Detection of Cytomegalovirus, Epstein-Barr Virus and Human Herpes Virus 6 and 7 DNA in Febrile Children with Cancer

Background-Patients with cancer have long periods of severe neutropenia due to chemotherapy and are particularly vulnerable to infectious complications. Most fever episodes are treated with empiric antibacterial therapy without identifying the etiologic agent. Blood culture is the gold standard test to detect infections, but it usually presents negative results. Human herpes virus establishes latency after primary infection and the potential for complications following cytotoxic chemotherapy in the absence of allogeneic transplantation is not clearly understood. This study aimed to use molecular testing to detect EBV, HCMV, and HHV-6 and -7 viruses in serum from children with cancer. MethodsA Nested PCR (N-PCR) technique was used to detect viral DNA extracted from serum. All patients tested presented with fever at or above 38oC. Results-The results showed that herpes virus DNA was found in 70/168 (41.6%) of the samples from pediatric oncology patients with or without neutropenia. Positive DNA for EBV occurred in 3/168 (1.8%); HCMV in 16/168 (9.5%); HHV-6 in 27/168 (16%) with liver changes in 14/27 (51%) p<0.0049 and HHV7 in 24/168 (14%). The presence of two or more microorganisms was found in 9/168 samples (6%). ConclusionFever in children with cancer and herpes virus DNA was detected in some samples, but only presence of HHV-6 was associated with liver changes. The significance of these findings needs to be further evaluated to clarify their correlation with the signs, symptoms, febrile episodes and infections in children with oncology diseases. Daniel Thome Catalan 1,2 , Saulo Duarte Passos 3 , Sandra Cecília Botelho Costa 1 and Sandra Helena