Early Post-Transplant Torquetenovirus Viremia Predicts Cytomegalovirus Reactivations In Solid Organ Transplant Recipients

Fabrizio Maggi, Daniele Focosi, Maura Statzu, Gabriele Bianco, Cristina Costa, Lisa Macera, Pietro Giorgio Spezia, Chiara Medici, Eliseo Albert, David Navarro, Carolina Scagnolari, Mauro Pistello, Rossana Cavallo, Guido Antonelli, Fabrizio Maggi, Daniele Focosi, Maura Statzu, Gabriele Bianco, Cristina Costa, Lisa Macera, Pietro Giorgio Spezia, Chiara Medici, Eliseo Albert, David Navarro, Carolina Scagnolari, Mauro Pistello, Rossana Cavallo, Guido Antonelli

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.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
TTV DNA loads in plasma specimens of all study transplant recipients monitored for one year post-transplant and grouped according to their CMV DNA status as measured in the first four months post-transplant.
Figure 2
Figure 2
Comparison of TTV levels in all study transplant recipients monitored between 0 and 10 days post-transplant and grouped according to their CMV DNA status as measured in the first four months post-transplant.
Figure 3
Figure 3
Comparison of TTV levels in liver and kidney transplant recipients monitored between 0 and 10 days post-transplant and grouped according to their CMV DNA status as measured in the first four months post-transplant.
Figure 4
Figure 4
Receiver operating characteristic (ROC) curve for distinguishing the optimal cutoff value for TTV load.

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