The aim. To identify the influence of the latent form of Epstein-Barr virus infection on the clinical picture, parameters of clinical blood analysis and cytokine response of children with rotavirus gastroenteritis. Materials and methods. 56 children were examined. Of them, 33 children (group 1) had no background infection with herpesviruses, and 23 patients (group 2) suffered from rotavirus gastroenteritis against the background of Epstein-Barr virus (EBV) infection. The patients were comparable in terms of sex, age and disease severity. Differences at p <0.05 were considered statistically significant. Results. The analysis of the obtained data showed that the latent form of EBV infection affects the clinical picture, indicators of clinical blood analysis and the reaction of serum cytokines of children with rotavirus gastroenteritis. Сonclusions. A comparative analysis revealed that a latent form of herpesvirus infection in children with rotavirus gastroenteritis is associated with lower temperature reaction and a lower frequency of vomiting in the acute period of the disease against the background of longer persistence of fever, diarrhoea and catarrhal syndromes. On the part of the investigated laboratory indicators, the presence of EBV infection is characterized by a lower level of haemoglobin (р = 0,013) against a higher content of neutrophils (p = 0.002), eosinophils (p = 0.033) and monocytes (p < 0.001) in the acute period of RVI, and a significantly higher content of eosinophils (p = 0.001) and monocytes (p < 0.001) against the background of a lower level of the relative content of lymphocytes compared to patients of Group 1 in the period of early convalescence. Changes in the cytokine response in children with mixed infection are characterized by a significantly lower concentration of IL-1β at the onset of RVI and a higher content of IL-4 and TNF-α throughout the disease compared to children with mono-RVI

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The aim is to evaluate the effect of cytomegalovirus on clinical and paraclinical as well as immunological parameters in children with rotavirus infection (RVI). Materials and methods. 50 children aged one to three years, patients with moderate and severe intestinal infections of rotavirus etiology were examined. All children were examined for herpes virus infections types 1, 2, 4, 5, 6. Enzyme-linked immunosorbent assay (ELISA) was used to determine the level of specific Ig G and Ig M for herpes viruses types 1, 2, 4, 5, 6, and in the case of a positive test, polymerase chain reaction (PCR) determined the presence of DNA (qualitatively) of these herpesviruses. Group 1 (mono-RVI), which was taken as a reference, included 33 children in whom no infection with any of these viruses of the herpes group was detected. Group 2 included 17 patients who underwent RVI on the background of CMV infection, the presence of infection with other viruses of the herpes group was excluded. Immune response parameters (CD 3+, CD 4+, CD 8+, CD 16+, CD 22+, Ig A, Ig M, Ig G, IL 1β, 4, TNF-α) in the acute period of the disease and in the period of convalescence were analyzed. Qualitative indicators were given in the form of absolute and relative (%) value. Significance of differences was determined using Pearson’s χ2 test (Pearson’s Chi-squared test). Quantitative indicators were given in the form of median (Me) and values of lower (LQ) and upper (UQ) quartiles. The significance of differences in quantitative indicators in two unrelated groups was determined using the Mann–Whitney U-test. The threshold value of the confidence level was taken as 0.05. Results. The analysis of the obtained data allows to establish that in the acute period of RVI infection in children with CMV leads to lower figures of temperature reaction, lower vomiting rate, prolongation of hospitalization, along with decrease in leukocytes, CD 16+ (%) cells and immunoregulatory index (CD 4+/CD 8+) against the background of increased levels of monocytes, CD 8+ (%) T-lymphocytes, concentrations of IL-4 and TNF-α. During convalescence, the presence of CMV is associated with an increase in the duration of fever and diarrhea, an increase in monocytes, CD 8+ (%) T cells, concentrations of IL-4, TNF-α and lower figures of immunoregulatory index, CD 16+ (%), CD 22+ (%) T cells and Ig M. Conclusions. Latent cytomegalovirus infection in children with rotavirus gastroenteritis significantly affects a number of clinical and paraclinical as well as immune parameters, which leads to a decrease in the intensity of clinical manifestations in the acute period of the disease and the prolongation of some symptoms during convalescence.

