A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea
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Our aim was to evaluate the literature for the prevalence of and interventions for oral viral infections and, based on scientific evidence, point to effective treatment protocols. Quality of life (QOL) and economic impact were assessed if available in the articles reviewed.
Our search of the English literature focused on oral viral infections in cancer patients within the timeframe of 1989–2007. Review methods were standardized. Cohort studies were used to determine the weighted prevalence of oral viral infection in cancer patients. The quality of selected articles were assessed and scored with respect to sources of bias, representativeness, scale validity, and sample size. Interventional studies were utilized to determine management guidelines. Literature search included measures of QOL and economic variables.
Prevalence of oral herpes simplex virus (HSV) infection in neutropenic patients was higher than in patients treated with radiotherapy for head and neck cancer (49.8% vs. 0%, respectively). In patients treated with radiochemotherapy for head and neck cancer, the prevalence of oral HSV infection increases up to 43.2% (CI, 0–100%). Prevalence of HSV infection was higher when oral ulcers existed. Information about other oral viral infections is sparse. There was a significant benefit of using acyclovir to prevent HSV oral infection (at 800 mg/day). Various dosing protocols of valacyclovir achieved prevention of HSV reactivation (500 or 1,000 mg/day). The prevalence of HSV reactivation was similar for acyclovir and valacyclovir. No information about impact on QOL and economic burden was available.
Acyclovir and valacyclovir are equally effective in preventing oral HSV infection. Neutropenic patients, who were primarily treated for hematological malignancies in the studies reviewed, are at a greater risk for viral infection.
KeywordsViral Infection Herpes Oral Complication Cancer HSV Acyclovir Valacyclovir
Conflict of interest
None to declare.
- 3.Khan SA, Wingard JR (2001) Infection and mucosal injury in cancer treatment. J Natl Cancer Inst Monogr (29):31–36Google Scholar
- 4.Wingard JR (1990) Oral complications of cancer therapies. Infectious and noninfectious systemic consequences. NCI Monogr (9):21–26Google Scholar
- 17.Brennan MS, Elting LS, Spijkervet FK (2010) Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO: methodology and quality of the literature. Support Care Cancer. doi: 10.1007/s00520-010-0856-3
- 18.Somerfield M, Padberg J, Pfister D et al (2000) ASCO clinical practice guidelines: process, progress, pitfalls and prospects. Class Pap Curr Comments 4:881–886Google Scholar
- 22.Sepulveda E, Brethauer U, Rojas J et al (2005) Oral ulcers in children under chemotherapy: clinical characteristics and their relation with herpes simplex virus type 1 and Candida albicans. Med Oral Patol Oral Cir Bucal 10(Suppl 1):E1–E8Google Scholar
- 42.Nicolatou-Galitis O, Dardoufas K, Markoulatos P et al (2001) Oral pseudomembranous candidiasis, herpes simplex virus-1 infection, and oral mucositis in head and neck cancer patients receiving radiotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash. J Oral Pathol Med 30:471–480CrossRefPubMedGoogle Scholar
- 46.Sullivan KM, Dykewicz CA, Longworth DL et al (2001) Preventing opportunistic infections after hematopoietic stem cell transplantation: the Centers for Disease Control and Prevention, Infectious Diseases Society of America, and American Society for Blood and Marrow Transplantation Practice Guidelines and beyond. Hematology Am Soc Hematol Educ Program 392–421Google Scholar
- 48.Apperley J, Carreras E, Gluckman E et al (2004) The EBMT handbook: haematopoietic stem cell transplantation. European School of Haemtology and European Group for Blood and Marrow Transplantation, ParisGoogle Scholar
- 59.Kim DH, Messner H, Minden M et al (2008) Factors influencing varicella zoster virus infection after allogeneic peripheral blood stem cell transplantation: low-dose acyclovir prophylaxis and pre-transplant diagnosis of lymphoproliferative disorders. Transpl Infect Dis 10:90–98CrossRefPubMedGoogle Scholar