title: HSV-1 as well as HSV-2 is frequent in oral mucosal lesions of children on chemotherapy.
abstract: OBJECTIVE
  Prevalence data of herpes simplex virus (HSV) in oral mucositis in children on treatment for cancer is limited. Quantitative polymerase chain reaction (PCR) has been seldom utilized for detection of HSV-1/2 in oral mucosa.
  
  
  METHODS
  Children on treatment for cancer with oral mucositis were enrolled as cases and healthy children as controls. An oral swab from the lesion in cases and mucosal scraping in controls were obtained. Both qualitative and real-time quantitative PCR for HSV-1/2 were performed. Serum ELISA-IgG/IgM for HSV-1/2 antibodies (NovaLisa™-Dietzenbach-Germany) were measured.
  
  
  RESULTS
  Thirty-two cases (Age, 6.3±3.4 years) and 30 controls were enrolled. Majority (69%) of cases had ALL. All patients had febrile neutropenia, except two. ELISA-IgM-HSV-1/2 was not positive in any case or control. ELISA-IgG-HSV-1/2 was positive in 11 (34%) cases and nine (30%) controls (p=1.0). Qualitative PCR for HSV-1 detected the virus in eight (25%) cases and nil controls (p=0.009). HSV-2 was not detected in any case/control by qualitative PCR. Quantitative PCR detected HSV-1 in 21 (66%) and HSV-2 in 22 (69%) cases. In controls, quantitative PCR detected HSV-1 in three (10%) and HSV-2 in none. In patients, the mean viral load of HSV-1 (5,500±15,987×10(4) copies/nanogram DNA) was more than HSV-2 (4.03±8.5×10(4)) (p=0.11). There was no correlation of HSV-1/2 with grading of mucositis.
  
  
  CONCLUSIONS
  Both HSV-1/2 are commonly shed from oral mucosal lesions in children receiving chemotherapy. In a novel finding, real-time PCR detected copies of HSV-2 in 69% cases, all missed by conventional PCR. Implication for morbidity, if any, or treatment needs to be determined.
authors: Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Ritu
authors: R
authors: Aggarwal
authors: Deepak
authors: D
authors: Bansal
authors: Jasmine
authors: J
authors: Naru
authors: Manila
authors: M
authors: Salaria
authors: Anita
authors: A
authors: Rana
authors: Ranjana W
authors: RW
authors: Minz
authors: Amita
authors: A
authors: Trehan
authors: R K
authors: RK
authors: Marwaha
mesh_terms: D000914:Antibodies, Viral / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006561:Herpes Simplex / Q000821:virology*; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000821:virology; D009369:Neoplasms / Q000188:drug therapy* / Q000821:virology*; D060888:Real-Time Polymerase Chain Reaction; D013280:Stomatitis / Q000821:virology*; D017201:Virus Shedding
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral