ГЕРПЕСВИРУСНЫЕ ИНФЕКЦИИ У ДЕТЕЙ С РЕЦИДИВИРУЮЩИМИ РЕСПИРАТОРНЫМИ ЗАБОЛЕВАНИЯМИ

The article presents the role of herpesviral infections caused by the herpes simplex virus (HSV), the Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6) in 36 children with recurrent respiratory tract diseases at the age from 1 to 18 years. Blood sera and blood cells were studied using ELISA, Indirect reaction of immunofluorescence and Rapid culture method.It was found that all 36 children (100%) were infected with HSV, EBV, CMV and HHV-6. Most often — in 19 children (52.8%) the signs of active HHV-6 were revealed. In the same number of children surveyed, it was possible to identify active EBVI (16 children — 44.4%) and CMVI (16—44.4%). Active HSVI was diagnosed in 13 children (36.1%). Herpes virus infections were most often detected in the age group of children from 3 to 7 years of age.All children with recurrent respiratory diseases should be examined for herpesvirus infections.В статье представлена роль герпесвирусных инфекций, вызванных вирусом простого герпеса (ВПГИ), вирусом Эпштейна-Барр (ВЭБИ), цитомегаловирусом (ЦМВИ) и вирусом герпеса человека 6-го типа (ВГЧИ-6) у 36 детей с рецидивирующими заболеваниями верхних дыхательных путей в возрасте от 1 года до 18 лет. Исследовали сыворотки крови и клетки крови методами ИФА, НРИФ и БКМ.Установлено, что все 36 детей (100%) были инфицированы ВПГ, ВЭБ, ЦМВ и ВГЧ-6. Наиболее часто — у 19 детей (52,8%) были выявлены признаки активной ВГЧИ-6. У одинакового числа обследованных детей удалось выявить активную ВЭБИ (16 детей — 44,4%) и ЦМВИ (16 — 44,4%). Активную ВПГИ диагностировали у 13 детей (36,1%). Герпесвирусные инфекции наиболее часто выявлялись в возрастной группе детей от 3 до 7 лет жизни.Таким образом, необходимо всех детей с рецидивирующими респираторными заболеваниями обследовать на герпесвирусные инфекции

ЗНАЧЕНИЕ ГЕРПЕСВИРУСОВ В ЭТИОЛОГИИ РЯДА ИНФЕКЦИОННЫХ И СОМАТИЧЕСКИХ ЗАБОЛЕВАНИЙ ДЕТЕЙ

The article is devoted to study the etiological role of herpes viruses in infectious and somatic pathology of children (n = 770) using the complex of methods of laboratory diagnostics. Determined the leading etiological role of HSV in children with neuroinfections (12,7%) during primary infection and in children with intrauterine infection (29,0%) during its reactivation. It is shown that in 50,9% of cases, the diagnosis of «infectious mononucleosis» confirmed by the detection of markers of acute EBV-infection, and 20,0%, it was replaced by mononucleotides syndrome was discovered markers of acute CMV-infection, and 18,1% — markers of acute HHV-6-infection. The role of HHV-6 as the primary etiologic agent of the disease is established at 36,3% of children admitted with convulsive syndrome on the background of febrile, at 29,1% — a sudden exanthema and 25,5% — with fever of unknown origin.  Статья посвящена изучению этиологической роли герпесвирусов в инфекционной и соматической патологии детей (n = 770) с использованием комплекса методов лабораторной диагностики. Определена ведущая этиологическая роль ВПГ у детей с ней-роинфекциями (12,7%) при первичном инфицировании и у детей с внутриутробной инфекцией (29,0%) при ее реактивации. Показано, что в 50,9% случаев диагноз «инфекционный мононуклеоз» подтвержден обнаружением маркеров острой ВЭБИ, а 20,0% он был заменен на мононуклеозоподобный синдром, так были обнаружены маркеры острой ЦМВИ и в 18,1% — маркеры острой ВГЧИ-6. Роль ВГЧ-6 как основного этиологического агента заболевания установлена у 36,3% детей, поступивших с судорожным синдромом на фоне фебрилитета, у 29,1% — с внезапной экзантемой и у 25,5% — с лихорадкой неясного генеза. 

