Abstract
Monitoring the human virome has been recently suggested as a promising and novel area of research for identifying new biomarkers which would help physicians in the management of transplant patients. Imbalance of the immune system in transplant recipients has a significant impact on replication of Torquetenovirus (TTV), the most representative and abundant virus of human virome. TTV kinetic was studied by real-time PCR in 280 liver or kidney transplant recipients who underwent different drug regimens to maintain immunosuppression. During one-year post-transplant follow-up, TTV viremia fluctuated irrespective of transplanted organ type but consistent with the immunosuppression regimen. TTV kinetic in patients who manifested cytomegalovirus (CMV) reactivation within the first four months post-transplant differed from that observed in patients who did not experience CMV complications. Importantly, plasma TTV load measured between day 0 and 10 post-transplant was significantly higher in CMV DNA positive than in CMV DNA negative patients. TTV viremia above 3.45 log DNA copies/ml within the first 10 days post-transplant correlates with higher propensity to CMV reactivation following transplantation. This study provides further evidence for using early post-transplant TTV viremia to predict CMV reactivation in liver or kidney transplant recipients.
Highlights
With regard to the latter aspect, findings have shown that TTV plasma loads tend to be higher in patients with immune system dysfunction compared to healthy controls and viremia fluctuations parallel immunity perturbations due to routine immunization, immunosuppressive medications, chemotherapy, hematopoietic stem cell transplantation, etc.[9,10,11,12,13,14]
Plasma TTV kinetics has been studied in 280 SOT recipients during the first 12 months post-transplant to determine whether there is a relationship among TTV viremia and type of transplanted organ, immunosuppressive drug regimen, and CMV post-transplant reactivation
Two hundred fifty-eight patients (92%) were plasma TTV positive before transplantation and, as shown in Table 1, mean TTV levels were 3.9 and 4.2 log DNA copies per ml of plasma in patients receiving kidney or liver transplant, respectively, confirming that TTV is prevalent in the blood of patients with different clinical conditions with levels of viremia low and comparable to healthy donors in transplant candidates[13]
Summary
TTV exhibits several remarkable properties, including a small single-stranded circular DNA genome, a high degree of genetic heterogeneity, an uncanny ability to establish chronic infections with no clearly associated clinical manifestations, and a high worldwide prevalence regardless of age, ethnicity, sex, and socio-economic status of the population[8]. From all of these properties, it is evident that TTV has established a successful interaction with its host, even though many aspects of its life cycle and pathogenesis are still poorly understood. Plasma TTV kinetics has been studied in 280 SOT recipients during the first 12 months post-transplant to determine whether there is a relationship among TTV viremia and type of transplanted organ, immunosuppressive drug regimen, and CMV post-transplant reactivation
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