High torque tenovirus (TTV) load before first vaccine dose is associated with poor serological response to COVID-19 vaccination in lung transplant recipients

Rogier AS Hoek, Erik AM Verschuuren, Rory D. de Vries, Judith M. Vonk, Debbie van Baarle, Marieke van der Heiden, Johanna P. van Gemert, Edmund J. Gore, Hubert GM Niesters, Michiel Erasmus, Merel E. Hellemons, Sandra MJ Scherbeijn, Nynke Wijbenga, Edris A.F. Mahtab, Corine H. GeurtsvanKessel, Coretta Van Leer Buter*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
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Background: Serological responses to COVID-19 vaccination are diminished in recipients of solid organ transplants, especially in lung transplant recipients (LTR), probably as result of immunosuppressive treatment. There is currently no marker of immunosuppression that can be used to predict the COVID-19 vaccination response. Here, we study whether torque tenovirus (TTV), a highly prevalent virus can be used as an indicator of immunosuppression. Methods: The humoral response to the mRNA 1273 vaccine was assessed in 103 LTR, who received a transplant between 4 and 237 months prior to vaccination, by measuring Spike (S)-specific IgG levels at baseline, 28 days after first, and 28 days after the second vaccination. TTV loads were determined by RT-PCR and Pearson's correlation coefficient was calculated to correlate serological responses to TTV load. Results: Humoral responses to COVID-19 vaccination were observed in 41 of 103 (40%) LTR at 28 days after the second vaccination. Sixty-two of 103 (60%) were non-responders. Lower TTV loads at baseline (significantly) correlated with higher S-specific antibodies and a higher percentage of responders. Lower TTV loads also strongly correlated with longer time since transplantation, indicating that participants with lower TTV loads were longer after transplantation. Conclusions: This study shows a better humoral response to the SARS-CoV-2 vaccine in subjects with a lower TTV load pre-vaccination. In addition, TTV load correlates with the time after transplantation. Further studies on the use of TTV load in vaccination efficacy studies in immunocompromised cohorts should provide leads for the potential use of this marker for optimizing vaccination response.

Original languageEnglish
Pages (from-to)765-772
Number of pages8
JournalJournal of Heart and Lung Transplantation
Issue number6
Early online date16 Mar 2022
Publication statusPublished - 1 Jun 2022

Bibliographical note

Funding Information:
We thank Annemarie Geel, Thea Scholtens, Annika Post and Willie Steenhuis for their assistance in the logistical and administrative management of the participants, and Susanne Bogers en Faye de Wilt for their dataprocessing expertise.

Funding Information:
The authors have no conflicts of interest. This study was made possible by the support of the Netherlands Organization for Health Research and Development (ZonMW).

Publisher Copyright:
© 2022 The Authors


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