Herpesvirus infections in ARVI episodes in children

Abstract

T.A. Ruzhentsova1,2, R.V. Popova3, A.A. Garbuzov1, E.K. Shushakova4, I.N. Khalyastov2,5, N.A. Meshkova6 1G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology of the Federal Service for the Oversight of Consumer Protection and Welfare, Moscow, Russian Federation 2Moscow Medical University "Reaviz", Moscow, Russian Federation 3Mytishchi Regional Clinical Hospital, Mytishchi, Russian Federation 4City Center for Medical Study LLC, Moscow, Russian Federation 5Rehabilitation Center of the Pension and Social Insurance Fund of the Russian Federation "Volginskii", Mashinostroitel, Russian Federation 6I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation Aim: to evaluate the detection rate of the herpesvirus activity in children with acute respiratory viral infection (ARVI) signs for determination of the optimal treatment tactics. Patients and Methods: the study included 1120 children aged 3 to 18 years (mean age 7.48±3.91 years) who were observed on an outpatient basis (n=650) or hospitalized (n=379) due to the lack of improvement on the 3rd day after the first ARVI symptoms onset (n=1029) or due to the detected complication (n=91). The herpesvirus DNA was detected in throat swabs by PCR. Enzyme immunoassay was used to evaluate the levels of IgG, IgM, and IgA antibodies. Results: the presence of IgG antibodies to at least one of the herpes viruses was detected in 1097 (97.9%) of patients: in the children group over 6 years old in 723 (100%) patients. The presence of herpesvirus DNA in smears from the posterior pharyngeal wall and tonsils was detected in 234 (20.9%) children: 178 (15.9%) — isolated, 56 (5.0%) — in various combinations. IgM antibodies to Epstein-Barr virus and cytomegalovirus were detected in all cases in the herpesvirus DNA presence in the blood. The herpes simplex virus DNA has not been detected in any case. However, antibodies were detected in 63 (5.6%) children: IgA in 57 (5.1%) and IgM in 6 (0.5%) children. Conclusions: in children with ARVI symptoms, signs of an active infection caused by one or another type of herpes were detected in 26.5% of cases, and in 5% — their combination. The high prevalence of the herpesvirus activity comparable with the detection rate of seasonal respiratory viral infections, along with the adverse effect of herpesvirus infection on the immune system with the severe somatic pathology probability, necessitates the use of a drug with a wide spectrum of antiviral action for the ARVI signs in children — inosine pranobex. In the presence of complications caused by herpesvirus, inosine pranobex does not cause negative trend of antibody activity indicators, inosine pranobex, Groprinosin®. Keywords: HHV-6, human herpesvirus type 6, herpes simplex virus, Epstein-Barr virus, herpes, herpesvirus infection, herpes infection, ARVI, cytomegalovirus, inosine pranobex, Groprinosin. For citation: Ruzhentsova T.A., Popova R.V., Garbuzov A.A., Shushakova E.K., Khalyastov I.N., Meshkova N.A. Herpesvirus infections in ARVI episodes in children. Russian Journal of Woman and Child Health. 2023;6(4):399–404 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-12.