Prevalence of oral herpes simplex virus reactivation in cancer patients: a comparison of different techniques of viral detection.
BACKGROUND
Oral reactivation of latent Herpes simplex virus (HSV) infection may easily occur in cancer patients. Virus reactivation can cause oral mucosa damage, worsen already existing lesions caused by stomatotoxic effect of cancer therapy and, whether symptomatic or asymptomatic, ample spreading and promote viral transmission.


METHODS
Polymerase chain reaction (PCR), cell-culture and direct immunofluorescence have been used to determine the frequency of oral HSV reactivation in 60 patients undergoing chemotherapy for different malignancies.


RESULTS
By means of PCR, the presence of viral DNA was detected in 71.7% of patients prior to chemotherapy and in 85.0% after chemotherapy. 33.3% of patients before and 40.0% after chemotherapy were viral-culture positive, while 3.3% of patients before and 11.7% after chemotherapy were positive as shown by direct immunofluorescence. No significant difference in HSV-1 reactivation was found before and after chemotherapy. In addition, no significant difference was found when comparing HSV-1 reactivation in patients with and without mucositis. HSV-2 was not detected in any of the patients.


CONCLUSIONS
Reactivation of latent HSV is exceptionally frequent in cancer patients. The results of this study suggest that virus reactivation occurs independently of cancer chemotherapy. The potential role of HSV reactivation in oral mucosa damage remains unclear.
Djuric
Milanko
M
Clinic for Dentistry, School of Medicine, Novi Sad, Serbia. mdjuric@eunet.yu
Jankovic
Ljiljana
L
Jovanovic
Tanja
T
Pavlica
Dusan
D
Brkic
Snezana
S
Knezevic
Aleksandra
A
Markovic
Dubravka
D
Milasin
Jelena
J
D000328:Adult; D000368:Aged; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002522:Chlorocebus aethiops; D004279:DNA, Viral / Q000032:analysis; D019085:Fluorescent Antibody Technique, Direct; D018259:Herpesvirus 1, Human / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects / Q000821:virology*; D052016:Mucositis / Q000139:chemically induced / Q000821:virology; D009369:Neoplasms / Q000188:drug therapy*; D016133:Polymerase Chain Reaction; D013283:Stomatitis, Herpetic / Q000821:virology*; D014709:Vero Cells / Q000821:virology; D014775:Virus Activation; D055815:Young Adult
D004279:DNA, Viral