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HSV-1 as well as HSV-2 is frequent in oral mucosal lesions of children on chemotherapy

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Abstract

Purpose

Prevalence data of herpes simplex virus (HSV) in oral mucositis in children on treatment for cancer is limited. Quantitative polymerase chain reaction (PCR) has been seldom utilized for detection of HSV-1/2 in oral mucosa.

Methods

Children on treatment for cancer with oral mucositis were enrolled as cases and healthy children as controls. An oral swab from the lesion in cases and mucosal scraping in controls were obtained. Both qualitative and real-time quantitative PCR for HSV-1/2 were performed. Serum ELISA-IgG/IgM for HSV-1/2 antibodies (NovaLisa™-Dietzenbach-Germany) were measured.

Results

Thirty-two cases (Age, 6.3 ± 3.4 years) and 30 controls were enrolled. Majority (69 %) of cases had ALL. All patients had febrile neutropenia, except two. ELISA-IgM-HSV-1/2 was not positive in any case or control. ELISA-IgG-HSV-1/2 was positive in 11 (34 %) cases and nine (30 %) controls (p = 1.0). Qualitative PCR for HSV-1 detected the virus in eight (25 %) cases and nil controls (p = 0.009). HSV-2 was not detected in any case/control by qualitative PCR. Quantitative PCR detected HSV-1 in 21 (66 %) and HSV-2 in 22 (69 %) cases. In controls, quantitative PCR detected HSV-1 in three (10 %) and HSV-2 in none. In patients, the mean viral load of HSV-1 (5,500 ± 15,987 × 104 copies/nanogram DNA) was more than HSV-2 (4.03 ± 8.5 × 104) (p = 0.11). There was no correlation of HSV-1/2 with grading of mucositis.

Conclusions

Both HSV-1/2 are commonly shed from oral mucosal lesions in children receiving chemotherapy. In a novel finding, real-time PCR detected copies of HSV-2 in 69 % cases, all missed by conventional PCR. Implication for morbidity, if any, or treatment needs to be determined.

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Acknowledgement

Research grant (no. 56/7/2007/BMS) from Indian Council of Medical Research, New Delhi is gratefully acknowledged.

Conflict of interest

The corresponding author (DB) has full control of all the primary data. They agree to allow the journal to review the data if requested. None of the authors have a financial relationship with the organization that sponsored the research.

Source of funding

Indian Council of Medical Research, New Delhi.

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Authors and Affiliations

  1. Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Ritu Aggarwal, Jasmine Naru, Manila Salaria, Anita Rana & Ranjana W. Minz

  2. Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Deepak Bansal, Amita Trehan & R. K. Marwaha

Authors
  1. Ritu Aggarwal
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  2. Deepak Bansal
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  3. Jasmine Naru
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  4. Manila Salaria
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  5. Anita Rana
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  6. Ranjana W. Minz
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Correspondence to Deepak Bansal.

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Aggarwal, R., Bansal, D., Naru, J. et al. HSV-1 as well as HSV-2 is frequent in oral mucosal lesions of children on chemotherapy. Support Care Cancer 22, 1773–1779 (2014). https://doi.org/10.1007/s00520-014-2152-0

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  • DOI: https://doi.org/10.1007/s00520-014-2152-0

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