Jb. Epstein et al., ACYCLOVIR PROPHYLAXIS OF ORAL HERPES-VIRUS DURING BONE-MARROW TRANSPLANTATION, European journal of cancer. Part B, Oral oncology, 32(3), 1996, pp. 158-162
Oropharyngeal shedding of herpes viruses (herpes simplex, cytomegalovi
rus) was assessed in patients on standard acyclovir prophylaxis during
bone marrow transplantation (BMT) to determine the frequency of viral
shedding and to assess possible oropharyngeal complications that may
be associated with viral reactivation in these patients. We conducted
a prospective assessment of 83 patients receiving BMT. Patients were e
valuated weekly and oral surveillance cultures were completed. Sheddin
g of herpes simplex virus (HSV) was detected in the oropharynx of 2.9%
of seropositive patients on prophylactic acyclovir, and only one case
of clinical oral herpetic infection was seen. Cytomegalovirus (CMV) w
as cultured from the oropharynx in 13.3% of CMV seropositive patients
provided with prophylactic acyclovir, but no oropharyngeal lesions wer
e attributed to CMV reactivation. No correlation was seen between HSV
and CMV pretransplant serology and severity of oral mucositis and acut
e graft versus host disease. No effect on time to engraftment was dete
cted. This study supports the continuing use of acyclovir prophylaxis
in HSV seropositive patients receiving BMT. Acyclovir prophylaxis was
effective in preventing viral shedding in all but 2.9% of patients, an
d only one case of clinical infection was diagnosed. The frequency of
CMV shedding was approximately four times that of HSV; however, no ora
l lesions were attributed to CMV. Copyright (C) 1996 Elsevier Science
Ltd