Herpesvirus infections and HIV (diagnosis and clinical features)

Abstract

Objective. Epidemiologic analysis of the incidence, prevalence, and structure of various forms of herpesvirus infections (HVI) in patients with and without HIV infection. Material and Methods. The study included 8729 adult patients with HIV-negative status, as well as 937 HIV-infected patients of both sexes aged over of 18 years, with established diagnoses of manifest HVI in 224 cases. The methods used were epidemiological, clinical, laboratory and statistical methods of data processing (Excel, Statistica 10). Results. Among the total number of adult patients, herpes zoster (HZ) was detected in 4446 patients without HIV infection. In 218 patients, a combined course of HVI and HIV infection was detected, of which 203 (22.02%) patients were hospitalized with clinically and laboratory confirmed HVI with moderate to severe course. The frequency of combination of HVI+HIV in relation to the entire group of HVI in hospitalized patients was 1.94%. Among all identified forms of HVI, the most common was HZ – 89.16%, while herpes simplex – 10.71%, Epstein-Barr virus (EBV) infection including infectious mononucleosis – 5.80%, and cytomegalovirus infection (CMVI) – 2.68%. In hospitalized patients with HVI and HIV, HZ was diagnosed in 89.16% of cases, herpes simplex in 6.90%, infectious mononucleosis in 2.46%, and CMVI in 1.48%. Among outpatients with HIV infection, the most common forms of HVI were herpes simplex in 47.61%, EBV infection, including infectious mononucleosis, in 38.09%, and CMVI in 14.29%. Among HIV-infected patients, the main reason for hospitalization was HZ (89.16%). HZ in the presence of HIV infection prevailed among young patients under 40 years of age, and patients over 55 years of age with HZ were significantly more common among patients without HIV infection. Among patients with HZ and HIV infection, severe and generalized forms, cases of meningitis and meningoencephalitis, and damage to 2 dermatomes were significantly more common. The incidence of postherpetic neuralgia and neuropathy among patients with HZ without HIV infection was 14.10% of cases, among patients with HZ and HIV infection in 10.49%. Cases of acute cerebral circulatory failure occurred only among patients of older age groups without HIV infection with the presence of HZ. The most common cause of death among all examined patients with HVI was HZ – 71.43% with complications (encephalitis, pneumonia).