научно-исследовательский центр эпидемиологии и микробиологии им. Н.Ф. Гамалеи» Минздрава России, 2 ГБУЗ «Инфекционная клиническая больница №2 Департамента здравоохранения города Москвы», 3 ГБОУ ВПО Первый МГМУ им. И.М. Сеченова Минздрава России, 4 ГБОУ ВПО РНИМУ им. Н.И. Пирогова Минздрава России, Москва Статья посвящена изучению этиологической роли герпесвирусов в инфекционной и соматической патологии детей (n = 770) с использованием комплекса методов лабораторной диагностики. Определена ведущая этиологическая роль ВПГ у детей с нейроинфекциями (12,7%) при первичном инфицировании и у детей с внутриутробной инфекцией (29,0%) при ее реактивации. Показано, что в 50,9% случаев диагноз «инфекционный мононуклеоз» подтвержден обнаружением маркеров острой ВЭБИ, а 20,0% он был заменен на мононуклеозоподобный синдром, так были обнаружены маркеры острой ЦМВИ и в 18,1%-маркеры острой ВГЧИ-6. Роль ВГЧ-6 как основного этиологического агента заболевания установлена у 36,3% детей, поступивших с судорожным синдромом на фоне фебрилитета, у 29,1%-с внезапной экзантемой и у 25,5%-с лихорадкой неясного генеза. Ключевые слова: герпесвирусные инфекции, маркеры острой инфекции, реактивация инфекции, латентная инфекция

Aim. To study the dependence of detection of markers of opportunistic infections from afherence to antiretroviral therapy in children born to HIV-infected mothers on the example of herpesvirus infectionsand pneumocystis. Materials and methods. Samples of biological materials (blood serum and blood cells) of 66 children with HIV infection aged 1 month to 15 years old were treated in Children’s Boxed Department of Children’s Hospital No. 2 with diagnoses «incomplete HIV test» (children from the age of one month to one and a half years) and «HIV infection». To determine IgM and IgG to herpesviruses and pneumocyst, the method of enzyme immunoassay was used; indirect immunofluorescence reaction for the detection of herpesviruses and their antigens in the blood, early antigens and virus reproduction were determined using a rapid culture method. Results. 56.0% of the surveyed children received complete antiretroviral therapy, in 16,7% of cases they were not complete, and 27,3% of children did not fully adhere to ARVT. Despite the fact that 100% of children with an incomplete diagnosis of HIV infection were covered by ARVT due to the use of chemotherapy drugs by their mothers during pregnancy, they still had markers of both active and latent forms of herpesvirus infections and pneumocystis. In children with confirmed HIV infection living both in social institutions and in families, the markers of opportunistic infections were more often diagnosed in patients receiving ARVT in full and not in full volume than in children who did not have it. Conclusion. Identification of markers of active forms of herpesvirus infections and pneumocystis in HIV-positive children not receiving ARV is the basis for its immediate appointment.

Aim. Study the role of herpes viruses and pneumocystis in infectious complications in children from HIV-infected mothers. Materials and methods. Sera and blood cells from 59 children from HIV-infected mothers were studied for the presence of various markers of herpes virus infections and pneumocystosis by a complex of methods of modem laboratory diagnostics. Results. Frequency of detection of markers of herpes virus infection was from 10% for chicken pox in children with non-final HIV test to 93% for herpes simplex virus in HIV-infected children from closed organized groups. Signs of active infection in children with laboratory confirmed HIV infection were diagnosed 2.5 times more frequently for HSV infection and chicken pox and 1.8 times more frequently for HHV-6 and pneumocystis than in children with non-final HIV test. Markers of various disease stages with opportunistic infections (01) were detected in children with confirmed HIV-infection: primary acute and latent forms of the infection, reactivation, reconvalescence, whereas in children with non-final HIV test maternal antibodies against herpes virus and pneumocystis predominated. Markers of active infections excluding HSV and HHV-6 were more frequently detected in children from families than in children from closed organized groups. Conclusion. The feature detected - a lower percentage of detection of markers of active forms of 01 in HI V-infected children from social institutions - is determined by the fact that observation of these children is carried out by medical personnel that have the knowledge and experience of prophylaxis of infectious complications in HIV-infected children, whereas quality anti-epidemic regimen is frequently not maintained regarding home children with HIV infection. Another factor facilitating spread of opportunistic infections is the asocial lifestyle of most of the examined families. These data dictate the necessity of enhancement of anti-epidemic regimen and prophylaxis of opportunistic infections in family loci. Not only HIV-infected children, but also all the family members should be examined for markers of herpes virus infection and pneumocystosis in order to detect sources of the infection and timely execution of the prophylaxis measures.