BK virus associated meningoencephalitis in an AIDS patient treated with HAART

Abstract

A severely immune-suppressed AIDS patient was suspected of suffering from BK virus (BKV) meningoencephalitis, after being studied for common causes of neurological complications of co-infectious origin. Polymerase chain reaction (PCR) and sequence analysis of cerebrospinal fluid and brain samples, confirmed the presence of BKV. His clinical condition improved along with the regression of brain lesions, after modifications on his antiretroviral regime. Five months after discharge, the patient was readmitted because of frequent headaches, and a marked inflammatory reaction was evidenced by a new magnetic resonance imaging (MRI). The symptoms paralleled a rising CD4+ lymphocyte count, and immune reconstitution syndrome was suspected. This is the first non-postmortem report of BKV meningoencephalitis in an AIDS patient, showing clinical and radiographic improvement solely under HAART.

Human polyomaviruses JC and BK in the urine of Brazilian children and adolescents vertically infected by HIV

“…Although BKV is considered a nephrotropic virus and JCV a CnS-tropic virus, a few cases of BK CnS disease have been reported (Weimberg & Mian 2010). Although BKV infections in the CnS have been reported less frequently than those related to JCV (Fink et al 2006, Vidal et al 2007, there is evidence for BKV occurrence in the CnS of immunocompromised hosts. Therefore, in patients with neurological alterations and preceding or concurrent signs of renal involvement with BK viruria, the possibility of BK CnS disease should be investigated (Bratt et al 1999).…”

The Human Fetal Glial Cell Line SVG p12 Contains Infectious BK Polyomavirus

“…Was BKPyV already present in the fetal brain tissue when the SVG cell line was established in 1985, or did it enter later as a contamination of the cell line? There have been some reports of BKPyV in the central nervous system (CNS) of adults (66)(67)(68)(69)(70), and one group has reported finding BKPyV DNA in fetal brains (71). It is more likely, however, that BKPyV entered as a contamination of the cell line.…”

Polyoma BK virus: an emerging opportunistic infectious agent of the human central nervous system

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Most of them occurred in patients with depression of their immune function (eight cases in AIDS patients; one case in a renal allograft recient; six cases in the context of hemato-oncological diseases under chemotherapy or bone marrow transplantation, and one case in a patient under longterm steroid therapy). However, eight cases were diagnosed in apparently healthy and immunocompetent individuals, with self-limited clinical manifestations (Table 1).…”

“…[6][7][8][10][11][12][13][14][15][16][17][18][19][20][21][22][23] So far, only two cases presented an ophthalmologic disease manifested as an acute retinitis due to extension of the CNS BKV infection. 8,9,13 The most common symptom is headache.…”

“…Deep white matter of the cerebellum is generally spared while deep gray matter structures are compromised. [6][7][8]10,11,18,19,[21][22][23] There are two cases, one in a renal transplant recipient and another in a patient under long term steroids, suggestive of PML, but whose PCR for JCV was negative. 16,17 Instead, BKV DNA of CSF and urine detected by PCR was positive.…”