Salivary shedding of herpesviruses in renal transplant recipients

J Investig Clin Dent. 2018 Nov;9(4):e12356. doi: 10.1111/jicd.12356. Epub 2018 Jul 30.

Abstract

Aim: The aim of the present study was to describe the salivary shedding of human herpesviruses (HHV) in renal transplant recipients and to observe the oral manifestations in this group.

Methods: A prospective case-control study was conducted with a study group of 20 renal transplant recipients and a control group of 20 non-transplanted, immunocompetent individuals. Clinical examination evaluated the presence of drug-induced gingival overgrowth (DIGO), salivary flow, and caries. Stimulated saliva was collected from both groups, with HHV being detected by using real-time polymerase chain reaction.

Results: The mean age of the study group was 45.90 ± 9.89 years, with 55% (11/20) being female, 60% (12/20) being Caucasian, 65% (13/20) having a deceased donor, and 70% (14/20) having used tacrolimus as the main immunosuppressive drug. Renal transplant recipients had shedding of more herpesviruses compared to the control group, with the exception of HHV-7. Statistical significance was found for herpes simplex virus-1 (HSV-1) (P = 0.017) and cytomegalovirus (P = 0.035). DIGO was observed in seven patients (35%), with 35% (7/20) presenting with decreased salivary flow and four (20%) reporting xerostomia.

Conclusion: Renal transplant recipients excreted herpesviruses more often than control individuals, especially HSV-1. Decreased salivary flow and xerostomia were more frequent in patients who used tacrolimus, whereas those who used cyclosporine had more cases of DIGO.

Keywords: drug-induced gingival overgrowth; herpesviruses; saliva; salivary shedding; transplantation.

MeSH terms

  • Brazil / epidemiology
  • Case-Control Studies
  • Cyclosporine / therapeutic use
  • Cytomegalovirus
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / virology
  • Epstein-Barr Virus Infections / epidemiology
  • Epstein-Barr Virus Infections / virology
  • Female
  • Herpes Simplex / epidemiology
  • Herpes Simplex / virology
  • Herpesviridae Infections / epidemiology*
  • Herpesviridae Infections / virology
  • Herpesviridae*
  • Herpesvirus 1, Human
  • Herpesvirus 4, Human
  • Herpesvirus 6, Human
  • Herpesvirus 7, Human
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Real-Time Polymerase Chain Reaction
  • Roseolovirus Infections / epidemiology
  • Roseolovirus Infections / virology
  • Saliva / virology*
  • Tacrolimus / therapeutic use
  • Virus Shedding / drug effects

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • Tacrolimus