Immunocytochemical detection of herpes viruses in oral smears of HIV‐infected patients

Abstract

Langford A, Kunze R, Sehmelzer S, Wolf H, Pohle H-D, Reichart P: Immunocytochemical detection of herpes viruses in oral smears of HIV-infected patients. J Oral Pathol Med 1992; 21: 49-57.Cytologie smears (CS) were taken from the lateral border of the tongue of HIVseropositive patients (HlV-f) {n = 39) and of seronegative controls (HIV-) (n = 19) and examined by immunocytochemistry (APAAP) and in situ hybridization (ISH) (biotinylated DNA probes) for the presence of viral antigens/DNA of EBV and CMV. While none of the HIV controls showed positive results for EBV antigen, 61% (APAAP) resp. 79% (ISH) of oral epithelial eells in the group of HIV-I-patients were EBV-positive. While all CS taken from areas with the elinical diagnosis of hairy leukoplakia (HL) were EBV positive (APAAP and/ or ISH), the detection of EBV in CS from uninvolved oral mueosa seemed to be assoeiated with the later development of HL. In the group of HIV-I-patients the detection rate for CMV was about five times (APAAP) resp. three times (ISH) higher than in HIV-persons. This non-invasive technique seems to be a valuable tool to screen for viral antigens/getioms.

Presence of Epstein–Barr virus, cytomegalovirus and human papillomavirus in normal oral mucosa of HIV‐infected and renal transplant patients

“…Our results show that, in clinically normal oral mucosa of immunodeficient subjects, HPV, EBV and, less frequently, CMV are present and easily detectable by PCR from epithelial brushings. EBV‐DNA, has been shown to be the most frequently present genome in our study groups, and its presence should be monitored in HIV + patients, especially among men, in order to prevent or to diagnose early the possible occurrence of OHL (Langford et al , 1992).…”

Detection of Epstein-Barr virus (EBV) in the oral mucosa of renal transplant patients

“…31 The detection of EBV in the mucosa has been performed using various techniques, such as PCR, in situ hybridization, immunohistochemistry, and electron microscopy. 12,15,18,[32][33][34] The material to be examined may be collected by biopsy or cytological examination of the oral mucosa.…”

Usefulness of oral cytopathology in the diagnosis of infectious diseases

“…12,14 With the objective of performing less invasive diagnostic procedures, studies have shown exfoliative cytology to be an alternative approach to biopsy analysis for diagnosis. [15][16][17][18][19] Pap-stained cytological smears of hairy leukoplakia show nuclear changes such as Cowdry type A inclusions surrounded by a clear zone, a homogeneous nuclear membrane, peripheral margination of chromatin, and ground-glass nuclei (Figure 1e). However, the diagnostic accuracy of Pap smears for EBV infections is of low sensitivity and specificity because the cytopathological changes induced by EBV overlap with those of herpetic nuclear inclusions and are not pathognomonic.…”

“…The current gold standard for definitive diagnosis of hairy leukoplakia is EBV ISH 12,14 . With the objective of performing less invasive diagnostic procedures, studies have shown exfoliative cytology to be an alternative approach to biopsy analysis for diagnosis 15–19 . Pap‐stained cytological smears of hairy leukoplakia show nuclear changes such as Cowdry type A inclusions surrounded by a clear zone, a homogeneous nuclear membrane, peripheral margination of chromatin, and ground‐glass nuclei (Figure 1e).…”

“…However, the diagnostic accuracy of Pap smears for EBV infections is of low sensitivity and specificity because the cytopathological changes induced by EBV overlap with those of herpetic nuclear inclusions and are not pathognomonic. Because of this, it is essential to confirm the diagnosis of EBV infection by ancillary methods such as immunocytochemistry, ISH (Figure 1f) , PCR and electron microscopy 15,17–19 …”