The association of Torque Teno viral load with CMV and BKV infection in pediatric and adolescent kidney transplant patients.

IF 4 3区 医学 Q2 VIROLOGY Journal of Clinical Virology Pub Date : 2024-03-26 DOI:10.1016/j.jcv.2024.105673
Fabian Eibensteiner , Ines Messner , Phoebe Uhl , Gregor Bond , Elisabeth Puchhammer-Stoeckl , Thomas Mueller-Sacherer , Christoph Aufricht , Krisztina Rusai
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Abstract

Background

: Long-term allograft and patient survival after kidney transplantation (KTX) depends on the balance between over- and under-immunosuppression (IS). High levels of IS predispose to opportunistic infections. Plasma load of Torque Teno Virus (TTV), a non-pathogenic highly prevalent Annellovirus, is associated with its hosts immune status, especially after solid organ transplantation.

Objectives

: To investigate the association of plasma TTV load and opportunistic viral infections after pediatric KTX.

Study design

: This retrospective study includes all pediatric KTX patients followed at the Medical University of Vienna 2014–2020. PCR for Cytomegalovirus (CMV), Epstein-Barr virus (EBV), BK virus (BKV), and TTV was performed every 4–8 weeks at routine follow-up visits.

Results

: 71 pediatric KTX patients were followed with TTV measurements for a median of 2.7 years. TTV plasma load was associated with CMV DNAemia at the next visit with an OR of 2.37 (95 % CI 1.15–4.87; p = 0.03) after adjustment for time after KTX and recipient age. For a cut-off of 7.68 log10 c/mL TTV a sensitivity of 100 %, a specificity of 61 %, a NPV 100 %, and a PPV of 46 % to detect CMV DNAemia at the next visit was calculated. TTV plasma loads were also associated with BKV DNAuria and BKV DNAemia at the next visit, but not with EBV DNAemia.

Conclusions

: This is the first study to analyse associations between TTV plasma loads and opportunistic viral infections in pediatric KTX. We were able to present a TTV cut-off for the prediction of clinically relevant CMV DNAemia that might be useful in clinical care.

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在儿童和青少年肾移植患者中,Torque Teno 病毒载量与 CMV 和 BKV 感染的关系。
背景:肾移植(KTX)后异体移植物和患者的长期存活取决于免疫抑制(IS)过度和不足之间的平衡。高水平的免疫抑制易导致机会性感染。血浆中的托克-特诺病毒(TTV)是一种非致病性的高流行性安氏病毒,它与宿主的免疫状态有关,尤其是在实体器官移植后:研究设计:这项回顾性研究包括维也纳医科大学 2014-2020 年随访的所有小儿 KTX 患者。在常规随访时,每 4-8 周进行一次巨细胞病毒(CMV)、爱泼斯坦-巴氏病毒(EBV)、BK 病毒(BKV)和 TTV 的 PCR 检测:对 71 名小儿 KTX 患者进行了中位 2.7 年的 TTV 测量随访。在对 KTX 后的时间和受者年龄进行调整后,TTV 血浆载量与下一次就诊时的 CMV DNA 血症相关,OR 值为 2.37(95 % CI 1.15-4.87;p = 0.03)。以 7.68 log10 c/mL TTV 为临界值,计算出下次就诊时检测 CMV DNA 血症的灵敏度为 100%,特异度为 61%,NPV 为 100%,PPV 为 46%。TTV血浆载量还与下次就诊时的BKV DNA尿和BKV DNA血症有关,但与EBV DNA血症无关:这是第一项分析 TTV 血浆载量与小儿 KTX 机会性病毒感染之间关系的研究。我们提出了预测临床相关的 CMV DNA 血症的 TTV 临界值,这可能对临床治疗有用。
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来源期刊
Journal of Clinical Virology
Journal of Clinical Virology 医学-病毒学
CiteScore
22.70
自引率
1.10%
发文量
149
审稿时长
24 days
期刊介绍: The Journal of Clinical Virology, an esteemed international publication, serves as the official journal for both the Pan American Society for Clinical Virology and The European Society for Clinical Virology. Dedicated to advancing the understanding of human virology in clinical settings, the Journal of Clinical Virology focuses on disseminating research papers and reviews pertaining to the clinical aspects of virology. Its scope encompasses articles discussing diagnostic methodologies and virus-induced clinical conditions, with an emphasis on practicality and relevance to clinical practice. The journal publishes on topics that include: • new diagnostic technologies • nucleic acid amplification and serologic testing • targeted and metagenomic next-generation sequencing • emerging pandemic viral threats • respiratory viruses • transplant viruses • chronic viral infections • cancer-associated viruses • gastrointestinal viruses • central nervous system viruses • one health (excludes animal health)
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