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Monitoring of alphatorquevirus DNA levels for the prediction of immunosuppression‐related complications after kidney transplantation
Author(s) -
FernándezRuiz Mario,
Albert Eliseo,
Giménez Estela,
RuizMerlo Tamara,
Parra Patricia,
LópezMedrano Francisco,
San Juan Rafael,
Polanco Natalia,
Andrés Amado,
Navarro David,
Aguado José María
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15145
Subject(s) - immunosuppression , medicine , hazard ratio , confidence interval , kidney transplantation , viral load , transplantation , malignancy , kidney transplant , real time polymerase chain reaction , gastroenterology , immunology , virus , biology , biochemistry , gene
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 DNA emia 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.