Torque teno virus loads after kidney transplantation predict allograft rejection but not viral infection.

Autor: van Rijn AL; Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: a.l.van_rijn.mm@lumc.nl., Wunderink HF; Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands., Sidorov IA; Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands., de Brouwer CS; Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands., Kroes AC; Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands., Putter H; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands., de Vries AP; Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands., Rotmans JI; Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands., Feltkamp MC; Department of Medical Microbiology, Leiden University Medical Center, Leiden, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology [J Clin Virol] 2021 Jul; Vol. 140, pp. 104871. Date of Electronic Publication: 2021 May 25.
DOI: 10.1016/j.jcv.2021.104871
Abstrakt: The main challenge of immunosuppressive therapy after solid organ transplantation is to create a new immunological balance that prevents organ rejection and does not promote opportunistic infection. Torque teno virus (TTV), a ubiquitous and non-pathogenic single-stranded DNA virus, has been proposed as a marker of functional immunity in immunocompromised patients. Here we investigate whether TTV loads predict the risk of common viral infection and allograft rejection in kidney transplantation recipients. In a retrospective cohort of 389 kidney transplantation recipients, individual TTV loads in were measured by qPCR in consecutive plasma samples during one year follow-up. The endpoints were allograft rejection, BK polyomavirus (BKPyV) viremia and cytomegalovirus (CMV) viremia. Repeated TTV measurements and rejection and infection survival data were analysed in a joint model. During follow-up, TTV DNA detection in the transplant recipients increased from 85 to 100%. The median viral load increased to 10 7 genome copies/ml within three months after transplantation. Rejection, BKPyV viremia and CMV viremia occurred in 23%, 27% and 17% of the patients, respectively. With every 10-fold TTV load-increase, the risk of rejection decreased considerably (HR: 0.74, CI 95%: 0.71-0.76), while the risk of BKPyV and CMV viremia remained the same (HR: 1.03, CI 95%: 1.03-1.04 and HR: 1.01, CI 95%: 1.01-1.01). In conclusion, TTV load kinetics predict allograft rejection in kidney transplantation recipients, but not the BKPyV and CMV infection. The potential use of TTV load levels as a guide for optimal immunosuppressive drug dosage to prevent allograft rejection deserves further validation.
(Copyright © 2021. Published by Elsevier B.V.)
Databáze: MEDLINE
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