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Figure 1.

Immunization of mice with BKV-I and BKV-IV VLPs.

Six mice were immunized with BKV-I (red circles) or BKV-IV (blue squares) VLPs. In the top panel, sera were serially diluted and tested in separate BKV-I (x axis) or BKV-IV (y axis) VLP ELISAs. A data point from one relatively non-responsive animal is shown as an open circle. The middle panel depicts BKV type-specific neutralizing titers for the same set of mice. The gray diagonal line depicts a theoretical 1∶1 correlation (i.e., perfect cross-reactivity) between BKV-I and BKV-IV titers. The bottom panel shows the ratio of the neutralizing titer for the BKV type administered as a vaccine versus the neutralizing titer for the heterologous BKV type for individual animals. The wide bar represents the geometric mean and the error bars show the 95% confidence interval. Since the BKV-IV ELISA titer of the non-responsive animal could not be calculated, this animal was excluded from the analysis in the bottom panel.

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Figure 2.

Analysis of sera from healthy adults.

Sera from 48 healthy adults were evaluated for BKV type-specific serological titers. The upper panel shows BKV-I and BKV-IV titers evaluated by ELISA. The lower panel shows neutralizing titers.

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Figure 3.

BKV-I and BKV-IV serological patterns in kidney transplant recipients.

Sera from kidney transplant recipients were titered for the presence of BKV-I (red circles) or BKV-IV (blue squares) neutralizing antibodies. The neutralizing titer categories shown on the y axis are defined as 1) <95% neutralization at a serum dilution of 1∶100, 2) ≥95% neutralization at 1∶100, 3) ≥95% neutralization at 1∶500, 4) ≥95% neutralizing at 1∶5,000, and 5) ≥95% neutralizing at 1∶50,000. Sera were collected at 5 different time points (x axis) spanning roughly 1, 4, 12, 26, and 52 weeks post-transplantation, designated A-E. In each panel, the notations in the bottom right corner represent the BKV genotype (I or IV) observed in the patient's urine (superscript u) or blood (superscript b). The subject denoted I/IVu showed urinary shedding of BKV-I at week 5 and urinary shedding of BKV-IV at week 16. The patterns of 12 representative patients are shown. Results for all 108 study subjects are shown in Figure S3.

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Table 1.

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Figure 4.

BKV-I and BKV-IV neutralizing titers in kidney transplant patients at study entry and exit.

Sera from 108 kidney transplant recipients were titered for the presence of BKV-I (top panel) or BKV-IV (bottom panel) type-specific neutralizing antibodies. The percentage of patients at a particular titer cut-off at study entry (1 week after transplantation) are depicted as open bars, while the titers at study exit (1 year after transplantation) are shown as filled bars.

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