Quantification of Torque Teno Virus and Epstein-Barr Virus Is of Limited Value for Predicting the Net State of Immunosuppression After Lung Transplantation

Nordén, Rickard; Magnusson, Jesper; Lundin, Anna; Tang, Ka-Wei; Nilsson, Staffan; Lindh, Magnus; Andersson, Lars-Magnus; Riise, Gerdt C; Westin, Johan

The FU was divided into 4 periods, denoted q1 through q4, defined as 1-3 (q1), 3-6 (q2), 6-12 (q3), and 12-24 (q4) months after transplantation. The periodic intervals were chosen to distinguish the initial phase of intensive immunosuppression from the later periods when immunosuppressive therapy was gradually lowered. Viral infections (VRTI) were more common during the first 6 months, while bacterial and fungal infections were evenly distributed throughout the period and CMV viremia occurred at a higher frequency 3-12 months after LTx after discontinuation of prophylactic ganciclovir treatment ( Table 2) . Events of acute rejections were most common during the first postoperative months and then decreased over time ( Figure 1 ). All but 3 episodes of acute rejections were biopsy-verified. The frequency of infectious events ( Figure 1 and Table 2 ) was compared with the mean TTV-DNA or EBV-DNA levels during each period (q1-q4) and the during the total FU period, respectively. No statistically significant association was found. With logistic regression, log TTV-DNA or log EBV-DNA levels in the beginning of the period did not predict any infectious event in any of the periods (Supplementary Table 2 ).