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Papovaviridae: The Polyomaviruses

  • Chapter
Laboratory Diagnosis of Infectious Diseases Principles and Practice

Abstract

Disease: Progressive multifocal leukoencephalopathy (PML). Ureteral stenosis. Hemorrhagic cystitis.

Etiologic Agents: JC virus (JCV) of PML. BK virus (BKV) of urinary tract disease. A human B-cell lymphotropic polyomavirus is suspected to exist on the basis of serologic evidence. Simian virus 40 was a contaminant of early poliovirus vaccines.

Sources: JCV and BKV transmitted person to person probably by the respiratory route. Viruses excreted in urine. Donor kidneys may introduce infection in recipients of renal transplants.

Clinical Manifestations: Occur mainly in immunosuppressed populations as a result of virus reactivation. PML is a rare, fatal disease with an insidious onset and symptoms reflecting multifocal involvement of the brain by JCV. Ureteral stenosis is a rare, late complication of renal transplantation; some cases are associated with BKV. BKV- associated hemorrhagic cystitis occurs frequently in recipients of bone marrow transplants and rarely in immunologically normal individuals.

Pathology: Viruses produce basophilic intranuclear inclusions in infected cells. Urinary tract and central nervous system are affected.

Laboratory Diagnosis: Depends largely on demonstration of viral particles, viral antigen, or viral genome either directly in clinical specimens or after cultivation of the viruses in cell lines of human origin. Serologic tests not often helpful.

Epidemiology: Worldwide prevalence. Primary infections occur in childhood and are largely asymptomatic. Viruses are reactivated in times of immunologic impairment.

Treatment: Specific antiviral therapy is not available. Reduction in immunosuppression, when possible, may ameliorate disease.

Prevention and Control: No measures are in use or under investigation

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  1. Ray R. Arthur
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Arthur, R.R., Shah, K.V. (1988). Papovaviridae: The Polyomaviruses. In: Laboratory Diagnosis of Infectious Diseases Principles and Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3900-0_17

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