engleski

Human herpesviruses in oral chronic Graft-versus- Host Disease

Human herpesviruses (HHVs) are commonly found in general population but also in patients after allogeneic hematopoietic stem cell transplantation (HSCT) where they may cause severe complications. Particularly, cytomegalovirus (CMV) infection was significantly more frequent among adults and was associated with a higher risk of developing acute graft-versus-host disease (aGvHD). Therefore, the aim of our study was to determine prevalence of particular HHVs in patients with oral chronic graft-versus-host disease (cGvHD) and possible role in these patients. Material (or patients) and methods: This pilot study enrolled 36 cGvHD patients who are part of a larger multidisciplinary cGvHD project at the University Hospital Center Zagreb, Croatia. Patients were evaluated for clinical and cGvHD characteristics ; severity of cGvHD and oral involvement were determined by using established NIH Consensus criteria. Cytobrush swabs from oral mucosa were collected from all patients. Specimens were analyzed by specific polymerase chain reaction (PCR) of several HHVs (CMV, Epstein-Barr virus (EBV), herpes simplex virus 1 and 2, and varicella zoster virus(VZV). Data were evaluated descriptively and Chi-square test was used to calculate statistical significance. Results: 36 cGVHD patient were enrolled, of which 18 men (average age 37.8) and 18 women (average age 40.9).Twenty patients had diagnostic signs of oral cGvHD (55.6%), 13 were (36.1%) without, and 3 (8.3%) had distinctive signs of oral cGvHD. Overall, in 18 of 36 patients (50%) no HHVs were identified, 3/36 (8.33%) had CMV, 13/36 (36.11%) had EBV, 2/33 (6.06%) VZV and no HSV 1 and 2 were found, respectively. EBV was statistically significantly found more often than the second most common CMV (P = 0.0046). There was no statistically significant difference in HHVs between patients with and those without oral cGvHD. Conclusion: Although proportion of patients with cGvHD, especially patients with oral cGvHD was EBV positive, indicating the possibility that EBV is more common in chronic GVHD, further studies with control groups are necessary to determine the role of EBV in cGVHD. Our preliminary data also indicate that the use of molecular methods to determine the presence of HHVs is valuable method in the follow-up of cGvHD patient particularly by using oral cytobrush specimens for PCR analysis as less invasive alternative method for monitoring these patients.

Graft versus host disease ; human herpesvirus ; allogeneic hematopoietic stem cell transplantation

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