{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:31:43Z","timestamp":1790418703968,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T00:00:00Z","timestamp":1584144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>BK polyomavirus (BKPyV) infections with multi\u2010organ involvement are rare. Here, we report for the first time whole genome sequencing data from a patient with systemic BKPyV disease. She presented post stem cell transplantation with graft\u2010vs\u2010host disease, suffered from profound immunosuppression, and developed fatal BKPyV disease of kidneys, lungs, and pancreas. The lytic infection was caused by an episomal BKPyV\u2010Ib strain with canonical structural and receptor encoding gene sequences. However, DNA from all infected tissue sites showed diverse BKPyV\u2010NCCR rearrangements (rr\u2010NCCR) involving the <jats:italic>P<\/jats:italic>, <jats:italic>Q<\/jats:italic>, and <jats:italic>R<\/jats:italic> domains, while largely sparing <jats:italic>O<\/jats:italic> and <jats:italic>S<\/jats:italic>, carrying initiation sites for early and late BKPyV gene transcripts crucial for viral replication and assembly. Common to all rr\u2010NCCR variants was a break point in <jats:italic>Q<\/jats:italic> (position 17\u201027) that can form the nidus for double DNA strand break formation and gene rearrangements. Metastatic clonal BKPyV spread from kidneys to other organs was not detected. We hypothesize that lack of immune surveillance and a specific NCCR break point promote profound gene rearrangements of NCCR\u2010<jats:italic>P, Q,<\/jats:italic> and <jats:italic>R<\/jats:italic> with alterations of regulatory feedback loops. As a result, viral replication and pathogenicity are enhanced leading to severe, often fatal systemic disease not caused by the common archetypical BKPyV strains.<\/jats:p>","DOI":"10.1111\/tid.13269","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T06:35:05Z","timestamp":1582526105000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["BK polyomavirus nephropathy with systemic viral spread: Whole genome sequencing data from a fatal case of BKPyV infection"],"prefix":"10.1111","volume":"22","author":[{"given":"Sanjeet","family":"Roy","sequence":"first","affiliation":[{"name":"Division of Nephropathology The University of North Carolina School of Medicine Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr A.","family":"Mieczkowski","sequence":"additional","affiliation":[{"name":"Department of Genetics The University of North Carolina Chapel 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