Cytomegalovirus shedding in the oral cavity of allogeneic haematopoietic stem cell transplant patients.
OBJECTIVE
This study was designed to investigate the effect of allogeneic haematopoietic stem cell transplantation (HSCT) on cytomegalovirus (CMV) shedding in the saliva by nested polymerase chain reaction (nested PCR) and its impact on patient survival.


METHODS
One hundred and twenty-four HSCT patients and 124 healthy volunteers were included in the study. Oral swabs were taken before, after 100 days and 1 year of HSCT at the buccal mucosa. Nested PCR was used to detect CMV in the saliva. Time of death after HSCT was displayed, by means of the Kaplan-Meier method, for the following parameters: age and gender of the patient, donor gender, primary disease, stem cell source, platelet number, chronic graft vs host disease (cGVHD) of salivary glands and oral mucosa, and oral CMV shedding. Cox proportional hazards model was used for multivariate survival analysis.


RESULTS
While none of the individuals in the control group showed positive swabs for CMV, the frequency of positive CMV oral swabs in patients at day + 100 after HSCT (45.2%) was statistically higher than before (7.2%) and 1 year after HSCT (17.5%). The presence of CMV was not associated with cGVHD and did not have any impact on post-transplant survival.


CONCLUSIONS
The present study shows that oral CMV shedding occurs after HSCT, especially at day +100 post-transplant. Identification of CMV in the saliva might be important for the early diagnosis of CMV infection in allo-HSTC.
Correia-Silva
J de F
Jde F
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antonio Carlos 6627, CEP 31270-901 Belo Horizonte, MG, Brazil.
Victória
J M N
JM
Guimarães
A L S
AL
Salomão
U E
UE
de Abreu
M H N G
MH
Bittencourt
H
H
Gomez
R S
RS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000821:virology; D009061:Mouth Mucosa / Q000821:virology*; D010976:Platelet Count; D012463:Saliva / Q000821:virology; D012466:Salivary Gland Diseases / Q000821:virology; D012737:Sex Factors; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous; D017201:Virus Shedding / Q000502:physiology*