РОЛЬ ОППОРТУНИСТИЧЕСКИХ ИНФЕКЦИЙ В ВОЗНИКНОВЕНИИ ОСЛОЖНЕНИЙ У ДЕТЕЙ

The article highlights problems in the diagnosis of opportunistic infections (OI), shows the frequency of detection of acute infections in children with immunodeficiency and without marked disturbances in the immune system. The mothers and their ailing children were surveyed, The children were diagnosed with immune neutropenia. High presence of opportunistic infection pathogens was revealed both in mothers and in children. 4,5% of cases proved the mother to be the source of infection. The article discusses the role of causative agents of OI in the etiology of obstructive bronchitis and prolonged subfebrility in children. В статье освещены вопросы диагностики оппортунистических инфекций (ОИ), показана частота выявления острых форм инфекции у детей с иммунодефицитом и без выраженных нарушений в иммунной системе. Проведены наблюдения за парами мать — ребенок, где ребенок болен иммунной нейтропенией и была показана высокая инфицированность как матерей, так и детей возбудителями ОИ. В 4,5% случаев была доказана роль матери как источника инфекции. Определена роль возбудителей ОИ в этиологии обструктивных бронхитов и длительных субфебрилитетов у детей.

Роль возбудителей оппортунистических инфекций как этиологических агентов внутриутробных инфекций

The study showed a high prevalence of markers of herpesvirus infections among mothers — from 71% to 98% of HSV, EBV and CMV infections and from 29% to 58% of HHV-6 infection. HSV remains the most common etiological agent of intrauterine infections among herpesviruses — markers of active infection caused by this virus were found in 28.3% samples. The difficulty of determining the source of infection in the absence of data in the early stages of pregnancy is presented on 4 out of 10 cases of active HHV-6 infection. Markers of active pneumocystic infection were detected only in mothers: in the group with children under the age of 21 days — in 21—27% of cases, with children aged 22 to 28 days — in 15—21%. In addition to non-specific multiple organ failure during intrauterine infections (26.3%), only one organ system was observed: hypoxic-hemorrhagic lesions of the central nervous system were diagnosed more often — 17%, as well as meningitis/encephalitis, or hepatitis, or pneumonia, or disorders of hematopoiesis, or rash. In 17.5% of children from the comparison group, i.e. without any clinical manifestations of intrauterine infections, markers of active herpes virus infections were detected.В исследовании показана высокая выявляемость маркеров герпесвирусных (ГВ) инфекций среди матерей — от 71% до 98% ВПГ, ВЭБ и ЦМВ и от 29% до 58% ВГЧ-6. Наиболее частым этиологическим агентом внутриутробных инфекций среди ГВ остается ВПГ — маркеры активной инфекции, вызванной этим вирусом, были обнаружены у 28,3%. При установлении источника инфекции, на примере 4 из 10 случаев активной инфекции ВГЧ-6, представлена трудность его определения при отсутствии данных в ранние сроки беременности. Маркеры активной пневмоцистной инфекции выявляли только у матерей: в группе с детьми в возрасте до 21 дня включительно — в 21—27% случаев, с детьми в возрасте от 22 до 28 дней — в 15—21%. Помимо неспецифической полиорганной недостаточности при ВУИ (26,3%) наблюдались и поражения только одной системы органов: чаще диагностировали гипоксически-геморрагические поражения центральной нервной системы — 17%, а также или менингит и/или энцефалит, или гепатит, или пневмонию, или нарушения гемопоэза, или сыпь. У 17,5% детей из группы сравнения, т.е. без каких-либо клинических проявлений внутриутробных инфекций, были обнаружены маркеры активных герпесвирусных инфекций

Выявление маркеров оппортунистических инфекций у часто болеющих детей Северо-Восточных регионов России

