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Supportive Care in Cancer

, Volume 18, Issue 8, pp 993–1006 | Cite as

A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea

  • Sharon Elad
  • Yehuda Zadik
  • Ian Hewson
  • Allan Hovan
  • M. Elvira P. Correa
  • Richard Logan
  • Linda S. Elting
  • Fred K. L. Spijkervet
  • Michael T. Brennan
  • Viral Infections Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)
Review Article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Viral Infection Herpes Oral Complication Cancer HSV Acyclovir Valacyclovir 

Notes

Conflict of interest

None to declare.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Sharon Elad
    • 1
  • Yehuda Zadik
    • 1
  • Ian Hewson
    • 2
  • Allan Hovan
    • 3
  • M. Elvira P. Correa
    • 4
  • Richard Logan
    • 5
  • Linda S. Elting
    • 6
  • Fred K. L. Spijkervet
    • 7
  • Michael T. Brennan
    • 8
  • Viral Infections Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO)
  1. 1.Department of Oral MedicineHebrew University, Hadassah School of Dental MedicineJerusalemIsrael
  2. 2.Dental UnitRoyal Melbourne HospitalParkvilleAustralia
  3. 3.Program in Oral OncologyBC Cancer AgencyVancouverCanada
  4. 4.Ambulatory of Oral Medicine, Hematology and Blood Transfusion CenterUniversity of CampinasCampinasBrazil
  5. 5.Oral Pathology, School of Dentistry, Faculty of Health SciencesThe University of AdelaideAdelaideAustralia
  6. 6.Department of BiostatisticsThe University of Texas M.D. Anderson Cancer CenterHoustonUSA
  7. 7.Department of Oral & Maxillofacial SurgeryUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
  8. 8.Department of Oral MedicineCarolinas Medical CenterCharlotteUSA

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