Viral shedding of HSV-1, HSV-2, CMV and EBV in saliva of hematopoietic stem cell transplant recipients at the Fundación Hospital de la Misericordia – Bogotá.

Objectives: Hematopoietic stem cell transplant (HSCT) in pediatric patients is an alternative treatment for hematologic and neoplastic conditions, and birth defects among others. The conditioning regimen (immunoablation) for transplant success predisposes to the infections development in the recipient. Frequently viral infections by Herpesviridae family such as herpes simplex 1 (HSV-1), herpes simplex 2 (HSV-2), cytomegalovirus (CMV) and Epstein - Barr virus (EBV), are causes of morbidity and mortality in this patient group. These viruses establish latency in various cell types and reactivation of latent infections may result in viral shedding that is detected in saliva. The detection of these virus in secretions may contribute to recognize the behavior of these viral infections in transplant patients and to the early diagnosis of reactivation.
Objective: To assess viral shedding of HSV-1, HSV-2, CMV and EBV in saliva of patients admitted for HSCT in the HOMI Foundation in the period between January and November 2012.
Methods: Weekly stimulated saliva samples of 17 HSCT recipients were evaluated. DNA extraction was done and the presence of DNA of HSV-1, HSV-2, CMV and EBV by PCR was established.
Results: There were processed between 3 and 13 samples from each patient (total 105 samples). HSV-2 DNA was detected in the saliva of 4 patients; CMV DNA in saliva of 4 patients and EBV DNA in 9 patients. Four of the 17 patients had simultaneous shedding of CMV and EBV. No HSV-1 DNA was detected. Viral shedding was associated with white blood cell counts below 200 cells/uL
Conclusions: By conventional PCR was demonstrated asymptomatic HSV-2, CMV and EBV viral shedding in saliva, associated to immunoablation prior to allogeneic transplant, and low white blood cell counts.