Эффективность коррекции цитокинового компонента локального иммунитета в лечении рецидивирующего бактериального вагиноза, ассоциированного с герпетической инфекцией

Abstract

The risk of bacterial vaginosis (BV) and recurrence rate increase in the presence of herpesviruses, which is associated with changes in local immune response. Objective. To determine the effect of exogenous cytokines on the cytokine component in local immunity and its efficacy in the treatment of recurrent bacterial vaginosis (RBV) associated with herpesvirus infection. Patients and methods. Eighty women of reproductive age with RBV and herpesvirus infection were randomized into two groups: group I (n = 40) received Clindamycin and a complex of exogenous cytokines (Superlymph®), group II – Clindamycin and placebo. The biocenosis and cytokine levels in vaginal discharge were examined. Results. Recovery occurred in 95% (38/40) of patients in group I versus 77.5% (31/40) of those using placebo; p = 0.05, OR = 5.52 (95% CI: 1.11–27.43). The recurrence rate for 12 months was 12.6% (5/40) versus 33.5% (13/40), respectively, p = 0.01, with a 3-fold decrease in the risk of recurrence (OR = 0.30; 95% CI: 0.09–0.93). There was the restoration of vaginal biocenosis and the decrease in viral release and pro-inflammatory cytokine levels by an average of 1.5 times (p < 0.001) compared with baseline values in patients who received Superlymph®. Conclusion. The complex of exogenous cytokines contributes to the normalization of cytokine component in local immune status and vaginal microbiota and to the decrease in recurrence rate of BV associated with herpesvirus infection. Key words: herpes infection, immunomodulatory therapy, recurrent bacterial vaginosis, Superlymph, cytokines