Human Herpesvirus Type Research Articles

The application of metagenomic next-generation sequencing for detection of pathogens from dialysis effluent in peritoneal dialysis-associated peritonitis .

Metagenomic next-generation sequencing (mNGS) can improve pathogen identification in infectious diseases. A prospective parallel control study was undertaken to evaluate the clinical significance of mNGS in identifying pathogens in dialysis effluent of patients with peritoneal dialysis-associated peritonitis (peritonitis). Dialysis effluent specimens were detected both by peritoneal dialysis effluent culture and mNGS. The positive rates and coincidence rates of the two methods were compared. From April 2020 to March 2021, 30 patients presenting with peritonitis were enrolled in this study. The positive pathogen detection rate of mNGS was significantly higher than that of the traditional culture method (86.67% vs. 60.00%; p = 0.039). Fifteen specimens were positive for both of the methods, while 11 specimens were negative for culture but positive for mNGS. Three specimens were positive for culture but negative for mNGS; all of them were streptococcus mitis. One specimen was negative for both methods. The culture method detected one type of pathogen in all specimens; however, two or more types of pathogens were detected in eight specimens by mNGS. In addition to common pathogens, additional pathogens detected by mNGS included Coxiella burnetii, human herpesvirus type 5, human herpesvirus type 6B and Mortierella. The pathogen detection rate of mNGS in dialysis effluent of peritonitis patients was significantly higher than that of traditional culture. The mNGS is advantageous in diagnosing the pathogens that are difficult to be cultured. However, mNGS did not demonstrate sensitivity to streptococcus mitis. Results from this study show that mNGS, combined with traditional culture, has potential application for detecting pathogens in peritoneal dialysis patients with peritonitis.

Evaluation of the association between human herpes virus 6 (HHV-6) and Hashimoto's thyroiditis.

Hashimoto's thyroiditis is a chronic inflammation and an autoimmune disease of the thyroid gland that causes hypothyroidism. Genetic, internal, and environmental factors are the causes of this disease. Because human herpes viruses such as herpesvirus type 6 (HHV-6) are involved in some autoimmune disorders, they may also play a role in causing this disease. This study aimed to evaluate the association between human herpes virus 6 (HHV-6) with Hashimoto's thyroiditis. In the present study, 64 samples of thyroid paraffin tissue including 32 samples of thyroid paraffin tissue of healthy individuals as control, and 32 samples of thyroid paraffin tissue of Hashimoto's thyroiditis patients were taken from the pathology department of Loghman Hakim Hospital in Tehran. A questionnaire collected demographic information of patients. After DNA extraction from the samples, the nested-PCR technique was performed using specific primers for HHV-6. Totally, the HHV6-DNA was found in 34.4% of thyroid tissues of healthy individuals (81.8% female and 18.2% male) and 46.9% of patients with Hashimoto's thyroiditis (73.3% female and 26.7% male). It was found that this difference in virus frequency between the two groups was not statistically significant (P value=0.309). There was also no statistically significant relationship between the prevalence of human herpesvirus type 6 and age or sex. Based on the present study, the number of HHV-6-infected individuals in Hashimoto's patients and controls did not differ significantly; therefore, HHV-6 appears not to be associated with Hashimoto's thyroiditis.

Evaluation of the influence of the etiological spectrum herpesviruses into systemic and local immune response in encephalitis in children

Herpesviruses are the most common etiological agents of encephalitis in children. The most pathogenic properties for humans are: Herpes Simplex virus type 1, type 2, Varicella Zoster virus, Human Herpes virus type 6 and Epstein-Barr virus, combined infection with which, along with the individual characteristics of the patient's immune status, can lead to a severe course and unpredictable outcome encephalitis.Materials and methods. Clinical and neurological monitoring, etiological verification of infectious agents in the blood and cerebrospinal fluid by PCR and ELISA methods were carried out in 85 children with encephalitis at the age of 10—18 years. In patients suffering from herpesvirus encephalitis, the levels of pro-inflammatory cytokines, interleukins, chemokines were determined in the blood during the acute period of the disease and after 10—14 days.Results. A decrease in the production of IFN-α and IFN-γ was revealed, which is an unfavorable factor prolonging the course of an active herpes virus infection. Conclusions. Cytokines should be considered as one of the prognostic factors for the course and outcomes of encephalitis in children, which will allow timely correction of patient management tactics in each specific case and improve the outcome of the disease.

