RESUMEN
Torque Teno Virus (TTV) is a non-pathogenic anellovirus, highly prevalent in healthy populations. Variations in its viral load have been associated with states of diminished immunity, as occurs after organ transplantation. It is hypothesized that TTV-load might be used as a diagnostic tool to guide prescription and dosing of immunosuppressive drugs. Not much is known about the effects of combined immunosuppressive drugs on TTV replication in renal transplantation. Belatacept was introduced to counter side-effects of calcineurin inhibitors (CNI). It was never widely adopted, mainly because its association with increased risk of rejection. To investigate the differential effects of a regimen based on calcineurin inhibitors versus belatacept on TTV-loads, we measured TTV-levels in 105 patients from two randomized controlled trials in kidney transplant recipients (KTRs). We observed that time after transplantation was inversely related to TTV-levels of patients that remained on a CNI-containing regime, whereas this decline over time was diminished after conversion to belatacept. In addition, a correlation with tacrolimus-trough levels and age were found. Our study is the first report on the impact of conversion from CNI to belatacept on TTV-levels in KTR. In conclusion, the time-related decline in TTV-levels is mitigated after conversion from CNI to belatacept.
Asunto(s)
Abatacept , Inhibidores de la Calcineurina , Inmunosupresores , Trasplante de Riñón , Torque teno virus , Carga Viral , Humanos , Trasplante de Riñón/efectos adversos , Abatacept/uso terapéutico , Inhibidores de la Calcineurina/uso terapéutico , Inhibidores de la Calcineurina/administración & dosificación , Inmunosupresores/uso terapéutico , Inmunosupresores/efectos adversos , Masculino , Persona de Mediana Edad , Femenino , Torque teno virus/efectos de los fármacos , Carga Viral/efectos de los fármacos , Adulto , Infecciones por Virus ADN/tratamiento farmacológico , Infecciones por Virus ADN/virología , Anciano , Receptores de Trasplantes , Rechazo de Injerto/prevención & controlRESUMEN
The term 'monitoring' is used in a confusing and inconsistent way. This paper deals with the terminology used in this issue.