From the Guidelines
BKV DNA PCR is a laboratory test that detects and quantifies BK virus (BKV) DNA using polymerase chain reaction (PCR) technology, primarily used to diagnose and monitor BK virus infections in immunocompromised patients, such as transplant recipients. This test is crucial in identifying the presence of the virus and measuring its concentration in patient samples, typically blood or urine. According to the American Society of Transplantation recommendations 1, BK virus infection can be defined as a quantitative BK viral DNA load in blood or urine above the detection threshold for the given laboratory’s assay. The test results are typically reported as copies per milliliter, with higher values indicating greater viral load and potentially more severe infection.
The importance of BKV DNA PCR lies in its ability to detect viral reactivation early, allowing for timely intervention such as reducing immunosuppression or initiating antiviral strategies before significant organ damage occurs. As suggested by the KDIGO clinical practice guideline for the care of kidney transplant recipients 1, screening for BKV with quantitative plasma NAT is recommended at least monthly for the first 3–6 months after transplantation, then every 3 months until the end of the first post-transplant year, and whenever there is an unexplained rise in serum creatinine.
Key points to consider when interpreting BKV DNA PCR results include:
- The test detects and quantifies BK virus DNA in patient samples
- Results are reported as copies per milliliter, with higher values indicating greater viral load
- Regular monitoring helps detect viral reactivation early, allowing for timely intervention
- Reducing immunosuppressive medications is suggested when BKV plasma NAT is persistently greater than 10,000 copies/ml 1
- The test is primarily used to diagnose and monitor BK virus infections in immunocompromised patients, such as transplant recipients.
From the Research
Definition of BKV DNA PCR
- BKV DNA PCR refers to a laboratory test used to detect the presence of BK virus (BKV) DNA in clinical specimens, such as blood, urine, or tissue samples 2, 3, 4.
- The test uses polymerase chain reaction (PCR) technology to amplify and quantify the BKV DNA, allowing for the detection of the virus even at low levels 2, 3.
Purpose of BKV DNA PCR
- The primary purpose of BKV DNA PCR is to diagnose and monitor BKV infections in individuals, particularly in immunocompromised patients, such as transplant recipients 2, 3, 5.
- The test can help identify patients at risk of developing BKV-related diseases, such as hemorrhagic cystitis or nephropathy 2, 3, 5.
Types of BKV DNA PCR
- There are different types of BKV DNA PCR, including real-time PCR 2, 3, 5 and nested PCR 4.
- Real-time PCR is a sensitive and quantitative method that can detect and measure the amount of BKV DNA in a sample 2, 3, 5.
- Nested PCR is a more sensitive method that uses two sets of primers to amplify the BKV DNA, allowing for the detection of the virus at very low levels 4.
Clinical Applications of BKV DNA PCR
- BKV DNA PCR is used to diagnose and monitor BKV infections in transplant recipients, particularly in those with kidney or bone marrow transplants 2, 3, 5.
- The test can help guide treatment decisions, such as reducing immunosuppression or using antiviral medications 3, 6.
- BKV DNA PCR can also be used to monitor the effectiveness of treatment and prevent the development of BKV-related diseases 3, 5.