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Controlling for Immunosuppressive Therapy in Studies of BK Virus Disease

I read with interest the study by Theodoropoulos et al. on BK virus replication and nephropathy in altemtuzumabinduced kidney transplantation (1). As alemtuzumab becomes more widely used for induction, it is important to ascertain the risk of infectious complications such as BK virus disease. Reassuringly, their study did not find an increased risk of BK viremia or BK virus nephropathy with the use of alemtuzumab compared to less potent induction. Their conclusions are strengthened by their large sample size and use of BK virus nephropathy as a primary outcome.