BK and JC viruses in patients with systemic lupus erythematosus: Prevalentand persistent BK viruria, sequence stability of the viral regulatory regions, and nondetectable viremia

A role for polyomaviruses in the pathogenesis of systemic lupus erythematos us (SLE) has been suggested. BK virus (BKV) and JC virus (JCV) were demonst rated in single urine specimens from 7 (16%) of 44 and 5 (11%) of 44 patien ts with SLE and 0/88 and 18 (21%) of 88 matched healthy controls, respectiv ely, During a I-year follow-up study, episodes of polyomaviruria were detec ted in 16 (80%) of 20 patients, BKV in 13, and JCV in 3 patients. A group o f 12 (60%) of 20 patients demonstrated persistent or recurrent polyomavirur ia, BKV viruria (n = 9), or JCV viruria (n = 3) in 180 (70%) of 256 specime ns. Polyomaviruria was not significantly associated with immunosuppressive therapy. The BKV and JCV isolates revealed predominantly stable archetypal regulatory regions over 3 years, indicating viral persistence rather than r einfection as a cause for urinary shedding. The demonstration of nondetecta ble viremia and stable archetypal BKV and JCV noncoding control regions dur ing persistent viruria argue against the urinary tract as a focus for the c reation of rearranged regulatory region variants.