Shedding of HSV-1, HSV-2, CMV, and EBV in the saliva of hematopoietic stem cell transplant recipients at Fundación HOMI - Hospital de la Misericordia, Bogotá, D.C.
BACKGROUND
Hematopoietic stem cell transplantation in pediatric patients is an alternative treatment for different diseases. The conditioning regimen for transplant predisposes recipients to the development of infections. Viral infections by herpes simplex virus 1 (HSV-1), herpes simplex virus 2 (HSV-2), human cytomegalovirus (CMV), and Epstein-Barr virus (EBV), are the most common, and the leading cause of morbidity and mortality among these patients. These viruses lie dormant in various cell types and the reactivation of latent infections may lead to asymptomatic viral shedding in saliva. The detection of these viruses in secretions may contribute to understand the behavioral dynamics of these viral infections in transplanted patients, and to the early diagnosis of reactivation.


OBJECTIVE
To assess HSV-1, HSV-2, CMV and EBV viral shedding in the saliva of patients admitted for hematopoietic stem cell transplantation at Fundación HOMI - Hospital de la Misericordia between January and November of 2012.


METHODS
We evaluated stimulated saliva samples of 17 hematopoietic stem cell transplantation recipients weekly. We performed DNA extraction from saliva, and we evaluated the presence of DNA for HSV-1, HSV-2, CMV, and EBV by PCR.


RESULTS
While we detected HSV-2 and CMV DNA in the saliva of four patients, EBV DNA was detected in nine patients with leukopenia. In contrast, we did not detect HSV-1 DNA in saliva. Additionally, four out of the 17 patients showed a simultaneous shedding of CMV and EBV.


CONCLUSIONS
By conventional PCR, we demonstrated asymptomatic HSV-2, CMV, and EBV viral shedding in saliva, associated with leukopenia.
Grupo de Investigación en Patogénesis Infecciosa, Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, D.C., Colombia. spbohorqueza@unal.edu.co.
Sonia P
SP
Bohórquez
Juliana
J
Díaz
Claudia M
CM
Rincón
Marcela
M
Estupiñán
Mauricio
M
Chaparro
Ana María
AM
Low-Calle
Jaime E
JE
Castellanos
D003105:Colombia; D003587:Cytomegalovirus / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D018259:Herpesvirus 1, Human / Q000276:immunology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006801:Humans; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000737:chemistry / Q000382:microbiology*; D014777:Virus Diseases / Q000276:immunology* / Q000635:transmission
Herpesviridae; bone marrow transplantation; cytomegalovirus; hematopoietic stem cell transplantation; herpes simplex; herpesvirus 4; simplexvirus