Oral shedding of CMV and HSV‐1 in hematopoietic stem cell transplantation patients

Objectives To evaluate the oral shedding of herpesviruses in patients undergoing hematopoietic stem cell transplantation (HSCT) and correlate it with oral mucositis (OM). Methods Saliva samples were collected before the HSCT and on day D + 8. Multiplex Polymerse Chain Reaction (PCR) was performed to detect herpes simplex virus (HSV)‐1 and HSV‐2, Epstein‐Barr virus (EBV), Cytomegalovirus (CMV), Variella‐zoster virus (VZV), and human herpesvirus (HHV)‐6, HHV‐7, and HHV‐8. OM was assessed according to WHO criteria. Results Thirty one patients were enrolled, in which 20 of 31 (64.5%) were males; median age was 50 (21–70) years; 16 of 31 (51.6%) underwent allo‐HSCT; and 15 of 31 (48.4%) underwent auto‐HSCT. On D + 8, OM grades III and IV were observed in 8 of 31 (25.8%) patients. In the first salivary collection, EBV was found in 24 of 31 (77.4%), followed by HHV‐6 (7/31, 22.6%) and HHV‐7 (8/31 25.8%). In the second collection, EBV was found in 24 of 27(89%), followed by HSV‐1 (8/27, 30%) and CMV, HHV‐6, and HHV‐7 (5/27, 18.5%, each one). On D + 8, OM grades II and IV were associated with the presence of HSV‐1. HSV‐1 was also associated with worsening degrees of OM on D + 15. Conclusion The presence of HSV‐1 and CMV in oral samples was more frequent on day D + 8 after HSCT. HSV‐1 detection was associated with severity and worsening of OM. HSV‐1 and CMV seem to be associated with oral dysbiosis due to HSCT.