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Honorato L, Witkin SS, Mendes-Correa MC, Conde Toscano ALC, Linhares IM, de Paula AV, Paião HGO, de Paula VS, Lopes ADO, Lima SH, Raymundi VDC, Ferreira NE, da Silva Junior AR, Abrahim KY, Braz-Silva PH, Tozetto-Mendoza TR. The Torque Teno Virus Titer in Saliva Reflects the Level of Circulating CD4 + T Lymphocytes and HIV in Individuals Undergoing Antiretroviral Maintenance Therapy. Front Med (Lausanne) 2022; 8:809312. [PMID: 35096897 PMCID: PMC8795607 DOI: 10.3389/fmed.2021.809312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/22/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction Torque teno virus (TTV) is a non-pathogenic virus present in body fluids. Its titer in the circulation increases in association with immune suppression, such as in HIV-infected individuals. We evaluated if the TTV titer in saliva from HIV-positive individuals undergoing antiretroviral therapy (ART) was related to the circulating CD4+ T lymphocyte concentration and the HIV titer. Methods Saliva was collected from 276 asymptomatic individuals undergoing ART, and an additional 48 individuals positive for AIDS-associated Kaposi's Sarcoma (AIDS-KS). The salivary TTV titer was measured by gene amplification analysis. The circulating CD4+ T lymphocyte and HIV levels were obtained by chart review. Results TTV was detectable in saliva from 80% of the asymptomatic subjects and 87% of those with AIDS-KS. In the asymptomatic group the median log10 TTV titer/ml was 3.3 in 200 males vs. 2.4 in 76 females (p < 0.0001). TTV titer/ml was 3.7 when HIV was acquired by intravenous drug usage, 3.2 when by sexual acquisition and 2.4 when blood transfusion acquired. The salivary TTV titer was inversely correlated with the circulating CD4+ T lymphocyte level (p < 0.0001) and positively correlated with the circulating HIV concentration (p = 0.0005). The median salivary TTV titer and circulating HIV titer were higher, and the CD4+ count was lower, in individuals positive for AIDS-KS than in the asymptomatic subjects (p < 0.0001). Conclusion The TTV titer in saliva is a potential biomarker for monitoring immune status in individuals undergoing ART.
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Affiliation(s)
- Layla Honorato
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Steven S Witkin
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.,Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Maria Cássia Mendes-Correa
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | | | - Iara Moreno Linhares
- Departamento de Ginecologia e Obstetrícia, Universidade de São Paulo, São Paulo, Brazil
| | - Anderson Vicente de Paula
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Heuder Gustavo Oliveira Paião
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Vanessa Salete de Paula
- Laboratory of Molecular Virology, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Amanda de Oliveira Lopes
- Laboratory of Molecular Virology, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Silvia Helena Lima
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Vanessa de Cássia Raymundi
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Noely Evangelista Ferreira
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Almir Ribeiro da Silva Junior
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Karim Yaqub Abrahim
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Henrique Braz-Silva
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.,Faculdade de Odontologia da Universidade de São Paulo, São Paulo, Brazil
| | - Tania Regina Tozetto-Mendoza
- Laboratory of Virology (LIM 52), Department of Infectious Diseases, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
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Redondo N, Navarro D, Aguado JM, Fernández-Ruiz M. Viruses, friends and foes: The case of Torque Teno virus and the net state of immunosuppression. Transpl Infect Dis 2021; 24:e13778. [PMID: 34933413 DOI: 10.1111/tid.13778] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/16/2021] [Accepted: 12/05/2021] [Indexed: 11/30/2022]
Abstract
New reliable biomarkers are needed to improve individual risk assessment for post-transplant infection, acute graft rejection and other immune-related complications after solid organ transplantation (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). One promising strategy relies on the monitoring of replication kinetics of virome components as functional surrogate for the net state of immunosuppression. Torque Teno Virus (TTV) is a small, non-enveloped, circular, single-stranded DNA anellovirus with no attributable pathological effects. A major component of the human blood virome, TTV exhibits various features that facilitate its application as immune biomarker: high prevalence rates, nearly ubiquitous distribution, stable viral loads with little intra-individual variability, insensitivity to antiviral drugs, and availability of commercial PCR assays for DNA quantification. The present review summarizes the available studies supporting the use of post-transplant TTV viremia to predict patient and graft outcomes after SOT and allo-HSCT. Taken together, this evidence suggests that high or increasing TTV DNA levels precede the occurrence of infectious complications in the SOT setting, whereas low or decreasing viral loads are associated with the development of acute rejection. The interpretation in allo-HSCT recipients is further complicated by complex interplay with the underlying disease, conditioning regimen and timing of recovery of lymphocyte counts, although TTV kinetics may act as a marker of immunological reconstitution at the early post-transplant period. The standardization of PCR methods and reporting units for TTV DNAemia and the results from ongoing interventional trials evaluating a TTV load-guided strategy to adjust immunosuppressive therapy are achievements expected in the coming years. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Natalia Redondo
