Torque-Teno Virus for the Prediction of Graft Rejection and Infection Disease after Kidney Transplantation: A Systematic Review and Meta-Analysis by Jun Zeng

J Med Virol. 2023 Mar 17. doi: 10.1002/jmv.28677. Online ahead of print.

ABSTRACT

BACKGROUND: Torque Teno virus (TTV) is a promising novel marker for quantifying the immune function in solid organ recipients, whose diagnostic accuracy of acute rejection (AR) and infection after kidney transplantation (KT) has not been evaluated.

METHODS: We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of TTV for discriminating AR and infection after KT.

RESULTS: Eleven studies were included in the meta-analysis. Seven studies focused on the diagnostic accuracy of TTV for AR, and the pooled analysis indicated patients who developed AR had a significant lower TTV viral DNA load (log10 copies/mL, MD: -0.74, p < 0.01). The pooled sensitivity, specificity, and area under the receiver operating characteristics curve for TTV in AR differentiation were 0.61 (0.36-0.82), 0.81 (0.64-0.91), and 0.79 (0.75-0.82), respectively. The overall diagnostic odds ratio (DOR) was 6.74 (2.60-17.50), positive likelihood ratio (PLR) was 3.22 (1.75-5.95), and negative likelihood ratio (NLR) was 0.48 (0.27-0.84), respectively. Similarly, seven studies investigated the infection discrimination and found that patients who subsequently developed posttransplant infection had higher plasma TTV DNA loads (log10 copies/mL, MD: 0.65; P < 0.01) than those remaining infection-free. Pooled sensitivity, specificity, and area under the receiver operating characteristics curve for TTV in infection differentiation were 0.72 (0.39-0.91), 0.57 (0.30-0.80), and 0.68 (0.64-0.72), respectively. The overall DOR was 3.28 (95% CI, 2.08-5.17), the pooled PLR and NLR were 1.65 (95% CI, 1.25-2.18) and 0.50 (95% CI, 0.29-0.86), respectively.

CONCLUSIONS: TTV might be a modest indicator for risk stratification of AR after KT, but it is a poor to discriminate post-transplant infection. This article is protected by copyright. All rights reserved.

PMID:36929741 | DOI:10.1002/jmv.28677