BK Polyomavirus Diversity After Hematopoietic Stem Cell Transplantation

• Published in: The Journal of infectious diseases 2023-11, Vol.228 (9), p.1208-1218
• Main Authors: Odegard, Elizabeth A, Meeds, Heidi L, Kleiboeker, Steven B, Ziady, Assem, Sabulski, Anthony, Jodele, Sonata, Seif, Alix E, Davies, Stella M, Laskin, Benjamin L, Blackard, Jason T
• Format: Article
• Language: English
• Subjects: BK Virus - genetics; Child; Cystitis; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Hemorrhage - complications; Hemorrhagic cystitis; Humans; Major; Next-generation sequencing; Pediatrics; Polyomavirus Infections; Stem cell transplantation; Tumor Virus Infections
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiad117

Abstract BK polyomavirus (BKPyV) infection is common after hematopoietic stem cell transplantation (HSCT) and is associated with the development of hemorrhagic cystitis (HC). The role that BKPyV plays in the pathogenesis of HC is not well characterized. We investigated the impact of BKPyV diversity on the development of HC using a previously established cohort of pediatric HSCT patients. There were 147 urine samples with quantifiable BKPyV at month 1 after HSCT; 137 (93.2%) were amplified using our in-house polymerase chain reaction approach and sent for next-generation sequencing. Subtype Ia was most frequent (61.3%), followed by subtype Ib1 (31.4%). The median viral load of subtype Ia samples was higher than for subtype Ib1 at month 1. Across the protein coding regions, APOBEC-induced mutations and signature patterns associated with HC were identified. This is the largest sequencing study of a single cohort of HSCT patients, providing a vast resource of sequence data for future analyses. BK polyomavirus was amplified from 137 pediatric allogenic hematopoietic stem cell transplant recipients. Subtype Ia was found to have higher viral loads at multiple timepoints posttransplantation, and APOBEC3-induced mutations were identified.