The article presents the results of a comparative analysis of clinical and immunological parameters in children with rotavirus gastroenteritis without background infection and those infected by herpes viruses. It was established that in children with rotavirus infection (RVI) on the background of infection by herpes viruses occurs with less pronounced symptoms of intoxication and a less frequency of vomiting at the onset of the disease, in combination with longer duration (more long period) of fever and diarrheal syndrome. Such features are probably associated with the formation of a hypergical regime of the functioning of the immune response in the group of patients with background infection by herpes viruses, in contrast to patients with mono- RVI, in whom the immune system functions in a normal compensation mode.

The article presents the results of our own studies. The aim was to determine the structural and functional status of blood lymphocytes in patients with acute and prolonged course of infectious mononucleosis (IM) in children. Materials and methods. 102 children were under clinical and laboratory-instrumental supervision, the children were divided into groups: group 1 – 65 children with IM with an acute course of the disease; group 2 – 37 children with a prolonged course of the disease. All children underwent standard clinical laboratory and instrumental laboratory examinations. The diagnosis of IM was confirmed by PCR (detection of EBV DNA in the blood) and ELISA (anti-EBV IgM and IgG). Research results. In the study of the structural state of the cytoplasmic membrane of the lymphocytes in the blood of patients with MI in the onset of the disease, it was found that the average values of penetration rate of the electron paramagnetic resonance of spin probes (PR EPR s. p.) in children of both groups were significantly higher than normal (P < 0.001). There are also differences between groups of patients. In this case, the value of PR EPR s. p. in patients with a prolonged course by 15.8 % exceeded those in patients with acute IM (P < 0.001). According to the rate of microviscosity of the intracellular content (MV IC), its values were reduced compared with the control – by 22.1 % (P < 0.001) in patients with acute course of the disease and by 25.1 % – with a prolonged course of IM). In addition, in patients with a prolonged course of the disease, the values were 9 % lower than in the group with acute infectious mononucleosis. When considering immunological parameters, it was found that the indicators of the T-immune system for patients with a prolonged course of the disease in comparison with the alternative group was characterized by a decrease in the content of CD3 <50 % (respectively in 51.3 % and 26.2 % of patients; P < 0.05); CD4 <31 % (62.1 % and 32.4 %, respectively; P < 0.05) and CD8 <15 % (37.8 % and 10.8 %, respectively; P < 0.01). With regard to the cytokine profile, the level of IL-1 <20.0 pg/ml was determined 3.5 times more often in patients with a prolonged course of the disease compared to the acute course (64.8 % and 18.5 % of patients, respectively); TNFα <20.0 pg/ml 1.9 times more often (48.6 % and 24.6 %, respectively) and a very high (>30.1 pg/ml) level of IL4 in 40.5 % and 20 %). From the B-system of immunity in patients with a prolonged course of IM in comparison with the acute course increased content of CD22 was more often determined, as well as low levels of IgA, IgM <1.1 g/l and IgG <10.0 g/l. Conclusions. According to the results of observations, the pathogenetic role of the violation of the structural organization of blood lymphocytes in the formation of IM is established. It was found that these disorders in the form of increased permeability of their cytoplasmic membrane and reduced viscoelastic properties of their intracellular environment are more pronounced with a prolonged course of the disease, which is a factor in the prolongation of the disease. It is determined that the indicators of cellular and humoral parts of the immune system affect the course of IM. During formation of an acute course of IM in children already in the acute period of a disease activation of both cellular and humoral links of immunity, which is shown in the form of increase in relative content of CD3+, CD4+, CD8+ and CD22+ and levels of immunoglobulins M, A, is noted. For the prolonged course of the disease depression of T-cell immunity in the form of a decrease in the relative content of CD3+, CD4+ and CD8+ lymphocytes and an increase in CD22+, as well as inhibition of antibody genesis are characteristic. It was found that the variant of IM depends on the type of reaction of T-helper clones, namely – in the initial period of manifestation of IM with its acute course there is activation of T1 and T2 helper response, which manifests itself in a significant increase in IL-1, TNFα and moderate IL-4. Prolonged course of the disease is formed against the background of weak activation of pro-inflammatory interleukins (IL-1, TNFα) and significant – anti-inflammatory IL-4.