Polyomavirus: BKV & JCV

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Questions and Answers

A researcher is investigating the mechanisms of viral latency in polyomaviruses. What cellular characteristic would most likely facilitate long-term BKV latency, specifically contributing to its ability to reactivate under immunosuppressed conditions?

High rate of replication within immune cells, leading to constant immune stimulation and viral clearance upon immune recovery.
Integration of the viral genome into actively transcribed regions of the host cell DNA, enhancing viral gene expression even in the absence of active replication.
Induction of a strong interferon response in infected cells, creating an environment conducive to viral clearance.
Ability to establish latency within long-lived renal tubular epithelial cells, providing a reservoir for reactivation upon immunosuppression. (correct)

In the context of kidney transplantation, what is the most significant clinical consequence of BKV reactivation, impacting long-term graft survival?

Transient viremia, causing mild flu-like symptoms but without affecting graft function.
Acute hemorrhagic cystitis, causing severe lower urinary tract symptoms but with no direct impact on kidney function.
Ureteral stenosis leading to hydronephrosis, primarily affecting urine outflow without directly damaging the transplanted kidney.
Nephropathy and graft rejection, leading to chronic kidney damage and potential graft loss. (correct)

A patient presents with progressive neurological symptoms, and a cerebrospinal fluid (CSF) PCR test is positive for JCV. Magnetic resonance imaging (MRI) reveals multiple white matter lesions. Which pathological mechanism is most directly responsible for the observed white matter lesions in this patient?

Lymphocytic infiltration of the brain parenchyma, causing direct neuronal damage and inflammation.
Formation of amyloid plaques in the brain, causing neurodegenerative changes and cognitive decline.
Vascular occlusion and infarction, leading to ischemic damage in the affected brain regions.
Destruction of oligodendrocytes by JCV, leading to demyelination and white matter lesions. (correct)

What is the primary clinical challenge in managing progressive multifocal leukoencephalopathy (PML) associated with JCV infection, particularly in patients with HIV/AIDS?

The lack of effective antiviral therapies directly targeting JCV, coupled with the difficulty of restoring immune function in severely immunocompromised individuals. (B) Signup and view all the answers

A researcher aims to develop a novel diagnostic assay for early detection of BKV infection in kidney transplant recipients. Which biomarker would provide the most specific and sensitive indication of active BKV replication, enabling timely intervention to prevent nephropathy and graft rejection?

Detection of BKV DNA in urine or blood by PCR, indicating active viral replication and potential for kidney damage. (B) Signup and view all the answers

A kidney transplant recipient on immunosuppressive therapy develops ureteral stenosis secondary to BKV infection. What is the most appropriate and definitive interventional strategy to address the ureteral obstruction and prevent hydronephrosis?

Placement of a ureteral stent or balloon dilation to relieve the obstruction and maintain urine flow. (C) Signup and view all the answers

An immunocompromised patient presents with new-onset seizures, cognitive decline, and visual disturbances. A brain biopsy reveals the presence of enlarged oligodendrocytes with intranuclear inclusions. What molecular mechanism underlies the formation of these inclusions and the associated cellular dysfunction?

Replication of JCV within oligodendrocytes, resulting in viral protein accumulation and cellular lysis. (D) Signup and view all the answers

A hematologist is consulted regarding a bone marrow transplant recipient who develops hemorrhagic cystitis. What aspect of the patient's post-transplant management poses the greatest risk for BKV reactivation and subsequent hemorrhagic cystitis?

Intensive immunosuppressive therapy to prevent graft-versus-host disease (GVHD), impairing T-cell-mediated control of BKV. (B) Signup and view all the answers

What is the most critical factor determining the likelihood and severity of progressive multifocal leukoencephalopathy (PML) in an individual infected with JCV?

The degree of immunosuppression, with profoundly immunocompromised individuals at highest risk. (B) Signup and view all the answers

An infectious disease specialist is monitoring a cohort of immunocompromised patients for polyomavirus infections. What preventative measure would be most effective in reducing the overall risk of BKV and JCV infections in this high-risk population?

Careful monitoring and management of immunosuppressive therapy to minimize the degree of immune suppression. (C) Signup and view all the answers

Flashcards

Polyomaviruses

A family of viruses that can transform normal cells and induce tumors, particularly in non-native species. BKV and JCV are members.

Hemorrhagic Cystitis (BKV)

In immunocompromised individuals, BKV can lead to this condition, characterized by bloody urine.

Progressive Multifocal Leukoencephalopathy (PML)

A rare, often fatal, demyelinating disease of the brain associated with JCV in immunocompromised patients.

BKV nephropathy

BKV can cause this condition, potentially leading to kidney dysfunction and graft rejection in transplant recipients.