Association between oral HSV-1 and survival in allogeneic hematopoietic stem cell transplanted patients

Area of Science:

• Infectious Diseases
• Hematology
• Transplantation Immunology

Background:

• Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a critical treatment for various hematologic malignancies and other diseases.
• Opportunistic infections, including those caused by herpes simplex virus type 1 (HSV-1), pose a significant risk to immunocompromised allo-HSCT patients.
• The impact of oral HSV-1 shedding on post-transplant outcomes remains an area requiring further investigation.

Purpose of the Study:

• To investigate the association between oral HSV-1 shedding and patient survival following allo-HSCT.
• To determine if the timing of HSV-1 shedding (pre-transplant, early post-transplant, or late post-transplant) influences survival rates.

Main Methods:

• A cohort of 119 allo-HSCT patients was studied, categorized into three groups based on time relative to transplant: pre-transplant, 100 days post-transplant, and 1 year post-transplant.
• Oral swabs were collected, and nested PCR was employed to detect HSV-1 DNA in oral mucosa samples.
• Statistical analyses included chi-square tests, Kaplan-Meier survival curves with log-rank tests, and Cox proportional hazards multivariate models.

Main Results:

• HSV-1 shedding prevalence was comparable across different time points after allo-HSCT.
• Multivariate analysis revealed that HSV-1 shedding detected before the allo-HSCT procedure was significantly associated with reduced survival rates.
• No significant association was found between HSV-1 shedding at 100 days or 1 year post-transplant and survival.

Conclusions:

• Oral HSV-1 shedding prior to allo-HSCT is a significant negative prognostic factor for patient survival.
• These findings highlight the importance of assessing and potentially managing oral HSV-1 shedding in patients undergoing allo-HSCT before the procedure.