HSV excretion after bone marrow transplantation: a 4-year survey.
BACKGROUND
Herpes simplex virus (HSV) oral excretions are common after bone marrow transplantation (BMT).


OBJECTIVE
We report a 4-year systematic survey of HSV excretions in an adult population who underwent BMT (289 transplantations).


METHODS
Patients received either intravenous ACV treatment when mucositis occurred or systematic intravenous ACV prophylaxis from initiation of the BMT conditioning until the end of aplasia. All patients were followed up for HSV excretions.


RESULTS
Twenty-eight patients (9.7%) excreted HSV. The occurrence of HSV excretions was similar in both allogeneic and autologous transplant patients. The incidence was significantly lower when ACV was systematically used after transplantation (2.5%) compared to when ACV was implemented for mucositis (12%). ACV-resistant HSV was detected in three patients who received allogeneic transplantation, representing 27% of allogeneic recipients excreting HSV.


CONCLUSIONS
HSV infection prophylaxis with high dose of intravenous ACV resulted in a decreased incidence of HSV excretion. Nevertheless, the risk of emergence of ACV resistance, especially among allogeneic transplant patients, appears to be identical whatever the route and dose of ACV prophylaxis.
Morfin
Florence
F
Laboratory of Virology of the Hospices Civils de Lyon, Domaine Rockefeller, 8 avenue Rockefeller, 69373 Lyon Cedex 08, France. fmorfin@rockefeller.univ-lyon1.fr
Bilger
Karin
K
Boucher
Anne
A
Thiebaut
Anne
A
Najioullah
Fatiha
F
Bleyzac
Nathalie
N
Raus
Nicole
N
Bosshard
Sylvie
S
Aymard
Michèle
M
Michallet
Mauricette
M
Thouvenot
Danielle
D
D000212:Acyclovir / Q000494:pharmacology / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D024882:Drug Resistance, Viral; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000821:virology*; D013280:Stomatitis / Q000188:drug therapy / Q000821:virology; D017201:Virus Shedding
D000998:Antiviral Agents; D000212:Acyclovir