В ирус Эпштейна-Барр является гамма-герпесвирусом 4-го типа. К большинству вирусов из группы герпесов длительное время было принято относиться несерьезно, учитывая их широкое рас-пространение и редкость летальных исходов, в основном наступающих на фоне выраженного иммунодефицита. Уровень инфицированности вирусом Эпштейна-Барр у взрослого населения старше 35-40 лет в среднем превышает 90% [1]. Детей в возрасте моложе 6 мес от инфицирования защищают материнские антитела, после полугода вероятность встречи с вирусом постепенно растет. Так, по данным Р.Е. Бошьяна (2009), антитела к вирусу Эпштейна-Барр выявляются только у 10% детей в возрасте до 1 года. Далее круг общения ребенка постепенно расширяется, и в возрасте 1-3 года серопозитивны уже 28,5% детей. В условиях детского кол
Epstein – Barr virus, related to herpes viruses, causes infectious mononucleosis during the initial infection; after recovery, the virus persists in the body throughout lifetime. The presence of clinical symptoms and viral load in a patient in 6 months after the infectious mononucleosis disease indicates the formation of chronic active Epstein – Barr viral infection. Hemophagocytic lymphohistiocytosis, posttransplantation lymphoproliferative disease and chronic fatigue syndrome, which has a polyetiological nature, are also associated with the activation of the persistent Epstein – Barr virus. Most of these diseases develop in children due to their physiological immunodeficiency and are accompanied by high mortality – up to 50%. Immune mechanisms, in addition to the virus itself, play a leading role in the pathogenesis of the diseases. The article summarizes all existing approaches to the treatment of chronic Epstein – Barr virus-associated diseases. The authors have analyzed the effectiveness of these approaches on the basis of various published studies. These diseases are treated with etiotropic antiviral drugs – nucleoside analogs, nonspecific immunotherapy, targeted therapy with monoclonal antibody preparations, immune cellular CD8+ therapy. In case of ineffectiveness of these methods, the alternative bone marrow transplantation is used. The article highlightes promising areas for the development of new approaches to the treatment of Epstein – Barr virus-associated diseases.
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