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      Torque teno virus among dialysis and renal-transplant patients

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          Abstract

          Patients who undergo dialysis treatment or a renal transplant have a high risk of blood-borne viral infections, including the Torque teno virus (TTV). This study identified the presence of TTV and its genome groups in blood samples from 118 patients in dialysis and 50 renal-transplant recipients. The research was conducted in a hospital in the city of Maringá, state of Paraná. The viral DNA, obtained from whole blood, was identified by using two nested Polymerase Chain Reactions (PCR). The frequencies of TTV were 17% and 36% in dialysis patients using the methodology proposed by Nishizawa et al . (1997) and Devalle and Niel (2004) , respectively, and 10% and 54% among renal-transplant patients. There was no statistically significant association between the frequency of the pathogen and the variables: gender, time in dialysis, time since transplant, blood transfusions, and the concomitant presence of hepatitis B, for either the dialysis patients or the renal-transplant recipients. Among dialysis patients and renal-transplant recipients, genogroup 5 was predominant (48% and 66% respectively), followed by genogroup 4 (37% and 48%) and genogroup 1 (23% and 25%). Genogroup 2 was present in both groups of patients. Some patients had several genogroups, but 46% of the dialysis patients and 51% of the renal-transplant recipients had only a single genogroup. This study showed a high prevalence of TTV in dialysis patients and renal-transplant recipients.

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          Most cited references40

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          A novel DNA virus (TTV) associated with elevated transaminase levels in posttransfusion hepatitis of unknown etiology.

          By means of representational difference analysis, a viral clone (N22) of 500 nucleotides was isolated from serum of a patient (TT) with posttransfusion hepatitis of unknown etiology. The N22 clone showed a poor homology to any reported sequences. Oligonucleotide primers were deduced from the N22 sequence for detecting it by polymerase chain reaction. N22 sequence in serum banded at a sucrose density of 1.26 g/cm3, indicating its association with a viral particle which was designated TT virus (TTV). Since nucleic acids of TTV were sensitive to DNase I, it would be a DNA virus. TTV DNA was detected in sera from three of the five patients with posttransfusion non-A to G hepatitis, including the index case (TT). TTV DNA titers closely correlated with aminotransferase levels in the three patients. These results indicate that TTV would be a novel DNA virus with a possible capacity to induce posttransfusion non-A to G hepatitis. Copyright 1997 Academic Press.
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            Molecular properties, biology, and clinical implications of TT virus, a recently identified widespread infectious agent of humans.

            TT virus (TTV) was first described in 1997 by representational difference analysis of sera from non-A to non-G posttransfusion hepatitis patients and hence intensively investigated as a possible addition to the list of hepatitis-inducing viruses. The TTV genome is a covalently closed single-stranded DNA of approximately 3.8 kb with a number of characteristics typical of animal circoviruses, especially the chicken anemia virus. TTV is genetically highly heterogeneous, which has led investigators to group isolates into numerous genotypes and subtypes and has limited the sensitivity of many PCR assays used for virus detection. The most remarkable feature of TTV is the extraordinarily high prevalence of chronic viremia in apparently healthy people, up to nearly 100% in some countries. The original hypothesis that it might be an important cause of cryptogenic hepatitis has not been borne out, although the possibility that it may produce liver damage under specific circumstances has not been excluded. The virus has not yet been etiologically linked to any other human disease. Thus, TTV should be considered an orphan virus.
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              Improved detection systems for TT virus reveal high prevalence in humans, non-human primates and farm animals.

              TT virus is a newly described agent infecting humans. Initially isolated from a patient (initials T.T.) with unexplained hepatitis, the virus has since been found in both normal and diseased individuals. In the present study, we utilized genomic-length sequences from distinct genotypes of TT virus to design PCR-based assays using conserved oligonucleotide primers from three independent regions of the virus genome. Each of the three assays was found to be superior to the PCR-based assays previously published. The most sensitive of the new assays was utilized to demonstrate the prevalence of TT virus to be at least 34.1% in volunteer blood donors, 39.6% in commercial blood donors, 59.6% in non-A-GB hepatitis cases, 81.7% in injectable drug users and 95.9% in haemophiliacs. In an attempt to identify a possible source of human infection, we found TT virus sequences to be present in 19% of chickens, 20% of pigs, 25% of cows and 30% of sheep. Sequence determination and phylogenetic analyses demonstrated that isolates from farm animals were not genetically distinct from those found in humans. This study clearly demonstrates that previously reported PCR assays dramatically underestimate the true prevalence of TT virus within the human population. Due to the high rate of infection in both blood donors and those with non-A-GB hepatitis, these results question the causal role of TT virus in cases of unexplained hepatitis. Further, it is possible that domesticated farm animals serve as a source of human infection.
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                Author and article information

                Journal
                Braz J Microbiol
                Braz. J. Microbiol
                Brazilian Journal of Microbiology
                Sociedade Brasileira de Microbiologia
                1517-8382
                1678-4405
                01 March 2015
                March 2015
                : 46
                : 1
                : 307-311
                Affiliations
                [1 ]Departamento de Enfermagem, Universidade Estadual de Maringá, Maringá, PR, Brazil.
                [2 ]Departamento de Ciências Básicas da Saúde, Universidade Estadual de Maringá, Maringá, PR, Brazil.
                [3 ]Departamento de Patologia, Universidade Estadual de Londrina, Londrina, PR, Brazil.
                [4 ]Departamento de Estatística, Universidade Estadual de Maringá, Maringá, PR, Brazil.
                [5 ]Departamento de Ciências Básicas, Universidade Estadual de Maringá, Maringá, PR, Brazil.
                [6 ]Departamento de Enfermagem, Universidade Estadual de Maringá, Maringá, PR, Brazil.
                Author notes
                Send correspondence to A.Y. Takemoto. Departamento de Enfermagem, Universidade Estadual de Maringá, Maringá , PR, Brazil. E-mail: angelica.takemoto@ 123456hotmail.com .

                Associate Editor: Maurício Lacerda Nogueira

                Article
                1517-8382-bjm-46-01-0307
                10.1590/S1517-838246120131195
                4512073
                2836513c-4408-4a7a-8b74-1d905dee1e03
                Copyright © 2015, Sociedade Brasileira de Microbiologia

                All the content of the journal, except where otherwise noted, is licensed under a Creative Commons License CC BY-NC.

                History
                : 12 November 2013
                : 06 June 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 5
                Categories
                Genetics and Molecular Microbiology

                torque teno virus,renal dialysis,kidney transplant,infection

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