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Journal of Clinical Microbiology, June 1998, p. 1660-1665, Vol. 36, No. 6
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Tubulointerstitial Nephritis Due to a Mutant Polyomavirus BK Virus Strain, BKV(Cin), Causing End-Stage Renal Disease

R. D. Smith,1,* J. H. Galla,1 K. Skahan,1 P. Anderson,1 C. C. Linnemann Jr.,1 G. S. Ault,2 C. F. Ryschkewitsch,2 and G. L. Stoner2

Departments of Pathology and Internal Medicine, University of Cincinnati, Cincinnati, Ohio 45267-0529,1 and National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-41262

Received 3 November 1997/Returned for modification 23 December 1997/Accepted 20 February 1998

A renal biopsy from a 36-year-old man with AIDS showed a severe tubulointerstitial nephritis with intranuclear inclusions in epithelial cells. Electron microscopy revealed the characteristic findings of a polyomavirus (PyV) infection, and immunofluorescence indicated the presence of BK virus (BKV) antigen. Inoculation of rhesus monkey kidney cell cultures both with urine and with buffy coat blood cells resulted in a cytopathic response which was subsequently confirmed to be due to BKV. Further characterization of the viral DNA from the kidney by PCR amplification and Southern blot analysis with PyV and strain-specific primers and probes indicated that the virus was closely related to the BK(Dun) strain but different in its apparent sequence arrangement. Subsequent cycle sequencing showed a dinucleotide mutation of TGright-arrowAA which substitutes hydrophilic Gln for hydrophobic Leu in a sequence homologous to an origin DNA-binding domain of simian virus 40 T antigen. It is suggested that the mutation and a coding region rearrangement of this strain of BKV designated BKV(Cin) has the potential to alter viral DNA replication and enhance pathogenicity.

* Corresponding author. Mailing address: Department of Pathology, University of Cincinnati, 231 Bethesda Ave., P.O. Box 670529, Cincinnati, OH 45267-0529. Phone: (513) 558-0135. Fax: (513) 558-2289. E-mail: smithrd{at}uc.edu.

Journal of Clinical Microbiology, June 1998, p. 1660-1665, Vol. 36, No. 6
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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