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Journal of Clinical Microbiology, May 2005, p. 2173-2180, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2173-2180.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Effect of Prophylactic Valacyclovir on the Presence of Human Herpesvirus DNA in Saliva of Healthy Individuals after Dental Treatment

Craig S. Miller,^1,2* Sergei A. Avdiushko,² Richard J. Kryscio,³ Robert J. Danaher,^1,2 and Robert J. Jacob^1,2

Department of Microbiology, Immunology & Molecular Genetics,¹ Department of Oral Health Practice,² Department of Statistics, University of Kentucky College of Medicine and College of Dentistry, Lexington, Kentucky 40536-0297³

Received 23 September 2004/ Returned for modification 13 December 2004/ Accepted 22 December 2004

Human herpesviruses (HHVs) are ubiquitous pathogens that intermittently reactivate from latency. Transmission is believed to be facilitated by their frequent appearance in saliva. This study sought to understand the factors that influence the appearance of these viruses in saliva by examining the prevalence, pattern, and quantity of all eight HHVs in saliva of immunocompetent adults with a history of recurrent oral herpes simplex virus (HSV) infections following dental treatment and antiviral therapy. Valacyclovir or matched placebo was given (2 g twice on the day of treatment and 1 g twice the following day) to 125 patients in a randomized, double-blind controlled trial. Saliva, collected on the day of dental treatment and 3 and 7 days later, was analyzed using real-time quantitative PCR. At all visits, HHVs coinfected saliva. Over the course of the week, the DNAs of HHV-6 and HHV-7 were detected significantly more often (97% to 99% of patients) than Epstein-Barr virus (EBV; 64.8%), HSV-1 (13.0%), HHV-8 (3.2%), cytomegalovirus (2.4%), HSV-2 (0%), and varicella-zoster virus (0%), irrespective of drug treatment (P < 0.002). Mean genome copy numbers were highest for HSV-1 and HHV-6. Dental treatment did not influence asymptomatic viral shedding patterns. However, valacyclovir treatment resulted in significantly fewer patients shedding EBV at both postoperative visits compared with placebo (P < 0.008). These results suggest that HHVs are simultaneously present in the saliva of healthy adults at levels that could facilitate transmission, and valacyclovir therapy decreases the prevalence of EBV in saliva but has little effect on HHV-6 and HHV-7.

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* Corresponding author. Mailing address: MN 324 Oral Medicine, College of Dentistry, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536-0297. Phone: (859) 323-5598. Fax: (859) 323-9136. E-mail: cmiller{at}uky.edu.

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Journal of Clinical Microbiology, May 2005, p. 2173-2180, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2173-2180.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

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