Torque teno virus viral load predicts SARS‐CoV‐2 vaccine response in kidney transplant recipients

Abstract

Transplant recipients display poor responses to SARS-CoV-2 mRNA vaccines. In this retrospective study, we investigate torque teno virus (TTV) viral load (VL), a ubiquitous virus reflecting global immune response levels, as a predictive factor of vaccine response in kidney transplant recipients (KTR). Four hundred and fifty-nine KTR having received two SARS-CoV-2 mRNA vaccine doses were enrolled, and 241 of them subsequently received a third vaccine dose. Antireceptor-binding domain (RBD) IgG response was assessed after each vaccine dose and TTV VL was measured in pre-vaccine samples. Prevaccine TTV VL > 6.2 log 10 copies (cp)/mL was independently associated with nonresponse to two doses (odds ratio (OR) = 6.17, 95% confidence interval (CI95) = 2.42-15.78) as well as to three doses (OR = 3.62, 95% CI95 = 1.55-8.49). In nonresponders to the second dose, high TTV VL in prevaccine samples or measured before the third dose were equally predictive of lower seroconversion rates and antibody titers. High TTV VL before and during SARS-CoV-2 vaccination schedules are predictive of poor vaccine response in KTR. This biomarker should be further evaluated regarding other vaccine responses.

Respiratory torque teno virus load at emergency department visit predicts intensive care unit admission of SARS‐CoV‐2 infected patients

“…Anelloviruses, and TTV in particular, are now considered potential surrogate markers of functional immunity in solid organ transplant recipients. Interestingly, recent reports found that high levels of TTV in the blood are predictive of a poor response to SARS‐CoV‐2 vaccination in lung and kidney transplant recipients 17–20 …”

“…Interestingly, recent reports found that high levels of TTV in the blood are predictive of a poor response to SARS-CoV-2 vaccination in lung and kidney transplant recipients. [17][18][19][20] In this study, we observed that the TTV load in nasopharyngeal samples could predict the need for ICU admission in patients infected with SARS-CoV-2. We established a threshold value as an independent predictor.…”

Challenges Faced by Solid Organ Transplant Recipients During the COVID-19 Pandemic in France: Historical Insights and Key Takeaways

“…A significant concern was the weak vaccine response in patients with comorbidities undergoing immunosuppressive therapy, particularly those treated with mycophenolate mofetil and belatacept. 15 In addition, identifying patients who may not be seroconverted after vaccination was challenging. To address this issue, researchers have explored the role of the torque teno virus, a virus that reflects the overall immune response levels, as a predictive factor for vaccine response.…”

“…A study found that patients with a high prevaccine torque teno viral load (>6.2 log 10 copies) were more likely to experience no response to 3 anti–SARS-CoV-2 vaccine doses (odds ratio, 3.62; 95% confidence interval, 1.55-8.49). 15 In the pursuit of finding effective solutions for nonresponders, alternative strategies involving the use of a combination of mAbs as preexposure prophylaxis were explored. One specific combination that has shown promise is casirivimab–imdevimab (Figure 1).…”

Torque Teno Viral Plasma Load for Immunologic Monitoring in Solid Organ Transplantation: One Step Further

“…Other researchers have also demonstrated an association between TTV load and the response to SARS-CoV-2 mRNA vaccination. [7][8][9] Seroconversion rates were acceptable among kidney transplant recipients exhibiting a TTV load below 2.6 log c/mL, whereas patients with a TTV load surpassing 4.6 log c/mL displayed low rates of seroconversion.…”