Международная научно
-
практическая конференция
«Современные аспекты инфекционных
заболеваний»
73
CLINICAL AND IMMUNOLOGICAL FEATURES OF THE COURSE OF
HERPESVIRAL DISEASES IN HIV INFECTION IN CHILDREN
Khairullina A.Kh.
Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Relevance
Activation of herpesvirus infection in HIV-infected patients, in addition to a
general increase in HIV replication, occurs with increased release of HIV virions
in areas of herpetic skin rashes, which do not always have the appearance
characteristic of herpes. The most important thing is that in this case particles of
a mixed phenotype can be formed
–
HIV virions, “dressed” in the h
erpes shell.
Such “camouflaged” particles, unlike ordinary HIV virions, are capable of infecting
various types of cells, including epithelial cells and fibroblasts, thereby giving a
productive HIV infection, that is, it becomes possible to become infected with HIV
through contact with the skin and mucous membrane.
The purpose of the research
The purpose of our study was to study the clinical and immunological
features of the course of herpes virus infections in children with HIV infection
Research materials
The study was conducted on the basis of a specialized clinic for infectious
diseases at the Republican AIDS Center; all hospitalized children were examined
for herpesvirus infections using the ELISA method in the first days after
hospitalization. The content of various groups of lymphocytes was determined by
flow cytofluorometry (Ortumspectrum) using monoclonal antibodies against CD.
Research results
Analysis of the frequency distribution of nosological forms of herpesvirus
infections with clinical and laboratory manifestation in patients with HIV
infection showed that most often the data diseases worsened in clinically
pronounced stages of HIV infection when the level of CD4+ lymphocytes was less
than 200 per 1
μ
l. The most common exacerbations of infection caused by the
herpes simplex virus type 1 (88.5%) and herpes zoster (86.5%). According to the
results of polymerase chain reaction, other viruses of this group were found in
96% of patients with herpes simplex virus in various environments. In half of the
cases, a mixed infection was detected
–
three viruses: herpes simplex virus, EBV,
and herpes virus type 6. Mixed infection with two pathogens was also quite often
recorded: herpes simplex virus and EBV, herpes simplex virus, and herpes virus
type 6 (22 and 15% of cases, respectively). EBV was most often detected (in
61.5% of cases, mainly in epithelial cells of the oropharynx, less often in saliva and
peripheral blood lymphocytes) and herpes virus type 6
–
in 58.2% of cases. CMV
Международная научно
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практическая конференция
«Современные аспекты инфекционных
заболеваний»
74
was detected only in 27% of cases in epithelial cells of the cervical canal, urethra
and peripheral blood lymphocytes. It should be noted that in 9.1% of patients,
DNA of the herpes simplex virus types 1 and 2 was detected in several samples;
in particular, with anogenital rashes, it was detected in the epithelial cells of the
oropharynx and peripheral blood lymphocytes.
Conclusion
Changes in the immune system increased as HIV infection progressed due
to the addition or activation of opportunistic diseases. Severe forms of
herpesvirus infections were observed in patients with a CD4+ lymphocyte level of
less than 200 in 1
μ
l of blood, and in 25% of cases the pathological process became
generalized. More than half of patients with HIV infection with a low level of CD4+
lymphocytes had a combination of herpes simplex with other opportunistic
infections (tuberculosis, toxoplasmosis, etc.).
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