Significance of polyomavirus detection in urine cytology: an update

Significance, cytomorphology of decoy cells in polyomavirus-associated nephropathy: Review of clinical, histopathological, and virological correlates with commentary

“…The medical literature now catalogs 13 distinct PyV types along with their pathogenicity in children and adults. 6,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] PyV-induced carcinogenesis has been explored through animal research models and studies based on Merkel cell carcinoma (MCC), a rare neuroendocrine cutaneous cancer wherein malignant transformation is mediated by the MCC polyomavirus (MCCPyV). 6,22,23 MCC is the first human malignancy reported to develop predominantly from PyV infections.…”

“…The actual incidence values of seropositivity in adults may be higher, however, as this parameter wanes with advancing age. [6][7][8]10,11,28 If BKVAN develops in renal transplant patients as a result of immunosuppression and BKPyV reactivation, the ensuing pathology may lead to graft failure and loss due to extensive interstitial fibrosis and tubular atrophy if the disease is undetected or untreated. The literature describes an associated 40% risk of graft loss in patients with BKVAN.…”

“…The risk of interstitial fibrosis thus decreases with improved prognosis for graft function as measured through successive serum creatinine level assays. [6][7][8]10,11,28 PyV reactivation precedes the clinical symptomatology of BKVAN. This phenomenon underscores the need for regular and structured post-transplant screening for early detection of the signs and symptoms of possible renal dysfunction.…”

“…The clinical impact of BKPyV infection seems to depend on the type of allograft: (a) hematopoietic stem cell transplantation is associated with hemorrhagic cystitis, hematuria, and renal impairment; while (b) renal transplantation is associated with BKVAN in 2% to 10% of patients. 8,11,28 BKVAN is a virally induced tubulointerstitial inflammatory disease and a critical consideration in renal transplant patients for suspected renal graft dysfunction and ensuing loss. 8,10,11,28 …”

“…8,11,28 BKVAN is a virally induced tubulointerstitial inflammatory disease and a critical consideration in renal transplant patients for suspected renal graft dysfunction and ensuing loss. 8,10,11,28 …”