Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 19, Issue 4, Pages 1139-1149Publisher
WILEY
DOI: 10.1111/ajt.15145
Keywords
biomarker; clinical research; practice; complication; infectious; complication; malignant; infection and infectious agents; infection and infectious agents - viral; infectious disease; kidney transplantation; nephrology
Categories
Funding
- Instituto de Salud Carlos III
- Fondo de Investigaciones Sanitarias (FIS) [15/01953]
- Proyecto Integrado de Excelencia (PIE) [13/00045]
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The replication kinetics of nonpathogenic anelloviruses belonging to the Alphatorquevirus genus (such as torque teno virus) might reflect the overall state of posttransplant immunosuppression. We analyzed 221 kidney transplant (KT) recipients in whom plasma alphatorquevirus DNA load was quantified by real-time polymerase chain reaction at baseline and regularly through the first 12 posttransplant months. Study outcomes included posttransplant infection and a composite of opportunistic infection and/or de novo malignancy (immunosuppression-related adverse event [iRAE]). Alphatorquevirus DNA loads at month 1 were higher among patients who subsequently developed posttransplant infection (P = .023) or iRAE (P = .009). Likewise, those with iRAE beyond months 3 and 6 also exhibited higher peak viral loads over the preceding periods. Areas under the curve for log(10) alphatorquevirus DNAemia estimated by months 1 or 6 were significantly higher in patients experiencing study outcomes. Alphatorquevirus DNA loads above 3.15 and 4.56 log(10) copies/mL at month 1 predicted the occurrence of posttransplant infection (adjusted hazard ratio [aHR]: 2.88; 95% confidence interval [CI]: 1.13-7.36; P = .027) and iRAE (aHR: 5.17; 95% CI: 2.01-13.33; P = .001). In conclusion, posttransplant monitoring of plasma alphatorquevirus DNA kinetics may be useful to identify KT recipients at increased risk of immunosuppression-related complications.
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