Association Between Torque Teno Virus and Systemic Immunodeficiency in Patients With Uveitis With a Suspected Infectious Etiology

Importance: Torque teno virus positivity in the aqueous humor of uveitis patients could be associated with systemic immunodeficiency. Objective: We explored the correlation between the presence of torque teno virus in the aqueous humor of uveitis patients and clinical information, including immunodeficiency history. Design: This was a retrospective, cross-sectional study. Setting: All participants were recruited at Nagoya University Hospital, Tokyo Medical University Hospital, or Yokkaichi Municipal Hospital between April 2017 and March 2022. Participants: The participants were 58 uveitis patients with a suspected infectious etiology and 24 controls with cataract or age-related macular degeneration. Main Outcomes and Measures: We used quantitative polymerase chain reaction to test all subjects for torque teno virus and multiplex polymerase chain reaction to test uveitis subjects for common ocular pathogens. When possible, both serum and aqueous humor samples were tested. Ocular torque teno virus positivity was compared with age, sex, and a history of systemic immunodeficiency with logistic analysis. Results: Torque teno virus positivity was found in 7 of 31 cases (23%) with herpetic uveitis, 3 of 27 cases (11%) with nonherpetic uveitis, and 0 of 24 controls (0%). Among patients with herpes infection, positivity for torque teno virus was found in 3 of 7 patients (43%) with cytomegalovirus retinitis, 1 of 12 (8%) patients with iridocyclitis, 1 of 7 patients (14%) with acute retinal necrosis, and 2 of 4 patients (50%) with Epstein–Barr virus–related uveitis. Cytomegalovirus retinitis patients showed a significantly higher rate of ocular torque teno virus infection than controls (P = .008). Serum analysis revealed torque teno virus positivity in 9 of 10 cases (90%) with uveitis and in all 8 controls (100%). Age- and gender-adjusted logistic analysis revealed a correlation between ocular torque teno virus positivity and systemic immunodeficiency (P = .01), but no correlations between ocular torque teno virus and age, gender, or viral pathogenic type. Conclusion and Relevance: This study found that positivity for ocular torque teno virus was correlated with a clinical history of systemic immunodeficiency. This suggests that ocular torque teno virus is a biomarker of systemic immunity.