Genotyping BK virus in kidney transplant recipients using novel algorithm

This study investigated the prevalence of BKV subtypes in kidney transplant recipients and evaluates their association with viral load and BKVAN risk. A total of 32 kidney transplant recipients with confirmed BKV infection were included in the study. BKV DNA was extracted from urine and plasma samples and genotyped using phylogenetic analysis and a novel genotyping algorithm. Viral loads were compared between subtypes, and the occurrence of BKVAN was analyzed in relation to genotype distribution All samples belonged to genotype I, with 78.5 % classified as Ib-2 and 21.4 % as Ib-1. No genotype II, III, or IV strains were detected. Although the Ib-1 subtype exhibited higher mean viral loads in both urine and plasma, the differences were not statistically significant (p = 0.055 and p = 0.07, respectively). Two patients developed BKVAN, both infected with the Ib-2 subtype. The genotyping algorithm demonstrated a 98 % concordance rate with phylogenetic analysis, confirming its reliability. The predominance of BKV genotype Ib-2 among kidney transplant recipients aligns with global trends. While no significant association between genotype and viral load was found, all BKVAN cases were linked to the Ib-2 subtype, suggesting a potential role in disease progression.