EXPERIENCE OF TREATMENT WITH GROPRINOSIN (INOSINE PRANOBEX) FOR HERPES VIRUS INFECTION IN CHILDREN WITH EPILEPSY AND INFANTILE CEREBRAL PALSY

Abstract

Relevance. Previous studies showed an important role of herpes viruses in children with epilepsy and infantile cerebral palsy (ICP). Materials and methods. This study was conducted from 2014 to 2018 on the basis of the Voino-Yasenetski Scientific and Practical Center for Specialized Medical Care for Children and the Morozov Children's City Clinical Hospital. Serological and microbiological molecular genetic (PCR test) methods, ELISA test, indirect immunofluorescence reaction and rapid culture method were used to confirm herpes infection. In the open prospective study 298 children with epilepsy and ICP were included, in 131 (44%) of them herpes infection was revealed. 100 children who received inosine pranobex (Groprinosin®) were under follow-up: 92 children were in the hospital and 8 children were outpatient. Inclusion criteria were: children aged 3-15 years with epilepsy and ICP. Most children have symptomatic focal epilepsy. Exclusion criteria were: age less than 3 years, severe hematological, oncological and somatic diseases. Children were divided into the following groups: group 1 - epilepsy (n=36); group 2 - epilepsy + ICP (n=20); group 3 - ICP (n=44). The comparison group (group 4) included 31 children aged 3 to 15 years with herpes virus infections: epilepsy (n=25) and cerebral palsy (n=6), who took conventional anticonvulsant therapy without inosine pranobex. Results. In the group of children examined, mainly aged 3-6 years, the most prevalent infections were cytomegalovirus (75.3%) and human herpes virus (HHV)-6 (86.2%) along with Epstein-Barr virus and HHV-1, HHV-2. Patients infected with cytomegalovirus and HHV-6 have mainly an acute course of disease (40.9 and 51.9%, respectively) while patient with Epstein-Barr virus and HHV-1, HHV-2 have a persistent chronic course of disease (76.1 and 75.5%, respectively). Most of the examined children showed mixed infection with 2 or 3 different herpes viruses. In groups of children who took inosine pranobex, treatment showed highly beneficial effect on dynamics of clinical, laboratory and instrumental parameters.