Molecular Epidemiology of Human Herpes Virus Type 8 Among Patients with Compromised Immune System in Ouagadougou, Burkina Faso.

IntroductionHuman herpesvirus type 8 (HHV-8) is the main etiological agent of Kaposi’s sarcoma. This virus is frequently associated with immunocompromision. This study aimed to detect HHV-8 in people with compromised immune system.Patients and MethodsThis is a cross-sectional study that included 180 subjects: 179 HIV-infected patients and 1 patient with bullous pemphigoid. Blood samples were taken from all subjects, and swabs of lesions were then taken from individuals with symptoms of Kaposi’s sarcoma. Viral load and CD4+ T lymphocytes count were performed for persons living with HIV and real-time PCR detection of HHV-8 DNA was performed in all subjects in the study.ResultsAmong HIV-infected persons, 13.41% had a viral load of more than 10,000 copies/mL, and 22.91% had a CD4+ T lymphocytes count of fewer than 350 cells/µL. A total of four (three HIV-1 infected patients and one patient with bullous pemphigoid) patients (2.22%) had apparent lesions of Kaposi’s sarcoma. In the plasmas and swabs from associated lesions, HHV-8 DNA was found in only two individuals, with an HHV-8 prevalence of 1.11% (2/180) with 0.55% (1/179) in an HIV-infected patient on antiretroviral therapy.ConclusionThese results exposing low prevalence levels of HHV-8 in HIV-infected patients could be due to the beneficial effect of antiretroviral drugs.

Investigation of the Etiological Causes of Central Nervous System Infection in Children with Multiplex PCR

Objective The aim of this study is to investigate the causative agents of central nervous system (CNS) infection in hospitalized pediatric patients by multiplex polymerase chain reaction. Methods We retrospectively reviewed the medical records of children who underwent lumbar puncture with suspected CNS infection between September 2019 and September 2021. The cerebrospinal fluid (CSF) samples were evaluated by the BioFire FilmArray Meningitis/Encephalitis (ME) Panel. Results The etiology of the infection was established in 13,02% (n = 25) cases. Human herpesvirus (HHV) type 6 was the most commonly identified pathogen 60% (n = 15), followed by enterovirus 20% (n = 5), Streptococcus pneumoniae 8% (n = 2), Streptococcus agalactiae 4% (n = 1), HHV type 1 4% (n = 1), and Listeria monocytogenes 4% (n = 1). The statistical analysis showed that the age of the group with enterovirus was younger than the age of the group with other causative microorganisms and the group with HHV-6 (respectively p: 0.032; p: 0.011). The hospitalization periods of the group with enterovirus and HHV-6 were shorter than the hospitalization periods of the other causative microorganisms (respectively p: 0.016; p: 0.000) and the absolute neutrophil count values of the group with HHV-6 were lower than the group of other causative microorganisms (p: 0.015). Conclusion Our study identified HHV-6 as the main cause of CNS infection in Istanbul during coronavirus disease 2019 pandemic when isolation measures were taken. The duration of hospital stay was found to be shorter in CNS infection caused by viral agents. Revealing the causative agent in the CSF is a fast and effective method that prevents unnecessary antibiotic treatment and shortens the hospitalization period of patients.

