Abstract
The aim of the work is to study the indicators of cellular and humoral immune response and FAN of patients with tonsillitis in children infected with HHV-6 type.
 Materials and methods of research. In 72 children aged 3–15 years (mean age 8.42±1.44 years), patients with streptococcal tonsillitis of moderate severity, the levels of the main subpopulations of blood lymphocytes were determined using monoclonal antibodies by solid-phase enzyme-linked immunosorbent assay, phagocytic activity of neutrophils (FAN) using the nitrosine tetrazolium reduction test (HCT test) and serum IgA, IgM, IgG levels by radial immunodiffusion. The studies were carried out in the acute period and in the period of convalescence. Mathematical and statistical processing of the data obtained was carried out using Microsoft Excel 2003 and Statistica 6.0 programs. The significance of differences between the mean values was determined using the Student's test (t).
 Results. Different mechanisms of formation of pathological process at streptococcal tonsillitis at children depending on the concomitant HHV-6 type infection are revealed. In patients with mixed infection in the acute period of tonsillitis determine the signs of deficiency of the cellular immune system with the maximum deviation of CD-lymphocytes (t=3.13 vs. t=2.16 in mono-infection), the tension in the humoral link of the immune response Ig deviation (t=1.63 against t=0.91 in mono-infection) on the background of phagocytosis violation in terms of FAN deviation (t=3.22 against t=2.01 in mono-infection). By the period of convalescence, the restoration of the imbalance of specific and non-specific protection factors does not occur. Increased IgG content in the acute period is one of the features of streptococcal tonsillitis in children on the background of HHV-6t infection.
 Conclusions. Concomitant VGL-6 type infection in children with streptococcal tonsillitis affects the mechanisms of formation of the inflammatory process and the reactivity of patients, forming the preconditions for adverse outcomes of the disease. The obtained results can be the basis for early detection of herpes virus infection in patients with tonsillitis, will help to optimize the management of patients in different periods of the disease.
Highlights
Streptococcal infection has long been a relevant pathology, especially among children [1, 2].The consequences of tonsillitis caused by hemolytic streptococcus, which often turn into a chronic form, are the development of infectious-allergic and immune-mediated pathology, which include diseases of the cardiovascular system, connective tissue, kidneys [3, 4].At the current stage of development of medicine in the practice of health care comorbid conditions are increasingly common, a combination of two or more pathogens that definitely affect (2021), «EUREKA: Health Sciences» Number 5 each other, can lead to changes in the clinical course and outcome of the disease
The study revealed signs of transient suppression of the cellular immune response in children with streptococcal tonsillitis, and this suppression was exacerbated in patients with concomitant HHV-6 infection
It is determined that the deficiency of natural killers in infected with HHV-6 increases the risk of severe brain damage [12, 13], this issue needs further study
Summary
At the current stage of development of medicine in the practice of health care comorbid conditions are increasingly common, a combination of two or more pathogens that definitely affect (2021), «EUREKA: Health Sciences» Number 5 each other, can lead to changes in the clinical course and outcome of the disease. The twenty-first century is called the «century of viruses», and because of the new coronaviruses, and because of the widespread spread of herpes viruses. Infection of the latter occurs in early childhood. Persistence of herpes viruses is one of the factors of frequent «respiratory» diseases, affects the formation of protective systems of the child’s body [5, 6]
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