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Due to increased use of kidneys from extended criteria donors, there is an increased early use of belatacept to avoid the nephrotoxicity of calcineurin inhibitors. A belatacept calcineurin inhibitors-free regimen is associated with an increased risk of T-cell mediated rejection and opportunistic infections, particularly cytomegalovirus (CMV) infection. To prevent CMV infection, a novel anti-viral drug, letermovir, is now available. In patients who present refractory/resistant CMV infections, it is nowadays recommended to use maribavir. However, the management of CMV infection still requires further studies. For instance, the role of anti-CMV immunoglobulins to prevent or to treat CMV infection, in association with classical anti-viral drugs, ought to be studied. The effect of belatacept on BK virus replication is controversial. There is no specific anti-viral treatment directed against BK virus. It is recommended to monitor closely BKV DNAemia and to reduce immunosuppression in case of positivity, especially in patients with high viral load or BKV-associated nephropathy