The study is devoted to the clinical examination of frequently ill children in the North-Eastern regions of Russia and the laboratory detection of markers of herpesvirus infections, as well as pneumocystosis and the establishment of the relationship with their immune status.62 children aged 8—15 years were examined. Samples of serum and blood cells, sputum on markers of herpesvirus infections and pneumocystosis by ELISA, indirect immunofluorescence reaction and rapid culture method were studied. Assessment of humoral immunity and determination of circulating immune complexes was performed by solid-phase enzyme immunoassay and immune turbodimetric analysis.The study shows the etiological role of herpesviruses. Active infection (acute, reactivation) was caused in 9.7% of cases of HSV-1,2, 12.9% — EBV, 6.5% — CMV, 19.4% — HHV-6. This is indicated by a large number of convalescents: with EBVI — 40.3%, HSVI — 27.4%, HHVI-6 — 8.1%, CMVI — 4.8%. Also, a significant number of children were found and latent form. The formation of the circulating immune complexes (CIC) is a physiological mechanism of protection of the body, and their excessive accumulation indicates the development of inflammatory processes and autoimmune diseases. In the increase in CIC observed mainly in individuals with latent infection: HSVI — 29.4%; HHVI-6 — 20.8%; CMVI — 16.7%, EBVI — 11.9%. It is important to note that in almost half of the cases the increase in CIC level occurred simultaneously with the increase in the concentration of total IgE. A survey of children on Pneumocystis showed that among them, dominated native — 11.3%, in which the sputum was identified pnevmotsisty. It should be noted that one child was found mixed infection with reactivated CMVI. Acute infection was diagnosed only in 6.4% of the patients.Исследование посвящено клиническому обследованию часто болеющих детей Северо-Восточных регионов России и лабораторному выявлению у них маркеров герпесвирусных инфекций, а также пневмоцистоза и установлению взаимосвязи с их иммунным статусом.Обследовано 62 ребенка в возрасте 8—15 лет. Были исследованы образцы сывороток и клеток крови, мокроты на маркеры герпесвирусных инфекций и пневмоцистоза методом ИФА, непрямой реакции иммунофлюоресценции и быстрым культуральным методом. Оценку состояния гуморального иммунитета и определение содержания циркулирующих иммунных комплексов проводили методом твердофазного иммуноферментного анализа и иммунного турбодиметрического анализа.В исследовании показана этиологическая роль герпесвирусов. Активная инфекция (острая, реактивация) была обусловлена в 9,7% случаев ВПГ-1,2, в 12,9% — ВЭБ, в 6,5% — ЦМВ, в 19,4% — ВГЧ-6. На это указывает и большое количество реконвалесцентов: с ВЭБИ — 40,3%, ВПГИ — 27,4%, ВГЧИ-6 — 8,1%, ЦМВИ — 4,8%. Также у значительного количества детей была обнаружена и латентная форма. Образование ЦИК является физиологическим механизмом защиты организма, а их избыточное накопление свидетельствует о развитии воспалительных процессов и аутоиммунных заболеваний. Повышение ЦИК отмечено преимущественно у лиц с латентной формой инфекции: при ВПГИ — 29,4%; ВГЧИ-6 — 20,8%; ЦМВИ — 16,7% и ВЭБИ — 11,9%. Важно отметить, что почти в половине случаев повышение уровня ЦИК происходило одновременно с увеличением концентрации общего IgE. Обследование детей на пневмоцистоз показало, что среди них преобладали носители — 11,3%, у которых в мокроте были выявлены пневмоцисты. Надо отметить, что у одного ребенка была обнаружена микст-инфекция с реактивированной ЦМВИ. Острая инфекция была диагностирована только у 6,4% обследованных

Клинико-эпидемиологические особенности ВГЧ-6А- и ВГЧ-6В-инфекции у детей г. Москвы

Human herpes virus type 6 (HHV-6) is the etiological agent of plenty diseases. The form of the developing pathology depends on the localization of the virus in T-lymphocytes and on virus type: HHV-6A or HHV-6B, but identification of the type is possible by nucleotide sequence only. In Russia, researching on the typing of HHV-6 are conducted in Moscow and St. Petersburg mainly, but results is discordant. Also the prevalence of HHV-6A and HHV-6B among various population groups is of particular interest.Вирус герпеса человека 6 типа (ВГЧ-6) является этиологическим агентом множества заболеваний. Форма развивающейся патологии зависит от локализации вируса в T-лимфоцитах и от его типа: ВГЧ-6А или ВГЧ-6В, но идентификация типа возможна только по нуклеотидной последовательности. В России типирование ВГЧ-6 проводится в основном в Москве и Санкт-Петербурге. Особый интерес вызывает распространенность ВГЧ-6А и ВГЧ-6В среди различных групп населения

DETECTION OF HERPESVIRUS INFECTIONS IN CHILDREN OF THE FIRST SIX MONTHS OF LIFE

Aim. To evaluate a possible role of herpes viruses in the pathogenesis of various infectious diseases of children in the first six months of life, including acute gastroenteritis and identify the markers of herpesvirus infections which occur most frequently. Materials and methods. Samples of biological materials (blood serum and blood cells, breast milk, urine, feces) were studied in 35 children aged 14 days to 5 months who are being treated in MRRCI Vladimirsky with diagnoses of «acute infectious gastroenteritis of unspecified etiology» (n=24), «urinary tract infection» (n=6), «intrauterine infection» (n=5) and of their mothers. To determine the antibodies of IgM, IgG in serum, an enzyme immunoassay was used, to detect common antigens of viruses in blood cells, urine, breast milk - an indirect reaction of immunofluorescence, to detect early antigens of viruses and their reproduction - a rapid cultural method. Results. Infection with herpesviruses was found in 85% of children and 91% of mothers, with the most often identified markers of active forms of infection caused by the herpes simplex virus. In children with a diagnosis of acute infectious gastroenteritis of unspecified etiology, no pathogens of viral and bacterial intestinal infections were detected in a large number of active forms of herpesviral infections in both children and their mothers (33% and 91%, respectively). As well as mothers and their children, there have been cases of mixed infections caused by associations of herpesviruses, most often with HSV. Conclusion. Detection of active forms of herpesviral infections in the absence of positive results in studies on viral and bacterial intestinal infections make it possible to assume that herpesviruses can participate in the etiology of these diseases and cause infectious complications in this pathology, as well as often act as a co-infection. An important epidemiological importance has a large number of identified latent forms of herpesvirus infections, because when exposed to adverse factors they can go into active forms

