Investigation of Torque Teno Virus Loads as a Marker of Immunosuppression in Pediatric Chronic Renal Failure: A Pilot Study
4 affiliations
- 1National Virus Reference Laboratory University College Dublin Dublin Ireland
- 2Children's Health Ireland at Temple Street Dublin Ireland
- 3Rotunda Hospital Dublin Ireland
- 4Royal College of Surgeons in Ireland Dublin Ireland
Abstract
Background: Torque Teno Virus (TTV), family Anelloviridae, is a small, non‐enveloped, single‐stranded DNA virus that has not been linked with any specific human illness but nevertheless constitutes a major component of the human virome. An association between TTV loads and the immune status of the host with reference to other viral infections, immunosuppression therapy, and acute rejection is reported in adult and pediatric kidney transplant recipients. We sought to investigate the feasibility of TTV as a surrogate marker of the degree of immunosuppression in pediatric kidney transplant patients.
Methods: 185 children attending the Nephrology clinic in Children's Health Ireland at Temple Street were studied over a four‐year period from September 2019 until November 2023, ranging from 0 to 17 years of age. Patients were enrolled from pre‐transplant undergoing kidney replacement therapy (n = 12), from post‐transplant (n = 124) groups, and from patients with chronic renal failure (n = 20) (without kidney replacement therapy), all of which were compared to controls (n = 35). TTV loads were quantified using a standardized TTV R‐gene kit.
Results: TTV loads were significantly higher compared to controls from 3 months post‐transplantation onward (p < 0.001), with the greatest increase observed between 3 and 6 months post‐transplantation. Immunosuppression exerted a significant independent effect on TTV loads after adjusting for age (p < 0.001). Overall, females exhibited significantly higher TTV loads than males (p = 0.01). Furthermore, a significant interaction was observed between patient group and gender (p < 0.001).
Conclusion: These findings suggest that both immunosuppressive status and gender‐related factors contribute to TTV kinetics after transplantation and should be considered when interpreting TTV as a biomarker of immune function. Larger studies are required to confirm our findings.
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BibTeX
@article{kelly2026investigation,
title = {{Investigation of Torque Teno Virus Loads as a Marker of Immunosuppression in Pediatric Chronic Renal Failure: A Pilot Study}},
author = {Ellen Kelly and Atif Awan and Dermot Wildes and Cillian F. De Gascun and Richard J. Drew and Alessandra Heggenstaller and Michael Riordan and Jaythoon Hassan},
journal = {Pediatric Transplantation},
year = {2026},
month = oct,
doi = {10.1111/petr.70491},
url = {https://doi.org/10.1111/petr.70491},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Investigation of Torque Teno Virus Loads as a Marker of Immunosuppression in Pediatric Chronic Renal Failure: A Pilot Study
AU - Ellen Kelly
AU - Atif Awan
AU - Dermot Wildes
AU - Cillian F. De Gascun
AU - Richard J. Drew
AU - Alessandra Heggenstaller
AU - Michael Riordan
AU - Jaythoon Hassan
PY - 2026
DA - 2026/10/26
JO - Pediatric Transplantation
DO - 10.1111/petr.70491
UR - https://doi.org/10.1111/petr.70491
AB - Background: Torque Teno Virus (TTV), family Anelloviridae, is a small, non‐enveloped, single‐stranded DNA virus that has not been linked with any specific human illness but nevertheless constitutes a major component of the human virome. An association between TTV loads and the immune status of the host with reference to other viral infections, immunosuppression therapy, and acute rejection is reported in adult and pediatric kidney transplant recipients. We sought to investigate the feasibility of TTV as a surrogate marker of the degree of immunosuppression in pediatric kidney transplant patients. Methods: 185 children attending the Nephrology clinic in Children's Health Ireland at Temple Street were studied over a four‐year period from September 2019 until November 2023, ranging from 0 to 17 years of age. Patients were enrolled from pre‐transplant undergoing kidney replacement therapy (n = 12), from post‐transplant (n = 124) groups, and from patients with chronic renal failure (n = 20) (without kidney replacement therapy), all of which were compared to controls (n = 35). TTV loads were quantified using a standardized TTV R‐gene kit. Results: TTV loads were significantly higher compared to controls from 3 months post‐transplantation onward (p < 0.001), with the greatest increase observed between 3 and 6 months post‐transplantation. Immunosuppression exerted a significant independent effect on TTV loads after adjusting for age (p < 0.001). Overall, females exhibited significantly higher TTV loads than males (p = 0.01). Furthermore, a significant interaction was observed between patient group and gender (p < 0.001). Conclusion: These findings suggest that both immunosuppressive status and gender‐related factors contribute to TTV kinetics after transplantation and should be considered when interpreting TTV as a biomarker of immune function. Larger studies are required to confirm our findings.
SN - 1397-3142
SN - 1399-3046
ER -