Department of Oral Medicine, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
Support Care Cancer. 2010 Aug;18(8):993-1006. doi: 10.1007/s00520-010-0900-3. Epub 2010 Jun 11.
Our aim was to evaluate the literature for the prevalence of and interventions for oral viral infections and, based on scientific evidence, point to effective treatment protocols. Quality of life (QOL) and economic impact were assessed if available in the articles reviewed.
Our search of the English literature focused on oral viral infections in cancer patients within the timeframe of 1989-2007. Review methods were standardized. Cohort studies were used to determine the weighted prevalence of oral viral infection in cancer patients. The quality of selected articles were assessed and scored with respect to sources of bias, representativeness, scale validity, and sample size. Interventional studies were utilized to determine management guidelines. Literature search included measures of QOL and economic variables.
Prevalence of oral herpes simplex virus (HSV) infection in neutropenic patients was higher than in patients treated with radiotherapy for head and neck cancer (49.8% vs. 0%, respectively). In patients treated with radiochemotherapy for head and neck cancer, the prevalence of oral HSV infection increases up to 43.2% (CI, 0-100%). Prevalence of HSV infection was higher when oral ulcers existed. Information about other oral viral infections is sparse. There was a significant benefit of using acyclovir to prevent HSV oral infection (at 800 mg/day). Various dosing protocols of valacyclovir achieved prevention of HSV reactivation (500 or 1,000 mg/day). The prevalence of HSV reactivation was similar for acyclovir and valacyclovir. No information about impact on QOL and economic burden was available.
Acyclovir and valacyclovir are equally effective in preventing oral HSV infection. Neutropenic patients, who were primarily treated for hematological malignancies in the studies reviewed, are at a greater risk for viral infection.
我们旨在评估文献中口腔病毒感染的流行情况和干预措施，并根据科学证据指出有效的治疗方案。如果文献中提供了生活质量（QOL）和经济影响评估，则进行评估。
我们对英语文献的搜索重点是 1989 年至 2007 年期间癌症患者的口腔病毒感染。采用标准化的综述方法。队列研究用于确定癌症患者口腔病毒感染的加权流行率。对选定文章的质量进行评估，并根据偏倚来源、代表性、量表有效性和样本量进行评分。干预性研究用于确定管理指南。文献检索包括 QOL 和经济变量的测量。
中性粒细胞减少症患者口腔单纯疱疹病毒（HSV）感染的流行率高于头颈部癌症接受放疗的患者（分别为 49.8%和 0%）。接受头颈部放化疗的患者中，口腔 HSV 感染的流行率高达 43.2%（CI，0-100%）。存在口腔溃疡时，HSV 感染的流行率更高。关于其他口腔病毒感染的信息很少。每天使用 800mg 阿昔洛韦预防 HSV 口腔感染具有显著益处。每天使用 500 或 1000mg 伐昔洛韦的各种剂量方案可预防 HSV 再激活。阿昔洛韦和伐昔洛韦预防 HSV 再激活的效果相似。关于对 QOL 和经济负担的影响，尚无信息。
阿昔洛韦和伐昔洛韦在预防口腔 HSV 感染方面同样有效。在综述研究中，主要接受血液系统恶性肿瘤治疗的中性粒细胞减少症患者，发生病毒感染的风险更高。
