Tuesday, November 12, 2013

Is BK Virus oncogenic?

EBV virus has been associated with PTLD and many other viruses have oncogenic potential. Does a common urological virus such as BK have oncogenic potential in our transplant patients?    
Given its predilection to lower GU tract, cancers of bladder have been reported with BK( just case reports). In the tumor cells, it is possible to detect fragments of the viral genome that could alter the control mechanisms of the cell cycle and DNA repair.

Besides the correlation between BKVN and graft failure, a small number of case reports suggest an association between BKV infection and the development of renal and bladder cancers in renal transplant recipients. Indeed, for more than 30 years, an oncogenic potential of BKV has been observed in vitro and in animal models. In humans, however, the implication of BKV in tumor development is still unclear.

A table in a recent publication summarizes some of the cases.

Interestingly, Lithium has been associated with collecting duct carcinomas due to the mode of it’s action. At ASN this year, the pathologist presented a case of collecting duct cancer in a transplanted kidney in  a patient who was on Lithium and had persistent BK nephropathy. The biopsy showed a tumor burden as well significant BK virus staining. Talk about second hits!

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