERS coronavirus</a></i> <ul><li><a href="/wiki/Middle_East_respiratory_syndrome" class="mw-redirect" title="Middle East respiratory syndrome">Middle East respiratory syndrome</a></li></ul></li> <li><i><a href="/wiki/Severe_acute_respiratory_syndrome_coronavirus" class="mw-redirect" title="Severe acute respiratory syndrome coronavirus">SARS coronavirus</a></i> <ul><li><a href="/wiki/Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">Severe acute respiratory syndrome</a></li></ul></li> <li><i><a href="/wiki/SARS-CoV-2" title="SARS-CoV-2">SARS-CoV-2</a></i> <ul><li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a></li></ul></li></ul> <ul><li><a href="/wiki/RNA_virus#Group_V_–_negative-sense_ssRNA_viruses" title="RNA virus">V</a>, <i><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></i>: <i><a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza virus A</a>/<a href="/wiki/Influenza_B_virus" title="Influenza B virus">B</a>/<a href="/wiki/Influenza_C_virus" title="Influenza C virus">C</a>/<a href="/wiki/Influenza_D_virus" title="Influenza D virus">D</a></i> <ul><li><a href="/wiki/Influenza" title="Influenza">Influenza</a>/<a href="/wiki/Avian_influenza" title="Avian influenza">Avian influenza</a></li></ul></li></ul> <ul><li>V, <i><a href="/wiki/Paramyxoviridae" title="Paramyxoviridae">Paramyxoviridae</a></i>: <i><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Human parainfluenza viruses</a></i> <ul><li><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Parainfluenza</a></li></ul></li> <li><i><a href="/wiki/Human_orthopneumovirus" class="mw-redirect" title="Human orthopneumovirus">Human orthopneumovirus</a></i></li> <li><i><a href="/wiki/Human_metapneumovirus" title="Human metapneumovirus">hMPV</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_digestive_system" title="Human digestive system">Human<br /> digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pharynx" title="Pharynx">Pharynx</a>/<a href="/wiki/Esophagus" title="Esophagus">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a></i> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li> <li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i> <ul><li><a href="/wiki/Cytomegalovirus_esophagitis" title="Cytomegalovirus esophagitis">Cytomegalovirus esophagitis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastroenteritis#Viral" title="Gastroenteritis">Gastroenteritis</a>/<br /><a href="/wiki/Gastroenteritis#Virus" title="Gastroenteritis">diarrhea</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Adenoviridae" title="Adenoviridae">Adenovirus</a></i> <dl><dd><a href="/wiki/Adenovirus_infection" title="Adenovirus infection">Adenovirus infection</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Rotavirus" title="Rotavirus">Rotavirus</a></i> (<a href="/wiki/Rotaviral_gastroenteritis" class="mw-redirect" title="Rotaviral gastroenteritis">Gastroenteritis</a>)</dd> <dd><i><a href="/wiki/Norovirus" title="Norovirus">Norovirus</a></i></dd> <dd><i><a href="/wiki/Astrovirus" title="Astrovirus">Astrovirus</a></i></dd> <dd><i><a href="/wiki/Coronavirus" title="Coronavirus">Coronavirus</a></i></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Hepatitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a></i> (<a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>)</dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i></dd> <dd><i><a href="/wiki/Hepatitis_A#Virology" title="Hepatitis A">HAV</a></i> (<a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>)</dd> <dd><i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a></i> (<a href="/wiki/Hepatitis_C" title="Hepatitis C">C</a>)</dd> <dd><i><a href="/wiki/Hepatitis_D" title="Hepatitis D">HDV</a></i> (<a href="/wiki/Hepatitis_D" title="Hepatitis D">D</a>)</dd> <dd><i><a href="/wiki/Orthohepevirus_A" title="Orthohepevirus A">HEV</a></i> (<a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>)</dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a class="mw-selflink selflink">BK virus</a></i></li> <li><i><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a></i> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" 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style="white-space:nowrap;"><a href="/wiki/Wikispecies" title="Wikispecies">Wikispecies</a>: <span class="uid"><span class="external"><a href="https://species.wikimedia.org/wiki/Human_polyomavirus_1" class="extiw" title="wikispecies:Human polyomavirus 1">Human polyomavirus 1</a></span></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Catalogue_of_Life" title="Catalogue of Life">CoL</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.catalogueoflife.org/data/taxon/3MT8J">3MT8J</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Global_Biodiversity_Information_Facility" title="Global Biodiversity Information Facility">GBIF</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.gbif.org/species/9888794">9888794</a></span></span></li> <li><span style="white-space:nowrap;"><a href="/wiki/Interim_Register_of_Marine_and_Nonmarine_Genera" title="Interim Register of Marine and Nonmarine Genera">IRMNG</a>: <span class="uid"><a rel="nofollow" class="external text" href="https://www.irmng.org/aphia.php?p=taxdetails&id=11459158">11459158</a></span></span></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=BK_virus&oldid=1254258655">https://en.wikipedia.org/w/index.php?title=BK_virus&oldid=1254258655</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Category</a>: <ul><li><a href="/wiki/Category:Alphapolyomavirus" title="Category:Alphapolyomavirus">Alphapolyomavirus</a></li></ul></div><div id="mw-hidden-catlinks" class="mw-hidden-catlinks 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