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Doctoral Thesis
Full name
Michelle Palmieri
Knowledge Area
Date of Defense
São Paulo, 2020
Silva, Paulo Henrique Braz da (President)
Jorge, Waldyr Antônio
Schussel, Juliana Lucena
Vicente, Renata Matalon Negreiros
Title in Portuguese
Excreção oral de herpesvírus humanos e poliomavirus em indivíduos imunocomprometidos
Keywords in Portuguese
Carcinoma epidermoide
Herpesvirus humanos
Transplantados renais
Abstract in Portuguese
Pacientes com comprometimento sistêmico, por tratamentos oncológicos ou por doenças crônicas, são mais susceptíveis às infecções oportunistas por fungos, bactérias e vírus, o que pode interferir no manejo clínico e na qualidade de vida desses indivíduos. O objetivo desse trabalho foi descrever um panorama de excreção oral de herpesvírus humanos e poliomavírus em 3 grupos de pacientes imunocomprometidos: pacientes sob radio/quimioterapia para neoplasias em região de cabeça e pescoço, pacientes HIV positivos, pacientes transplantados renais. No primeiro grupo avaliado, de pacientes sob radio/quimioterapia, a excreção oral dos herpesvírus humanos não é afetada pela presença de xerostomia (uma das principais complicações orais agudas do tratamento), uma vez que houve uma progressão em relação à excreção de herpesvírus, mesmo com a evolução da xerostomia, sugerindo uma replicação viral local na cavidade oral, que não é completamente dependente da excreção salivar. No segundo grupo avaliado, de pacientes HIV positivos, houve uma excreção oral infrequente e intermitente do HHV-8 sem associação com a viremia. No terceiro grupo avaliado, de pacientes transplantados renais, a excreção de herpesvírus ocorreu com mais frequência do que em indivíduos imunocompetentes, especialmente o HSV-1 e EBV. A excreção oral do poliomavírus BK foi mais frequentemente encontrada na saliva do que no sangue, especialmente naqueles recentemente transplantados. No contexto de imunocomprometimento, pudemos observar nos grupos estudados que a excreção oral de herpesvírus humanos e poliomavírus pode ser observada com maior frequência do que a viremia, evidenciando assim uma possível ferramenta adicional no acompanhamento desses pacientes.
Title in English
Oral shedding of human herpesvirus and poliomavirus in immunocompromised individuals
Keywords in English
Human herpesvirus
Renal transplant
Squamous cell carcinoma
Abstract in English
Patients with systemic impairment due to cancer treatments or chronic diseases are more susceptible to opportunistic infections by fungi, bacteria and viruses, which may interfere with the clinical management and quality of life of these individuals. The aim of this study was to describe a panorama of oral shedding of human herpesvirus and polyomavirus in 3 groups of immunocompromised patients: patients undergoing radio/chemotherapy for head and neck tumors, HIV-positive patients and renal transplant patients. In the first evaluated group, of patients on radio/chemotherapy, the oral shedding of human herpesvirus is unaffected by the presence of xerostomia (one of the main acute oral complications of the treatment), as there has been a progression towards herpesvirus shedding, even with xerostomia evolution, suggesting a local viral replication in the oral cavity, that is not completely dependent on salivary excretion. In the second evaluated group, of HIV-positive patients, there was an infrequent and intermittent oral shedding of HHV-8 without association with viremia. In the third evaluated group, of renal transplant patients, herpesvirus shedding occurred more frequently, when compared with immunocompetent individuals, especially for HSV-1 and EBV and the oral shedding of polyomavirus BK was more frequent in saliva than in blood, especially in newly transplanted patients. In the context of patient's immunocompromised status, we observed in the groups studied that oral shedding of human herpesvirus and polyomavirus may be observed more frequently than viremia, thus evidencing a possible additional tool in the follow-up of these patients.
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