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The kinetics of torque teno virus plasma DNA load shortly after engraftment predicts the risk of high-level CMV DNAemia in allogeneic hematopoietic stem cell transplant recipients

Bone Marrow Transplantation volume 53, pages 180–187 (2018)Cite this article

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Abstract

Monitoring Torque teno virus (TTV) DNA load helps to estimate the risk of opportunistic infections in solid organ transplant recipients. We investigated whether the early kinetic pattern of plasma TTV DNA load after allogeneic hematopoietic stem cell transplantation (allo-HSCT) associates with subsequent CMV and EBV DNAemia. This study included 71 allo-HSCT patients. We found that the area under the curve (AUC) for log10 TTV DNA loads quantified by days 20 and 30 after transplantation (TTV DNA load AUC20-30), was significantly lower (P=0.036) in patients who subsequently developed CMV DNAemia requiring preemptive antiviral therapy (n=17) than in those who did not (n=8) or had no CMV DNAemia (n=19). Patients displaying TTV DNA load AUC20-30⩽2.8 copies × days × mL−1 were more likely to have high-level CMV DNAemia. A trend towards a direct correlation between TTV DNA AUC20-30 and CMV-specific interferon-γ CD8+ T-cell counts by day +30 was noted (P=0.095). However, this dynamic parameter was not useful for anticipating the occurrence of either CMV recurrences (n=12) or EBV DNAemia (n=34). In summary, it may be possible to identify a subset of allo-HSCT patients at a high risk of developing high-level CMV DNAemia by analyzing the kinetics of plasma TTV DNA load early after engraftment.

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Acknowledgements

We thank Juan Manuel Moya Serrano for his technical assistance. Estela Giménez holds a Río-Hortega Contract from the Carlos III Health Institute (ISCIII) (Ref. CM16/00200). This work was presented, in part, at the European Congress of Clinical Virology in Lisbon, 2016.

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Authors and Affiliations

  1. Microbiology Service, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain

    E Albert, E Giménez & D Navarro

  2. Hematology Service, Hospital Clínico Universitario, Institute for Research INCLIVA, Valencia, Spain

    C Solano, A Pérez, J L Piñana & J C H Boluda

  3. Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain

    C Solano

  4. North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy

    D Focosi & F Maggi

  5. Virology Unit, Pisa University Hospital, Pisa, Italy

    L Macera

  6. Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain

    D Navarro

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Correspondence to D Navarro.

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Albert, E., Solano, C., Giménez, E. et al. The kinetics of torque teno virus plasma DNA load shortly after engraftment predicts the risk of high-level CMV DNAemia in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 53, 180–187 (2018). https://doi.org/10.1038/bmt.2017.235

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