Lab Test

BK Virus Quantitation, Serum

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

Test Codes

EPIC: LAB6406, Beaker: ISKG

Department

Molecular Pathology

Specimen Collection Criteria

Collect (preferred specimen): One Gold-top SST tube.
Also acceptable:
One plain Red-top tube.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells.

  • Centrifuged Gold-top SST tubes should be refrigerated (2-8°C or 36-46°F) prior to transport. Room temperature (20-26°C or 68-78.8°F) is acceptable for a maximum of 24 hours. Do not freeze the collection tube.
  • For Red-top tubes, transfer serum to a plastic transport tube after centrifugation. Maintain serum frozen (-20°C/-4°F or below) (preferred) or refrigerated (2-8°C or 36-46°F) prior to transport. Room temperature (20-26°C or 68-78.8°F) is acceptable for a maximum of 24 hours. Once a specimen is frozen, it must remain frozen (no exceptions).

Preparation for Courier Transport

Transport: Centrifuged SST tube, refrigerated (2-8°C or 36-46°F), or serum in a plastic transport tube, frozen (-20°C/-4°F or below). (Minimum: 0.5 mL)

Rejection Criteria

  • Specimens collected into Vacutainer® tubes other than specified.
  • Specimens subjected to freezing and thawing.
  • Specimens maintained at room temperature (20-25°C or 68-77 °F) for greater than 24 hours prior to being received in the Laboratory.
  • Specimens received in an unprocessed Red-top tube (i.e. have not been centrifuged with serum removed and placed into a plastic transfer tube).

In-Lab Processing

Following centrifugation, the serum should be poured over into a plastic transport tube and frozen (-20°C/-4°F or below).

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): Acceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Pour Over Specimens
Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): Acceptable
Frozen (-20°C/-4°F or below): Preferred

Specimen Storage in Department Prior to Disposal:

Thawed, Non-Extracted Specimens - Refrigerated (2-8°C or 36-46°F): Minimum of 7 days.
Specimens will not be discarded until results are reported.

Laboratory

Royal Oak Clinical Molecular Pathology Laboratory

Performed

Tuesday, Friday.
Results available within 24 hours.

Reference Range

Reportable Range: 500-10,000,000 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

Microtainer® and Vacutainer® are registered trademarks of Becton, Dickinson and Company.
UroVysion® is a registered trademark of Abbott Laboratories. ThinPrep® is a registered trademark of Hologic, Incorporated.