Clinical characteristics of Torquetenovirus infected immunocompromised patients explored by metagenomic next-generation sequencing.

Since the recent application of metagenomic next-generation sequencing (mNGS) techniques to clinics, Torquetenoviruses (TTV) have received much attention due to their high positive rates. However, there is an insufficient understanding in clinical settings of the pathogen, especially in immunocompromised patients. This study explores the clinical characteristics of TTV infection in immunocompromised patients using mNGS. We enrolled a total of 120 TTV-infected patients in the study, including 81 immunocompromised and 39 immunocompetent individuals. The prevalence, diagnosis, treatment, and co-pathogens were compared between the two groups. The microbial diversity and presence of co-pathogens in patients infected with Torquetenovirus (TTV) were elucidated through comprehensive analysis. T-tests compared the normally distributed continuous data. The immunocompromised patients exhibited significantly elevated TTV loads, and a notable proportion of these patients also presented with hematopoietic disorders. Importantly, our investigation revealed that current treatments showed no efficacy against TTV infection.Furthermore, the presence of copathogens such as Staphylococcus, Bacillus, Mycobacterium, and Acinetobacter was observed in TTV-infected individuals. Immunocompromised patients exhibited a significantly higher abundance of Staphylococcus and Shewanella compared to immunocompetent patients (p < 0.05). Cautious use of antiviral therapy is recommended for patients with TTV mono-infection. However, greater attention should be given to co-pathogens, such as Staphylococcus spp. and Shewanella spp. This cohort study provides valuable insights into the clinical significance of TTV infection, particularly in immunocompromised patients. We found that TTV is frequently detected in this population, often with higher viral loads and an increased burden of co-pathogens. These findings suggest that TTV may serve primarily as a marker of immune dysfunction rather than as a sole pathogen. Incorporating TTV monitoring into mNGS-based diagnostics could help identify high-risk patients, support early intervention, and guide tailored management strategies in immunocompromised settings.