Current diagnosis of mixed herpesvirus infection in children with viral encephalitis

Abstract

Sixty-five children aged 1 month to 15 years with a diagnosis of viral encephalitis, who had been admitted to the Clinic of the Pediatric Research and Clinical Center for Infectious Diseases, Federal Biomedical Agency, in 2013-2016 were examined. Objective: to establish the frequency of mixed herpesvirus infection in children with viral encephalitis, by using the current diagnostic methods to determine the role of reactivation of herpesvirus infection on the development of viral encephalitis. The investigators identified anti-herpesvirus antibodies and their avidity using an enzyme immunoassay and anti-cytomegalovirus antibodies specific for antigens by immunoblotting applying the kits. Herpesvirus DNA was detected in the biological material (blood, cerebrospinal fluid) by real-time polymerase chain reaction (PCR) and by electrophoresis using the PCR kits (Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Moscow). Young children were shown to develop the disease as a result of primary infection more commonly as monoinfection in the old age groups during the persistence of one or two herpesviruses in the body. In encephalitis caused by herpes simplex virus type 1 and type 2, reactivation of cytomegalovirus that could be a cofactor in the development of brain inflammation was proven by the current diagnostic technique immunoblotting. The comprehensive laboratory approach to the etiological diagnosis of viral encephalitis, which encompassesthe determination of antibody classes, avidity, and antibodiesto individual protein determinants of viral particles, makes it possible to specify the activity of different herpesviruses in mixed infection and to determine the stage of the infectious process, which is important for the choice of therapeutic policy.