#2694 Torque teno virus as an immunometer in kidney transplantation: a prospective observational study

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Abstract Background and Aims Nonpathogenic Torque Teno Virus (TTV), a component of the human virome may serve for quantifying immune status in kidney transplant recipients. TTV load can rise dramatically in immunocompromised patients such as kidney transplant recipients. This study aims to explore TTV dynamics in living renal transplant recipients and its potential as an immunometer. Method It is an initial data from a prospective observational study conducted among 36 (Mean Age- 38.44 ± 10.34, Females-11) living donor kidney transplants patients. All patients were on triple immunosuppression Tacrolimus, Mycophenolate Mofetil and Prednisolone and 28 on induction therapy also. Plasma TTV DNA load was assessed using next-generation sequencing (NGS). T-cell phenotype was analysed on fresh peripheral blood mononuclear cells. Results The prevalence of TTV in our study cohort was 100%. The TTV load was decreased at Day 10 (P = 0.003), and 1-month (P = 0.043)) however increased after 3-month (P = 0.036) post-transplant significantly than that of pre transplant period prior to start of immunosuppression (Fig. 1). At post-transplant Day 10, TTV load positively correlate with CD8+ cell (r = 0.771, P = 0.001) and negatively correlate with CD4+ cell (r = −0.894, P = 0.001) and CD19+ B cells frequency (r = −0.754, P = 0.038), however there was no correlation with Natural Killer (NK cell) cell frequency. Interestingly, patients with infection had significantly higher TTV load compared to patients without infection (6.82 Log10 Vs 2.53 Log10 copies/mL, P = .006) and two Acute T-cell mediated rejection patients had significantly low TTV load (P = 0.042). Conclusion Lower TTV loads were with incidence of acute rejection, while higher TTV loads were linked to CD8+ T cell and an increased risk of opportunistic infections. TTV quantification predicts infection after kidney transplantation and might be a potential tool to tailor immunosuppressive drug therapy.

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