HSV excretion after bone marrow transplantation: a 4-year survey

• Published in: Journal of clinical virology 2004-08, Vol.30 (4), p.341-345
• Main Authors: Morfin, Florence, Bilger, Karin, Boucher, Anne, Thiebaut, Anne, Najioullah, Fatiha, Bleyzac, Nathalie, Raus, Nicole, Bosshard, Sylvie, Aymard, Michèle, Michallet, Mauricette, Thouvenot, Danielle
• Format: Article
• Language: English
• Subjects: Acyclovir; Acyclovir - pharmacology; Acyclovir - therapeutic use; Adolescent; Adult; Aged; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Biological and medical sciences; Bone marrow transplantation; Bone Marrow Transplantation - adverse effects; Drug Resistance, Viral; Female; Fundamental and applied biological sciences. Psychology; Herpes Simplex - epidemiology; Herpes Simplex - prevention & control; Herpes Simplex - virology; Herpes simplex virus; Herpesvirus 1, Human - drug effects; Herpesvirus 1, Human - isolation & purification; Human viral diseases; Humans; Incidence; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Mouth - virology; Stomatitis - drug therapy; Stomatitis - virology; Viral diseases; Virology; Virus Shedding
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2004.03.002

Background: Herpes simplex virus (HSV) oral excretions are common after bone marrow transplantation (BMT). Objective: We report a 4-year systematic survey of HSV excretions in an adult population who underwent BMT (289 transplantations). Study design: Patients received either intravenous ACV treatment when mucositis occurred or systematic intravenous ACV prophylaxis from initiation of the BMT conditioning until the end of aplasia. All patients were followed up for HSV excretions. Results: Twenty-eight patients (9.7%) excreted HSV. The occurrence of HSV excretions was similar in both allogeneic and autologous transplant patients. The incidence was significantly lower when ACV was systematically used after transplantation (2.5%) compared to when ACV was implemented for mucositis (12%). ACV-resistant HSV was detected in three patients who received allogeneic tranplantation, representing 27% of allogeneic recipients excreting HSV. Conclusion: HSV infection prophylaxis with high dose of intravenous ACV resulted in a decreased incidence of HSV excretion. Nevertheless, the risk of emergence of ACV resistance, especially among allogeneic transplant patients, appears to be identical whatever the route and dose of ACV prophylaxis.