VIRAL CO-INFECTIONS IN PATIENTS WITH HIV-INFECTION

Abstract

The paper presents the results of a study of the detection frequency of co-infectionserological markers of viral origin in persons suffering from HIV infection who are onantiretroviral therapy (ART). The relationship between the number of CD4 lymphocytesand the presence of markers of pathogens’ active replication of co-infections, caused byherpesviruses (cytomegalovirus – CMV, herpes simplex viruses of types 1 and 2 – HSV½,Epstein- Barr virus – EBV), and hepatitis B, C viruses in the plasma of HIV-infectedpatients, was considered.The purpose of the study – to determine the spectrum of viral co-infections in patientswith HIV infection and to find out the impact of these infections on the developmentof immunodeficiency based on the number of CD4 lymphocytes. Materials and methods. 146 patients with HIV infection, who were under outpatientobservation during 2020-2022 in the regional center of prevention and fight against AIDS inChernivtsi, were examined. When establishing the diagnosis, clinical and epidemiologicaldata and the results of laboratory tests, in particular: serological and immunological, weretaken into account. The level of CD4+ T-lymphocytes was examined after the disappearanceof the symptoms of the accompanying acute infectious disease (at least after 4 weeks).The results. The significance of the clinical manifestations and the nature of the course ofherpes simplex and shingles against a background of HIV infection depended on the degree ofreduction in the number of CD4+ lymphocytes. In most of the examined (57.0 %), the numberof CD4+ lymphocytes was less than 500 cells in 1 mm3 of blood, which contributed to theactivation of herpes simplex and shingles. A careful analysis of the frequency of detection ofserological markers of viral co-infections, depending on the route of HIV infection, showedthat hepatitis B virus markers were significantly more often detected in persons with a sexualroute of infection, and hepatitis C and mixed hepatitis virus markers – in those personsinfected with HIV, most likely, due to parenteral administration of narcotic substances.Conclusions. 1. Analysis of the spectrum of co-infections of viral genesis in HIV-infectedpersons demonstrated a wide distribution of parenteral viral hepatitis and a high levelof activation of chronic infections caused by HSV½, CMV and EBV. Markers of viralhepatitis B and C were detected in 56.8 % of patients with HIV infection. Activationof chronic infections, caused by CMV, HSV½ and EBV, was observed in 32.2 % of thesubjects. 2. Serological markers of viral hepatitis C and mixed hepatitis (HS + HBV)are most often detected in persons with parenteral HIV infection, and markers of viralhepatitis B – mostly in persons with sexual infection of HIV. 3. Antiretroviral therapyeffectively suppresses the replicative activity of the hepatitis B virus (HBV). 4. Theaverage values of the number of CD4-lymphocytes in HIV-infected persons who hadmarkers of co-infections of viral genesis, almost did not differ from the values of the levelof CD4-lymphocytes of those patients in whom these markers were not observed. Thistestifies to the effectiveness of antiretroviral therapy used in patients with HIV infection.