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Background <p>Torque teno virus (TTV) viral loads may reflect patients’ net state of immunosuppression and identify patients at risk of infections and rejection early after solid organ transplantation. However, its role in long-term kidney recipients (KTRs) is less clear.</p> Methods <p>This single-centre prospective cohort study evaluated the association between TTV viral load at recruitment and severe infections requiring hospitalisation within 12 months as the primary outcome in kidney recipients &gt; 1-year post-transplant and on stable immunosuppression for &gt; 3 months. Participants were followed up for 12 months, until change of immunosuppression, graft loss, or death. Pre-specified, exploratory secondary outcomes, including opportunistic infections, malignancy, composite outcomes were also analysed.</p> Results <p>Median time after transplant amongst the 171 included participants was 10.3 years (interquartile range (IQR) 4.9–16.0). Thirty-one developed severe infections 105 days (IQR 65–204) after baseline TTV measurement. Higher baseline log10-transformed TTV viral load (logTTV) was associated with severe infections within 12 months (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.01–1.86, <i>p</i> = 0.045) with a modest area under receiver operating characteristics curve of 0.60 (95% CI 0.50–0.71). Compared to logTTV &lt; 4.6 copies/mL, logTTV &gt; 6.6 copies/mL (hazard ratio (HR) 3.45, 95% CI 1.10–10.9, <i>p</i> = 0.04) was associated with time to hospitalisations for infections but not logTTV 4.6–6.6 copies/mL (HR 2.30, 95% CI 0.97–5.47, <i>p</i> = 0.06). The ORs for the association between logTTV and malignancy, opportunistic infection and biopsy-proven rejection were 1.86 (95% CI 1.09–3.16), 1.21 (95% CI 0.69–2.13) and 1.09 (95% CI 0.70–1.69) respectively.</p> Conclusion <p>Elevated TTV viral loads were associated with severe infections amongst our cohort of long-term KTRs and may be a useful biomarker in this population.</p>

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Torque teno virus viral load and hospitalisation for infections in long-term kidney transplant recipients: a single-centre prospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月16日

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  • Quan Yao Ho,
  • Ian Tatt Liew,
  • Deborah Chooi Mun Lai,
  • Kun Lee Lim,
  • Carolyn Shan-Yeu Tien,
  • Rou Wei Lim,
  • Wei Mian Ang,
  • Xin Lin Joey Kay,
  • Minyi Lau,
  • Jenny Leong,
  • Yan Ting Yeo,
  • Chieh Suai Tan,
  • Shimin Jasmine Chung,
  • Puay Hoon Lee,
  • Sobhana Thangaraju,
  • Lynette Lin Ean Oon,
  • Terence Kee

摘要

Background

Torque teno virus (TTV) viral loads may reflect patients’ net state of immunosuppression and identify patients at risk of infections and rejection early after solid organ transplantation. However, its role in long-term kidney recipients (KTRs) is less clear.

Methods

This single-centre prospective cohort study evaluated the association between TTV viral load at recruitment and severe infections requiring hospitalisation within 12 months as the primary outcome in kidney recipients > 1-year post-transplant and on stable immunosuppression for > 3 months. Participants were followed up for 12 months, until change of immunosuppression, graft loss, or death. Pre-specified, exploratory secondary outcomes, including opportunistic infections, malignancy, composite outcomes were also analysed.

Results

Median time after transplant amongst the 171 included participants was 10.3 years (interquartile range (IQR) 4.9–16.0). Thirty-one developed severe infections 105 days (IQR 65–204) after baseline TTV measurement. Higher baseline log10-transformed TTV viral load (logTTV) was associated with severe infections within 12 months (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.01–1.86, p = 0.045) with a modest area under receiver operating characteristics curve of 0.60 (95% CI 0.50–0.71). Compared to logTTV < 4.6 copies/mL, logTTV > 6.6 copies/mL (hazard ratio (HR) 3.45, 95% CI 1.10–10.9, p = 0.04) was associated with time to hospitalisations for infections but not logTTV 4.6–6.6 copies/mL (HR 2.30, 95% CI 0.97–5.47, p = 0.06). The ORs for the association between logTTV and malignancy, opportunistic infection and biopsy-proven rejection were 1.86 (95% CI 1.09–3.16), 1.21 (95% CI 0.69–2.13) and 1.09 (95% CI 0.70–1.69) respectively.

Conclusion

Elevated TTV viral loads were associated with severe infections amongst our cohort of long-term KTRs and may be a useful biomarker in this population.