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BK Virus Quantitation, Urine

BKV, Polyomavirus, BK Virus Associated Nephropathy (BKVAN), Hemorrhagic Cystitis, Ureteral Stenosis, Renal Allograft, BK Virus, Urine Quantitative by Real-Time PCR

Test Codes

EPIC: LAB6407, Beaker: IUBKG

Department

Molecular Pathology

Specimen Collection Criteria

Collect: 2.0 mL random or mid-stream urine in a screw-capped container (preferred) or other sterile collection container without preservatives. (Minimum: 0.5 mL)

Physician Office/Draw Specimen Preparation

Preparation for Courier Transport

Transport: Urine in a sterile collection cup, refrigerated (2-8°C or 36-46°F) or frozen (-20°C/-4°F or below). (Minimum: 0.5 mL)

Rejection Criteria

• Specimens collected into containers with preservatives.
• Specimens subjected to freezing and thawing.
• Specimens maintained at room temperature for greater than 24 hours prior to being received in the Laboratory.
• Grossly bloody (intact red blood cells or hemolyzed), or grossly icteric (bilirubin) specimens may yield erroneous results and are discouraged from be submitted for analysis. Rejection of these specimens is under the discretion of the Medical Director.

In-Lab Processing

All specimens must remain frozen (-20°C /-4°F or below) until analysis.

Storage

Laboratory

Royal Oak Clinical Molecular Pathology Laboratory

Performed

Tuesday, Friday.
Results available within 24 hours.

Reference Range

Reportable Range: 500-5,000,000,000 copies/mL.

Test Methodology

Quantitative Real-Time Polymerase Chain Reaction (qPCR).

Clinical Utility

• BK polyoma virus is one of several members of the Papovaviridae family, which consists of small, non-enveloped viruses with a covalently closed, circular, dsDNA genome, surrounded by an icosahedral capsid composed of 72 capsomeres. Approximately 60% to 80% of adults in the U.S. and Europe have antibodies to BK virus, with the majority of asymptomatic infections occurring within the first 5 years of life. During initial infection, it is thought that viremia results in dissemination to the kidney, the site of viral latency.
  
• BK virus is a major cause of nephropathy (BK Virus Associated-Nephropathy: BKVAN) in renal allograft patients, affecting up to 8% of kidney transplants; resulting in renal loss in approximately 50% of untreated patients. Patients at risk for BKVAN, benefit from the early detection and management of their BKV viral load to prevent the progressive deterioration of graft function and more importantly graft loss.
  
• BK virus has also been associated with hemorrhagic cystitis in bone marrow transplant patients, as well as ureteral ulceration and stenosis in renal transplant patients.
  
• Effective pharmacologic management of BK virus resides in the ability to fine-tune immunosuppressive therapy to the point that BK virus associated complications are minimized without jeopardizing the life of the renal allograft. As such, it is imperative to quantitatively assess the viral load of BK virus in urine and serum.

Reference

1. Demeter LM. JC, BK, and Other Polyomaviruses; Progressive Multifocal Leukoencephalopathy, In Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 6th Ed, Chapter 141, pp:1856-1863.
2. Drachenberg, R.C., et al, 2001. Morphological spectrum of polyoma virus disease in renal allografts: Diagnostic accuracy of urine cytology. Am. J. Transplant. 1, 373-381.
3. Drachenberg, C.B., et al., 2004. Improved outcome of polyoma virus allograft nephropathy with early biopsy. Transplant Proc. 36, 758-759.
4. Nickeleit, V., et al., 2000. Testing for polyomavirus type BK DNA in plasma to identify renal-allograft recipients with viral nephropathy. N. England J. Med. 342, 1309-1315.
5. Randhawa, P.S., et al., 2002. Quantitation of viral DNA in renal allograft tissue from patients with BK virus nephropathy. Transplantation. 74, 485-488.

CPT Codes

87799
LOINC: 43201-3

Contacts

Last Updated

10/7/2023