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The role of citomegalovirus in children with acute respiratory viral infections
MarunichN.A., SoldatkinP.K., MerkulovaM.Ya., GordeenkovI.V.,SilchukN.V., SleptsovaL.S.
Amur state medical academy, Amur regional hospital of infectious diseases, Blagoveshchensk
Over the past 30 years there were revealed more than 30 kinds of infectious diseases, among which a special place occupies cytomegalovirus (CMV), which is caused by a virus belonging to the family of herpes viruses. It is known that the source of infection - a person infected with or affected by the acute form. In most cases cytomegalovirus proceeds latently, but becomes dangerous during pregnancy, perinatal period, in young children, as well as at immunodeficiency. After primary infection, the virus is not derived from the host and circulates there in a lifetime. Up to 3% of infants are born infected with cytomegalovirus (CMV) and 10% of the cases in the future suffer from its complications - lesions of the central nervous system - CNS, gastrointestinal tract, eye, lung, heart, organs of hematopoiesis. Unfortunately, there is rarely diagnosed CMV infection in pregnant women and in children at birth. Therefore, the primary implementation of acute respiratory viral infections (ARVI) in children is first detected long low-grade fever, the occurrence of lymphadenopathy and mononucleosis syndrome that causes a doctor to examine the child to herpesviruses and in particular CMV.In the past three years there were fulfilled clinical and laboratory studies of treatment and prevention measures and study the effectiveness of various therapeutic approaches to herpesvirus infections (CMV) in children in the Amur Regional Hospital of Infectious Diseases in Blagoveshchensk.
Keywords: cytomegalovirus, CMV infection, immune globulin, acute respiratory viral infections, infectious diseases
Materials and Methods
We observed 22 children aged from 6 months up to three years, admitted with a diagnosis of ARVI. In this group of patients, DNA to CMV was found in10 children, in 12 children - to the ARVI virus and CMV. The etiological diagnosis was established due to on the results of research material from children (nasal swab on ARVI viruses) for CMV - identifying cells in urine, saliva, blood using polymerase chain reaction (PCR) and specific antibodies by enzyme-linked immunosorbent assay (ELISA). Table 1 presents the results of a survey of children for markers of CMV infection.
Table 1.The results of a survey of children markers of CMV infection Materials research The number Markers of CMV detection
ofexamined Abs. %
IgM - anti - CMV 14 1 7,1
IgG - anti - CMV 22 14 63,6
IgM+IgG - anti - CMV 22 14 63,6
Avidity of antibodies(high avidity) 14 9 64,3
Avidity of antibodies(low avidity) 14 8 57
PCR blood 7 1 14,3
PCR saliva 14 9 64,3
PCR urine 6 2 33,3
Detection in children of anti - IgM - CMV and anti - IgG - CMV simultaneously, and identification of CMV antigen in blood and urine indicate that there is a form of acute or reactivated
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CMV.In the clinical picture it was most often observed in this group of patients were followed for a long low-grade fever, lymphadenopathy, splenhepatomegaly.
In the study of cellular and humoral immunity in 12 (54.5%) children with CMV infection there was revealed an imbalance of immune cells and a weak production ofinterferons.
Analysis of clinical and laboratory parameters in children with CMV infection revealed the need for combination therapy using anticytomegaloviruses immunoglobulin, interferon or interferon inducers and immunomodulating drugs. Results and Discussion
All the children admitted with diagnosis of ARVI, received basic therapy: human leukocyte interferon, viferon, arbidol, expectorants, mucolytics (lazolvan, ACC, ambroksal, sinekod) in dosages of age. The treatment showed improvement, all children discharged from recovery. In this group of patients there were five children with long-term, recurrent infections. A characteristic feature of this group of sick children was the fact that the markers were identified as herpes viruses, Epstein-Barr virus (EBV). Two children with active CMV-treated specific immunoglobulin (neotsitotekt) at a dose of 2 ml / kg / day at intervals of 48 hours had normalization of temperature in 3-4 days, decrease of lymph nodes and improvementofhemogram with the disappearance of disease markers.
Other three children received the standard immunoglobulin preparation in the form ofimmunovenina. They also observed a positive effect, but markers werekeptfor 6 months up to 1 year. The good therapeutic effect was shownby the combination of antibodies, interferon, in particular genferon light and correction of intestinal biocenosis. Conclusion
The study showed that in children who were often illwithARVI having trouble in childbirth, it will be necessary testing for herpes, and in particular onCMV infection.
Initiated studies of children with CMV infection have shown efficacy when used in combination with immunoglobulin therapy of interferon and the best effect when using a particular drug - neotsitotekta.It should be noted that the combination therapy was used in both stationary and in outpatient conditions that contributes to effective treatment and prevention of relapse. Literature
1. KitsakV.Ya. Virus infections of pregnant women: pathology of a foetus and newborn children. - Koltsovo, 2004. - 84 p.
2. Korovina N.A., Zaplatnikov A.A., Cheburkin A.V. Cytomegalovirus (salivary gland virus) infection of tender age children: doctors' manual. - M.: Medpraktika-M, 2001. - 64 p.
3. Samokhin P.A. Cytomegalovirus (salivary gland virus) infection of children. - M.: Medicine, 1987. - 160 p.
4. Skripchenko N.V., Skoromets A.P., Sorokina M.N. Nervous system disturbance with congenital infections: methodical recommendations. - St. Petersburg, 2003. - 48 p.
Antivirial therapy (AVT) of chronic hepatitis C (CHC) in the Amur Regional
Infectious Hospital
Mateishen R.S., Sayapina Ye.A., ServirogI.L.,Marunich N.A., Polovitsa N.V., Churina S.A.,
Nitsiyevskaya L.S., Pahnyuschaya Y.N.
Amur State Medical Academy, Amur Regional Infectious Hospital, Blagoveschensk, Russia
Aim of investigation: treatment of CHC in spite of good progress is still a problem for doctors working in this field of medicine. Wide spreading of viral hepatitis C, high ability of chronic process formation and subsequent liver cirrhosis in the outcome of chronic viral hepatitis C,
