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Clinical Oral Investigations
Published in: Clinical Oral Investigations 7/2017

01-09-2017 | Original Article

Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy treatment for head and neck squamous cell carcinoma

Authors: Michelle Palmieri, Victor Adriano de Oliveira Martins, Laura Masami Sumita, Tania Regina Tozetto-Mendoza, Bruna Baraldi Romano, Clarisse Martins Machado, Claudio Sergio Pannuti, Thaís Bianca Brandão, Ana Carolina Prado Ribeiro, Luciana Corrêa, Paulo Henrique Braz-Silva

Published in: Clinical Oral Investigations | Issue 7/2017

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Abstract

Objective

Opportunistic infections may affect the oral mucosa of patients undergoing radio/chemotherapy through exacerbation of oral mucositis. The aim of this study is to evaluate the oral shedding of all eight human herpesviruses and its possible association with oral mucositis.

Materials and methods

In this prospective cohort study, we analyzed oral rinse samples, collected weekly, from 20 patients during radiotherapy treatment. Serologic status to HSV1 and HSV2, EBV, CMV, and VZV in three different periods was performed by ELISA assay. PCR and enzymatic digestion was performed to detect HSV1, HSV2, EBV, CMV, VZV, HHV6, HHV7, and HHV8. Oral mucositis was evaluated according to the WHO criteria.

Results

Oral shedding of EBV, HHV6, and HHV7 was observed in all weeks of radiotherapy. Considering the episodes of shedding, the highest frequency was found in patients with EBV excretion (55.0%). No virus reactivation was observed by serological analysis. EBV oral shedding frequency was significantly higher than that of other viruses and showing a positive correlation with oral mucositis grade ≥2.

Conclusions

There was a positive correlation between EBV oral shedding and oral mucositis grade ≥2, particularly after 3 weeks of radiotherapy, a period in which the severity of mucositis was statistically higher. These findings allow us to infer that the local inflammatory environment in mucositis grade ≥2 is more favorable for EBV replication.

Clinical relevance

Mucositis is a frequent and important side effect of radio/chemotherapy treatment. Understanding the possible participation of viruses in the mechanism of this condition is important to develop strategies for treatment and prevention.
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Metadata
Title
Oral shedding of human herpesviruses in patients undergoing radiotherapy/chemotherapy treatment for head and neck squamous cell carcinoma
Authors
Michelle Palmieri
Victor Adriano de Oliveira Martins
Laura Masami Sumita
Tania Regina Tozetto-Mendoza
Bruna Baraldi Romano
Clarisse Martins Machado
Claudio Sergio Pannuti
Thaís Bianca Brandão
Ana Carolina Prado Ribeiro
Luciana Corrêa
Paulo Henrique Braz-Silva
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-016-2022-x

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