Детские инфекции (Москва) (Dec 2019)
Identification of markers of opportunistic infections in frequently ill children in the North-Eastern regions of Russia
Abstract
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.
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