Torque teno virus viremia and QuantiFERON®-CMV assay in prediction of cytomegalovirus reactivation in R+ kidney transplant recipients

Frontiers in Medicine

Medicine

Anaïs Labrunie¹  Melissa Gomes-Mayeras²  Sophie Alain²  Françoise Garnier²  Sébastien Hantz²  Sarah Mafi²  Nicolas Bouvier³  Anne-Elizabeth Heng⁴  Benedicte Janbon⁵  Antoine Garstka⁶  Jean-Philippe Rerolle⁷  Marie Essig⁷  Diego Cantarovitch⁸  Betoul Schvartz⁹  Romain Crochette^1,10  Stephanie Gouarin^1,11  Christine Archimbaut^1,12  Raphaële Germi^1,13  Ilka Engelmann^1,14  Céline Bressollette-Bodin^1,15  Véronique Brodard^1,16  Gisèle Lagathu^1,17 

[1] Biostatistics Department, Centre Hospitalier Universitaire de Limoges, Limoges, France;French National Reference Center for Herpesviruses, Bacteriology, Virology, Hygiene Department, Centre Hospitalier Universitaire de Limoges, Limoges, France;Inserm, RESINFIT, U1092, Université de Limoges, Limoges, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Caen, Caen, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Grenoble, Grenoble, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Lille, Lille, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Limoges, Limoges, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Nantes, Nantes, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Reims, Reims, France;Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Rennes, Rennes, France;Virology Department, Centre Hospitalier Universitaire de Caen, Caen, France;Virology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France;Virology Department, Centre Hospitalier Universitaire de Grenoble, Grenoble, France;Virology Department, Centre Hospitalier Universitaire de Lille, Lille, France;Virology Department, Centre Hospitalier Universitaire de Nantes, Nantes, France;Virology Department, Centre Hospitalier Universitaire de Reims, Reims, France;Virology Department, Centre Hospitalier Universitaire de Rennes, Rennes, France;

关键词: Torquetenovirus;    cytomegalovirus;    QuantiFERON CMV;    kidney transplantation;    CMV-seropositive recipients;   

DOI  :  10.3389/fmed.2023.1180769

 received in 2023-03-06, accepted in 2023-05-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionCytomegalovirus (CMV) is the most frequent infectious complication following solid organ transplantation. Torque teno viruses (TTV) viremia has been proposed as a biomarker of functional immunity in the management of kidney transplant recipients (KTR). The QuantiFERON®-CMV (QF-CMV) is a commercially available assay that allows the assessment of CD8+ T-cell responses in routine diagnostic laboratories.MethodsIn a prospective national multicenter cohort of 64 CMV-seropositive (R+) KTR, we analyzed the value of TTV load and the two markers of the QF-CMV assay [QF-Ag (CMV-specific T-cell responses) and QF-Mg (overall T-cell responses)], alone and in combination, in prediction of CMV reactivation (≥3 log10 IU/ ml) in the first post-transplant year. We compared previously published cut-offs and specific cut-offs optimized from ROC curves for our population.ResultsUsing the conventional cut-off (3.45 log10 copies/ml), TTV load at D0 [inclusion visit on the day of transplantation before induction (D0)], or at M1 (1-month post-transplant visit) perform better in predicting CMV viremia control than CMV reactivation. Survival analyses suggest a better performance of our optimized TTV cut-offs (3.78 log10 copies/ml at D0 and 4.23 log10 copies/ml at M1) for risk stratification of CMV reactivation in our R+ KTR cohort. The QF-CMV (QF-Ag = 0.2 IU/ml, and QF-Mg = 0.5 IU/ml) also appears to better predict CMV viremia control than CMV reactivation. Moreover, survival analyses suggest that the QF-Mg would perform better than the QF-Ag in stratifying the risk of CMV reactivation. The use of our optimized QF-Mg cut-off (1.27 IU/ml) at M1 further improved risk stratification of CMV reactivation. Using conventional cut-offs, the combination of TTV load and QF-Ag or TTV load and QF-Mg did not improve prediction of CMV viremia control compared to separate analysis of each marker but resulted in an increase of positive predictive values. The use of our cut-offs slightly improved risk prediction of CMV reactivation.ConclusionThe combination of TTV load and QF-Ag or TTV load and QF-Mg could be useful in stratifying the risk of CMV reactivation in R+ KTR during the first post-transplant year and thereby have an impact on the duration of prophylaxis in these patients.Clinical trial registrationClinicalTrials.gov registry, identifier NCT02064699.

【 授权许可】

Unknown   
Copyright © 2023 Mafi, Essig, Rerolle, Lagathu, Crochette, Brodard, Schvartz, Gouarin, Bouvier, Engelmann, Garstka, Bressollette-Bodin, Cantarovitch, Germi, Janbon, Archimbaut, Heng, Garnier, Gomes-Mayeras, Labrunie, Hantz and Alain.