BK virus infection is a concern particularly in which patient population?

• A. HIV infection
• B. Neonates
• C. Liver transplant recipients
• D. Renal transplant recipients

Answer: (D)

BK virus is a latent polyomavirus that resides in renal tubular cells after primary infection. It becomes a problem when cellular immunity is suppressed, such as after organ transplantation. In kidney transplant recipients, reactivation of BK virus can cause BK nephropathy, leading to inflammation of the kidney and potential graft loss. This direct impact on the transplanted kidney makes renal transplant patients the group most at risk. While BK virus reactivation can occur in other severely immunosuppressed states (like HIV), the strongest clinical concern and typical presentation are in those receiving renal transplants, where the virus targets the kidney itself. Neonates don’t usually develop clinically significant BK disease, and liver transplant recipients are less affected because the BK nephropathy pathology centers on the kidney. Managing this involves careful adjustment of immunosuppression and monitoring for BK viremia, as there isn’t a universally curative antiviral therapy.