BK and JC Virus Infections in Renal Failure: A Meta-Analysis of Genetic Susceptibility and Physiological Risk Factors

Khudhair, Anfal Mohammed; Al-Majeed, Mahasen M. Abd; Mohammed, Dhelal Qasim; Ali, Jaafar Alsadiq Arkan Farhan; Yaseen, Ahmed Jabbar; Abduljalil, Hayder Rafid; Mundher, Ahmed Ali; Meshaal, Yahya Hashim; Abbas, Abbas Imad

doi:10.21608/jmals.2025.443586

BK and JC Virus Infections in Renal Failure: A Meta-Analysis of Genetic Susceptibility and Physiological Risk Factors

Document Type : Original Article

Authors

¹ Department of Microbiology, College of Medicine, Al-Iraqia University, Baghdad, Iraq

² Department of Physiology, College of Medicine, Al-Iraqia University, Baghdad, Iraq

³ College of Medicine, Al-Iraqia University, Baghdad, Iraq

10.21608/jmals.2025.443586

Abstract

Background: BK and JC viruses (BKV and JCV) have been recognized as significant opportunistic infections due to their association with nephropathy and renal allograft failure in the context of immunosuppression. Increasing research suggests that a host's physiology and genetics may influence the degree of severity and progression of an infection. The objective of this study is to determine the prevalence and clinical implications of BKV and JCV infections in patients with renal failure and those in the post-transplant phase, in addition to investigating relevant physiological and genetic risk factors. Methods: A systematic review and meta-analysis adhering to PRISMA 2020 comprised 10 papers published before 2024, encompassing 2,050 renal transplant recipients. The majority of investigations employed viral PCR-based detection techniques. Pooled prevalence rates and odds ratios (ORs) were computed to evaluate hazards linked to HLA mismatch, age, sex, genetic characteristics, and infections. Heterogeneity (I²) and subgroup analysis were conducted. The prevalence of BKV infection was 15.2%, but JCV infection was 5.7%. BKV infection markedly elevated the risk of renal impairment (OR = 3.45), but JCV presented a moderate risk (OR = 1.75). Advanced age, male gender, HLA class II incompatibilities, and certain cytokine gene polymorphisms were associated with increased risk. Moderate heterogeneity (I² = 52%) and minimal publication bias were observed.
Conclusions: BKV and JCV are pivotal in renal complications post-transplantation. Disease progression is influenced by viral factors as well as the patient's genetic predisposition. Customized genetic screening and viral load assessment may enhance immunosuppressive protocols and optimize transplant outcomes

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