A Cross-Sectional Study Comparing Torque Teno Virus Infection and Bushmeat Exposure Among Pneumonia Patients: Sarawak, Malaysia

Background: Torque Teno Virus (TTV) is ubiquitous, possibly zoonotic, and has potential for clinical and global health research application. The goals of the current study were to determine prevalence of TTV among pneumonia patients in two Malaysian hospitals, compare results from qPCR and conventional PCR detection methods, and to compare TTV infection against self-reported exposure to bushmeat products.

Methods: Medical officers obtained plasma, PBMC, and NP swab samples, along with bushmeat exposure information from 34 pneumonia patients in Sibu and Kapit hospitals. Samples were tested for TTV using qPCR. Results were corroborated using conventional PCR. Cornfield’s and McNemar’s exact methods were used to analyze infection by exposure, and agreement between PCR results respectively. Diagnostic abilities of the qPCR test were analyzed using conventional PCR as the gold standard.

Results: Conventional PCR reported 17.65% TTV prevalence, while qPCR reported 91.18%. Household size (OR=0.00, 95% CI=0.00, 0.96) and gender (OR=infinity, 95% CI=1.39, infinity) had statistically significant impacts on odds of infection. The qPCR method showed 100% sensitivity, but 7.69% specificity.

Conclusions: Results suggest low prevalence of TTV within the study population, and reaffirm findings by other researchers that smaller household size and being female are associated with decreased odds of TTV infection. Though statistically insignificant, indications that exposure to bushmeat in general increases odds of TTV infection should be investigated further. Researchers must be aware of differences in diagnostic capabilities between PCR methods for TTV detection when designing their own diagnostic studies or conducting TTV related literature reviews.