Human pegivirus type 1 infection in kidney transplant recipients: Replication kinetics and clinical correlates

Abstract

Background: Increasing evidence suggests that infection with the nonpathogenic human pegivirus type 1 (HPgV-1) exerts a clinical benefit in human immunodeficiency virus (HIV) patients, which could be attributable to immunomodulatory effects.Whether this impact can be extrapolated to kidney transplantation (KT) remains largely unknown. Methods:We measured plasma HPgV-1 RNA by real-time polymerase chain reaction targeting the 5′ untranslated region at various points (pretransplantation, day 7, months 1, 3, 6, and 12) in 199 KT recipients. Study outcomes included posttransplant serious infection, immunosuppression-related adverse event (opportunistic infection and/or de novo cancer), and acute graft rejection. Results:HPgV-1 infection was demonstrated in 52 (26.1%) patients, with rates increasing from 14.7% at baseline to 19.1% by month 12 (p-value = .071). De novo infection occurred in 13.8% of patients with no detectable HPgV-1 RNA before transplantation. Double-organ (liver-kidney or kidney-pancreas) transplantation (odds ratio [OR]: 5.62; 95% confidence interval [CI]: 1.52-20.82) and donation after brain death (OR: 2.21; 95% CI: 1.00-4.88) were associated with posttransplant HPgV-1 infection, whereas pretransplant hypertension was protective (OR: 0.23; 95% CI: 0.09-0.55).There were no significant differences in the incidence of study outcomes according to HPgV-1 status. Plasma HPgV-1 RNA levels at different points did not significantly differ between patients that subsequently developed outcomes and those remaining free from these events. No correlation between HPgV-1 RNA and immune parameters or torque teno virus DNA load was observed either.

Longitudinal Detection of Twenty DNA and RNA Viruses in Allogeneic Hematopoietic Stem Cell Transplant Recipients Plasma

“…Since HPgV-1 is known to cause chronic infections, HPgV-1 detection at multiple consecutive time-points in most patients suggests sustained viremia despite the long intervals between the sampling time-points. Besides a possible association with lymphoma, HPgV-1 has not been associated with any overt clinical manifestations after transplantation, despite complex interactions with the immune system [4,[24][25][26][27][28][29]. Although lacking statistical significance, higher rates of progression-free survival and GVHD-free relapse-free survival, and lower aGVHD of grade ≥2 and relapse, have been reported among HPgV-1-infected versus HPgV-1-negative patients, illustrating that HPgV-1 may not be a silent bystander [3].…”

Monitoring of plasma Torque teno virus, total Anelloviridae and Human Pegivirus 1 viral load for the prediction of infectious events and acute graft versus host disease in the allogeneic hematopoietic stem cell transplantation setting

“…TAV DNA was quantified using a SYBR Green based real‐time PCR using the universal primers NG779/NG781 that target a conserved segment of the UTR region, as previously described 14,25 . Human Pegivirus (HPgV‐1) RNA was quantified using a one‐step RT‐PCR as previously described 26 …”

“…14,25 Human Pegivirus (HPgV-1) RNA was quantified using a one-step RT-PCR as previously described. 26 27 CMV DNA was quantified in plasma samples by using the Abbott RealTime CMV Assay (Abbott molecular). BK polyomavirusassociated haemorrhagic cystitis (BKPyV-HC) was diagnosed according to ECIL clinical guidelines.…”