HERPESVIRUS INFECTIONS IN CHILDREN WITH RECURRENT RESPIRATORY DISEASES

The article presents the role of herpesviral infections caused by the herpes simplex virus (HSV), the Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6) in 36 children with recurrent respiratory tract diseases at the age from 1 to 18 years. Blood sera and blood cells were studied using ELISA, Indirect reaction of immunofluorescence and Rapid culture method.It was found that all 36 children (100%) were infected with HSV, EBV, CMV and HHV-6. Most often — in 19 children (52.8%) the signs of active HHV-6 were revealed. In the same number of children surveyed, it was possible to identify active EBVI (16 children — 44.4%) and CMVI (16—44.4%). Active HSVI was diagnosed in 13 children (36.1%). Herpes virus infections were most often detected in the age group of children from 3 to 7 years of age.All children with recurrent respiratory diseases should be examined for herpesvirus infections

DETECTION OF MARKERS OF HERPES VIRUS INFECTION AND PNEUMOCYSTOSIS IN CHILDREN FROM HIV-INFECTED MOTHERS

Aim. Study the role of herpes viruses and pneumocystis in infectious complications in children from HIV-infected mothers. Materials and methods. Sera and blood cells from 59 children from HIV-infected mothers were studied for the presence of various markers of herpes virus infections and pneumocystosis by a complex of methods of modem laboratory diagnostics. Results. Frequency of detection of markers of herpes virus infection was from 10% for chicken pox in children with non-final HIV test to 93% for herpes simplex virus in HIV-infected children from closed organized groups. Signs of active infection in children with laboratory confirmed HIV infection were diagnosed 2.5 times more frequently for HSV infection and chicken pox and 1.8 times more frequently for HHV-6 and pneumocystis than in children with non-final HIV test. Markers of various disease stages with opportunistic infections (01) were detected in children with confirmed HIV-infection: primary acute and latent forms of the infection, reactivation, reconvalescence, whereas in children with non-final HIV test maternal antibodies against herpes virus and pneumocystis predominated. Markers of active infections excluding HSV and HHV-6 were more frequently detected in children from families than in children from closed organized groups. Conclusion. The feature detected - a lower percentage of detection of markers of active forms of 01 in HI V-infected children from social institutions - is determined by the fact that observation of these children is carried out by medical personnel that have the knowledge and experience of prophylaxis of infectious complications in HIV-infected children, whereas quality anti-epidemic regimen is frequently not maintained regarding home children with HIV infection. Another factor facilitating spread of opportunistic infections is the asocial lifestyle of most of the examined families. These data dictate the necessity of enhancement of anti-epidemic regimen and prophylaxis of opportunistic infections in family loci. Not only HIV-infected children, but also all the family members should be examined for markers of herpes virus infection and pneumocystosis in order to detect sources of the infection and timely execution of the prophylaxis measures

DEPENDENCE OF DETECTION OF MARKERS OF OPPORTUNISTIC INFECTIONS FROM ADHERENCE TO ANTIRETROVIRAL THERAPY IN CHILDREN BORN BY HIV-INFECTED MATTERS

Aim. To study the dependence of detection of markers of opportunistic infections from afherence to antiretroviral therapy in children born to HIV-infected mothers on the example of herpesvirus infectionsand pneumocystis. Materials and methods. Samples of biological materials (blood serum and blood cells) of 66 children with HIV infection aged 1 month to 15 years old were treated in Children’s Boxed Department of Children’s Hospital No. 2 with diagnoses «incomplete HIV test» (children from the age of one month to one and a half years) and «HIV infection». To determine IgM and IgG to herpesviruses and pneumocyst, the method of enzyme immunoassay was used; indirect immunofluorescence reaction for the detection of herpesviruses and their antigens in the blood, early antigens and virus reproduction were determined using a rapid culture method. Results. 56.0% of the surveyed children received complete antiretroviral therapy, in 16,7% of cases they were not complete, and 27,3% of children did not fully adhere to ARVT. Despite the fact that 100% of children with an incomplete diagnosis of HIV infection were covered by ARVT due to the use of chemotherapy drugs by their mothers during pregnancy, they still had markers of both active and latent forms of herpesvirus infections and pneumocystis. In children with confirmed HIV infection living both in social institutions and in families, the markers of opportunistic infections were more often diagnosed in patients receiving ARVT in full and not in full volume than in children who did not have it. Conclusion. Identification of markers of active forms of herpesvirus infections and pneumocystis in HIV-positive children not receiving ARV is the basis for its immediate appointment