Панавир® в комплексной профилактике реактивации герпесвирусных инфекций у детей с рецидивирующими инфекциями органов респираторного тракта

Abstract

Background: the importance of developing therapeutic options for the prevention of herpesvirus infection (HVI) reactivation in children is underpinned by a high prevalence of recurring diseases. Such recurrences with clinical manifestations are reported within 3 — 6 months after the clinically effective courses of antiviral therapy including direct-acting antivirals. Aim: analysis of clinical and virological efficacy of complex therapy which includes Panavir® Inlight spray for prevention of ARI in children with HVI reactivation. Patients and Methods: within the follow-up program, the clinical assessment was performed in 76 patients, comprising 35 (46.1%) girls and 41 (53.9%) boys, 0 — 14 years old, with a median age of 5 (IQR 2–8) years. The follow-up period was 3 months. The treatment group consisted of 49 children who received Panavir® Inlight Spray as a part of the combination therapy. The control group consisted of 27 children to whom Panavir® Inlight Spray was not administered. Panavir® Inlight Spray dosage regimen: 1 or 2 sprays in the throat after meals, 3 treatment courses, 14 days each, spaced 14 days apart. Clinical examinations and laboratory tests were performed for all patients over multiple time points. Serological and PCR methods were used for HHV diagnosing. The viral DNA load was evaluated for human herpes virus (HHV) 6А/В, cytomegalovirus, and Epstein-Barr virus in the oropharyngeal smears during the treatment. Results: 38 (77.6%) patients of the treatment group and 15 (55.6%) children of the control group reported that the subjective symptoms (monthly ARI, subfebrile fever, prolonged nasal congestion, etc.) disappeared or decreased. At the time of initiating therapy, DNA of one or more herpesviruses was isolated in the oropharyngeal smears of all patients from the compared groups. After the therapy completion, the viral DNA was not isolated in the oropharyngeal smears of 37 (75.5%) patients of the treatment group and in 16 (59.3%) patients of the control group. Median HHV 6А/В load in the oropharynx decreased from 645.0 (IQR 399.00–1600.00) copies/ml to 399.00 (IQR 0.00–775.00) copies/ml. Based on the results of complex assessment of patients, a reduction of HHV activity was found in 27 (55.1%) patients receiving Panavir® Inlight Spray and in 10 (37.0%) control group patients. Amid the administered therapy, the rate of HHV reactivation was significantly lower in the treatment group — in 3 (6.1%) patients than in the comparison group — in 10 (37.0%) patients (р<0,001). Conclusion: the use of Panavir® Inlight Spray in combination with other drugs for preventing HHV reactivation in children with recurring respiratory infections helps to improve the general sense of well-being and to preserve HHV latency after the treatment course containing direct antivirals. A decrease in the viral DNA load in the oropharyngeal smears (the most pronounced for HHV 6А/В) was reported in patients receiving Panavir® Inlight Spray. KEYWORDS: children, recurring respiratory infections, herpesvirus infections, Panavir Inlight Spray. FOR CITATION: Melekhina E.V., Muzyka A.D., Soldatova E.Yu., Shalbarova T.V. Panavir® in combination with other drugs for the prevention of herpesvirus infection reactivation in children with recurring respiratory infections. Russian Medical Inquiry. 2022;6(11):618–625 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-618-625.