Oral shedding of CMV and HSV-1 in hematopoietic stem cell transplantation patients.

OBJECTIVES To evaluate the oral shedding of herpesviruses in patients undergoing HSCT and correlate it with oral mucositis (OM). METHODS Saliva samples were collected before the HSCT and on day D+8. Multiplex PCR was performed to detect HSV-1 and 2, EBV, CMV, VZV, HHV-6, 7 and 8. OM was assessed according to WHO criteria. RESULTS 31 patients were enrolled, in which 20/31 (64.5%) were males; median age was 50 (21-70) years old; 16/31 (51.6%) underwent allo-HSCT; and 15/31 (48.4%) auto-HSCT. On D+8, OM grade III and IV were observed in 8/31 (25.8%) patients. In the first salivary collection, EBV was found in 24/31 (77.4%), followed by HHV-6 (7/31, 22.6%) and HHV-7 (8/31 25.8%). In the second collection, EBV was found in 24/27(89%), followed by HSV-1 (8/27, 30%) and CMV, HHV-6, HHV-7 (5/27, 18.5%, each one). On D+8, OM grades II and IV were associated with presence of HSV-1. HSV-1 was also associated with worsening degrees of OM on D+15. CONCLUSION The presence of HSV-1 and CMV in oral samples was more frequent on day D+8 after HSCT. HSV-1 detection was associated with severity and worsening of OM. HSV-1 and CMV seems to be associated with oral dysbiosis due to HSCT.