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Spain
| | - David Navarro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Spain.,Department of Microbiology, Hospital Clínico Universitario, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain.,Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - José María Aguado
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Spain.,Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mario Fernández-Ruiz
- Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Spain.,Department of Medicine, School of Medicine, Universidad Complutense, Madrid, Spain
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Lapa D, Del Porto P, Minosse C, D’Offizi G, Antinori A, Capobianchi MR, Visco-Comandini U, McPhee F, Garbuglia AR, Zaccarelli M. Clinical Relevance of Torque Teno Virus (TTV) in HIV/HCV Coinfected and HCV Monoinfected Patients Treated with Direct-Acting Antiviral Therapy. J Clin Med 2021; 10:jcm10102092. [PMID: 34068071 PMCID: PMC8152458 DOI: 10.3390/jcm10102092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023] Open
Abstract
Torque Teno virus (TTV) is a ubiquitous virus that causes chronic infection in humans with unknown clinical consequences. Here, we investigated the influence of TTV infection on HCV direct-acting antiviral (DAA) efficacy in HIV/HCV coinfected and HCV monoinfected patients as controls. Of 92 study patients, 79.3% were TTV DNA positive; untreated patients exhibited a significantly higher proportion of TTV DNA-positivity vs. sustained virological response (SVR) patients (100.0% vs. 65.2%, p < 0.001), while TTV positivity was not significant in DAA failure patients vs. SVR patients despite HIV/HCV coinfection. TTV DNA viral load was higher among HCV monoinfected patients vs. HIV/HCV coinfected, although marginally significant (p = 0.074) and no significant viral load difference was detected between DAA failures and SVR patients, while untreated vs. SVR patients had a significantly higher viral load (19,884, IQR 5977–333,534, vs. 469, IQR 10–4124, p = 0.004). Alpha-genogroup 3 TTV was the most prevalent genetic group, and no specific strain or genogroup was observed in relapser patients. Among HIV/HCV patients with HCV RNA detectable at end of treatment (EOT), TTV DNA was detected in 9/17 treatment responder patients and 3/5 relapser patients, thus, TTV infection does not appear to influence the control HCV viremia after EOT. Levels of IL-6 IL-4, and CD14 were not significantly different between TTV PCR-positive and -negative patients. These results suggest no association between TTV DNA positivity or viral load and HCV DAA failure whether patients were HIV/HCV coinfected or HCV monoinfected.
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Affiliation(s)
- Daniele Lapa
- Laboratory of Virology, “Lazzaro Spallanzani” National Institute for Infectious Diseases, IRCCS, 00149 Rome, Italy; (D.L.); (C.M.); (M.R.C.)
| | - Paola Del Porto
- Department of Biology and Biotechnology “C. Darwin”, Sapienza University, 00185 Rome, Italy;
| | - Claudia Minosse
- Laboratory of Virology, “Lazzaro Spallanzani” National Institute for Infectious Diseases, IRCCS, 00149 Rome, Italy; (D.L.); (C.M.); (M.R.C.)
| | - Gianpiero D’Offizi
- Hepatology and Infectious Diseases Unit, “Lazzaro Spallanzani” National Institute for Infectious Diseases IRCCS, 00149 Rome, Italy; (G.D.); (U.V.-C.)
| | - Andrea Antinori
- Clinical Department, “Lazzaro Spallanzani ” National Institute for Infectious Diseases, IRCCS, 00149 Rome, Italy; (A.A.); (M.Z.)
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, “Lazzaro Spallanzani” National Institute for Infectious Diseases, IRCCS, 00149 Rome, Italy; (D.L.); (C.M.); (M.R.C.)
| | - Ubaldo Visco-Comandini
- Hepatology and Infectious Diseases Unit, “Lazzaro Spallanzani” National Institute for Infectious Diseases IRCCS, 00149 Rome, Italy; (G.D.); (U.V.-C.)
| | | | - Anna Rosa Garbuglia
- Laboratory of Virology, “Lazzaro Spallanzani” National Institute for Infectious Diseases, IRCCS, 00149 Rome, Italy; (D.L.); (C.M.); (M.R.C.)
- Correspondence: ; Tel.: +39-06-5517-0692; Fax: +39-06-559-455
| | - Mauro Zaccarelli
- Clinical Department, “Lazzaro Spallanzani ” National Institute for Infectious Diseases, IRCCS, 00149 Rome, Italy; (A.A.); (M.Z.)
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Mrzljak A, Vilibic-Cavlek T. Torque teno virus in liver diseases and after liver transplantation. World J Transplant 2020; 10:291-296. [PMID: 33312890 PMCID: PMC7708878 DOI: 10.5500/wjt.v10.i11.291] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 09/22/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023] Open
Abstract
Torque teno virus (TTV) has been proposed as a surrogate biomarker for immune monitoring in different patient cohorts. Historically, TTV has been associated with different liver diseases such as post-transfusion hepatitis, hepatitis B, and hepatitis C, but the virus's pathogenicity is controversial. TTV is a ubiquitous DNA virus, highly prevalent and mostly indolent in the general population. Thus, TTV viral load is more relevant than prevalence to understand TTV infection. In the context of liver transplantation, TTV viral load is modulated by the immune, viral, and inflammatory status. After liver transplantation, the TTV viral load positively correlates with the intensity of immunosuppression (IS), and low TTV viral burden is a predictor of acute rejection episodes, making it an attractive marker for the efficacy of IS. However, the TTV role as a single or a panel biomarker needs to be evaluated in further independent prospective trails.
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Affiliation(s)
- Anna Mrzljak
- Department of Medicine, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian Institute of Public Health; School of Medicine, University of Zagreb, Zagreb 10000, Croatia
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