Abstract：
Anelloviridae and Human Pegivirus 1 (HPgV-1) blood burden have been postulated to behave as surrogate markers for immunosuppression in transplant recipients. Here, we assessed the potential utility plasma Torque teno virus (TTV), total Anelloviridae (TAV), and HPgV-1 load monitoring for the identification of allogeneic hematopoietic stem cell transplantation recipients (allo-HSCT) at increased risk of infectious events or acute graft versus host disease (aGvHD). In this single-center, observational study, plasma TTV DNA, TAV DNA, and HPgV-1 RNA loads were monitored in 75 nonconsecutive allo-HSCT recipients (median age, 54 years). Monitoring was conducted before at baseline or by days +30, +60, +90, +120, and +180 after transplantation. Pneumonia due to different viruses or Pneumocystis jirovecii, BK polyomavirus-associated haemorrhagic cystitis (BKPyV-HC), and Cytomegalovirus DNAemia were the infectious events considered in the current study. Kinetics of plasma TTV, TAV DNA, and HPgV-1 RNA load was comparable, with though and peak levels measured by days +30 and day +90 (+120 for HPgV-1). Forty patients (53%) developed one or more infectious events during the first 180 days after allo-HSCT, whereas 29 patients (39%) had aGvHD (grade II-IV in 18). Neither, TTV, TAV, nor HPgV-1 loads were predictive of overall infection or CMV DNAemia. A TTV DNA load cut-off ≥4.40 log10 (pretransplant) and ≥4.58 log10 (baseline) copies/mL predicted the occurrence of BKPyV-HC (sensitivity ≥89%, negative predictive value, ≥96%). TTV DNA loads ≥3.38 log10 by day +30 anticipated the occurrence of aGvHD (sensitivity, 90%; negative predictive value, 97%). Pretransplant HPgV-1 loads were significantly lower (p = 0.03) in patients who had aGvHD than in those who did not. Monitoring of TTV DNA or HPgV-1 RNA plasma levels either before or early after transplantation may be ancillary to identify allo-HSCT recipients at increased risk of BKPyV-HC or aGvHD.
摘要：
已经假定anellovibrae和人类Pegivirus1（HPgV-1）的血液负担在移植受体中充当免疫抑制的替代标记。这里,我们评估了潜在的效用血浆扭矩特诺病毒（TTV），总肛门病毒科（TAV），和HPgV-1负荷监测，以鉴定感染事件或急性移植物抗宿主病（aGvHD）风险增加的异基因造血干细胞移植受体（allo-HSCT）。在这个单一中心，观察性研究，等离子TTVDNA,TAVDNA,在75名非连续allo-HSCT接受者中监测HPgV-1RNA负荷(中位年龄，54年）。在基线之前或在移植后+30、+60、+90、+120和+180天进行监测。不同病毒或肺孢子虫肺炎，BK多瘤病毒相关出血性膀胱炎（BKPyV-HC），巨细胞病毒DNA血症是本研究中考虑的感染事件.等离子TTV的动力学，TAVDNA,和HPgV-1RNA载量相当，通过+30天和+90天测量的than和峰值水平(HPgV-1为+120)。40名患者（53％）在allo-HSCT后的前180天内发生了一种或多种感染事件，而29例患者(39%)有aGvHD(18例患者中II-IV级).都不是,TTV,TAV,HPgV-1负荷也不能预测总体感染或CMVDNA血症。TTVDNA负载截止值≥4.40log10（移植前）和≥4.58log10（基线）拷贝/mL预测BKPyV-HC的发生（灵敏度≥89％，负预测值，≥96%)。到第30天，TTVDNA负荷≥3.38log10预计会发生aGvHD(敏感性，90%；阴性预测值，97%）。患有aGvHD的患者的移植前HPgV-1负荷显着降低（p=0.03）。在移植前或移植后早期监测TTVDNA或HPgV-1RNA血浆水平可以辅助鉴定具有增加的BKPyV-HC或aGvHD风险的allo-HSCT受体。
