Abstract
Relevance.The study of the etiological structure, clinical features of congenital infections and the immune status of children with perinatal HIV contact will help to improve the program for the diagnosis, treatment and prevention of these diseases.Objective.To characterize the clinical features of congenital infections and changes in the immune system in children with perinatal HIV contact, taking into account their HIV status.Methods.A clinical, serological, molecular genetic, cytological, immunological examination of 203 children with perinatal HIV contact, including 91 HIV-positive patients and 112 HIV-negative patients.Results.Congenital infections were diagnosed in 43.3% of children with perinatal HIV contact. They were characterized by a predominance of cytomegalovirus (30%) and Chlamydia trachomatis (14.3%) in the etiological structure; those infections proceeded as a mono-infection (61.4%) or in a localized form (52.5%). In the group of HIV-positive children, congenital infections developed in 68.1% of patients. In most cases congenital infections were caused by cytomegalovirus (45.1%), herpes simplex virus (6.6%) and bacteria (11%); they proceeded as an associated infection (46.8%), and in a clinically manifest localized (61.3%) and generalized forms (33.9%). The clinical features of congenital infections in HIV-infected children were associated with more significant disorders in the immune system, especially in T-cell link.Conclusion.The revealed clinical and immunological features of congenital infections in children with perinatal HIV contact must be considered during diagnostic, therapeutic and preventive procedures.
Highlights
The study of the etiological structure, clinical features of congenital infections and the immune status of children with perinatal HIV contact will help to improve the program for the diagnosis, treatment and prevention of these diseases
Congenital infections were diagnosed in 43.3% of children with perinatal HIV contact
They were characterized by a predominance of cytomegalovirus (30%) and Chlamydia trachomatis (14.3%) in the etiological structure; those infections proceeded as a mono-infection (61.4%) or in a localized form (52.5%)
Summary
ФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава России, Ростов-на-Дону, Россия. Клинических особенностей врожденных инфекций и состояния иммунного статуса у детей с перинатальным контактом по ВИЧ позволит усовершенствовать программу диагностики, лечения и профилактики этих заболеваний. Охарактеризовать клинические особенности врожденных инфекций и изменения в иммунной системе у детей с перинатальным контактом по ВИЧ с учетом их ВИЧ-статуса. Врожденные инфекции диагностированы у 43,3% детей с перинатальным контактом по ВИЧ. Установлены различия по частоте врожденной цитомегаловирусной инфекции с учетом ВИЧ-статуса детей с перинатальным контактом по ВИЧ. Установлено, что у детей с перинатальным контактом по ВИЧ, которые одновременно инфицированы ВИЧ и цитомегаловирусом, развиваются глубокие нарушения иммунного статуса, особенно в Т-клеточном звене, что приводит к более быстрому прогрессированию ВИЧ-инфекции и высокой летальности [14]. Цель исследования: охарактеризовать клинические особенности врожденных инфекций и изменения в иммунной системе у детей с перинатальным контактом по ВИЧ с учетом их ВИЧ-статуса
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