A Rare Case of Acute Infectious Purpura Fulminans Caused by Klebsiella Pneumoniae and Human Herpesvirus Type 5

BackgroundPurpura fulminans (PF), a rare, life-threatening disorder, is a hematological emergency in which there is skin necrosis, disseminated intravascular coagulation (DIC), and protein C deficiency. In PF, the skin necrosis and DIC are secondary to protein C deficiency. This may progress rapidly to multiorgan failure caused by the thrombotic occlusion of small- and medium-sized blood vessels.Case ReportThis article presents the case of a 22-year-old male with fever as well as necrotic and purpuric skin lesions. The ultrasound and computed tomography scans revealed infections in the skin wounds as well as venous microthrombosis and thrombosis in multiple intracranial and pulmonary vessels. The laboratory tests showed signs of sepsis, thrombocytopenia, an abnormal decrease in protein C and antithrombin III, DIC, multiple organ and system failures, gastric varices, and gastrointestinal hemorrhage. The blood, sputum, and secretions under the skin lesions were cultured and were positive for Klebsiella pneumoniae. The results of the high-throughput genetic testing of the pathogenic microorganism DNA were consistent. In addition, human herpesvirus type 5 was detected. The histopathological examination of the skin lesions revealed pathological features consistent with PF. After successful treatment by the departments of Dermatology, Emergency Critical Care Medicine, and the Intensive Care Unit, the patient was discharged after 67 days of hospitalization.ConclusionAdults with acquired protein C and/or S deficiency states, including certain bacterial and viral infections, who drink alcohol and take varieties of non-steroidal anti-inflammatory analgesics at the same time, may develop acute infectious PF. Clinicians should be aware of this for early diagnosis and treatment.

The role of active herpesvirus infection in the formation of atopic dermatitis and psoriasis

The results of previous studies suggest the involvement of herpes viruses in the development of atopic dermatitis and psoriasis, but there is no convincing evidence. Aim of the study was to evaluate the role of active herpesvirus infection in exacerbation of atopic dermatitis and psoriasis. Material and methods. The analysis of the incidence of infectious mononucleosis, genital herpes, cytomegalovirus infection, skin and subcutaneous tissue diseases, atopic dermatitis, psoriasis in Russia in 2000–2020 was carried out. 92 blood donors and 97 patients with skin and subcutaneous tissue diseases (44 with atopic dermatitis and 53 with psoriasis) were examined for the presence of immunoglobulins M and G to herpes simplex viruses (HSV1,2), Epstein-Barr (EBV), cytomegalovirus (CMV), human herpes type 6 (HНV6). Results and discussion. A significant strong direct correlation was revealed between the incidence of genital herpes and diseases of the skin and subcutaneous tissue ( p = 0.85), atopic dermatitis ( p = 0.85); infectious mononucleosis and psoriasis ( p = 0.85). The frequency of detection of IgM to HSV1,2, in total, IgG EA and IgM VCA EBV in the group of patients is significantly higher than in donors ( p < 0.05). In patients with atopic dermatitis, IgM to HSV1 were detected significantly more often than in individuals with psoriasis, and markers of active EBV infection were significantly less common. The presence of IgM HSV-1 statistically significantly increases the incidence of atopic dermatitis (relative risk (RR) = 2.3, 95 % confidence interval (95 % CI) 1.6–3.3)), IgM VCA and IgG EA EBV – the incidence of psoriasis (RR = 2.3, 95 % CI 1.5–3.3). Conclusions. It has been shown for the first time that active HSV1,2 infection is a trigger factor for the development of atopic dermatitis, EBV infection is psoriasis.

Prevalence and prognostic relevance of myocardial inflammation and cardiotropic viruses in non-ischemic dilated cardiomyopathy.

BackgroundNon-ischemic dilated cardiomyopathy (DCM) is a heterogeneous disease with a spectrum of etiological factors. However, subsets of the disease are not well-characterized with respect to these factors. The aim of this study was to evaluate the prevalence of myocardial inflammation and cardiotropic viruses in DCM patients and their impact on clinical outcome.MethodsFifty-seven patients with DCM underwent endomyocardial biopsy between 2010 and 2013. Biopsies were analyzed by polymerase chain reaction (PCR) for the presence of cardiotropic viruses, and inflammatory cell infiltration was assessed by immunohistochemistry. During a 5-year follow-up, 27 (47%) patients reached the composite outcome measure: heart transplantation, left ventricle assist device implantation or cardiovascular-related death.ResultsThirty-one (54%) patients had myocardial inflammation and cardiotropic viruses were detected in 29 (52%). The most frequent viruses were parvovirus B19 and human herpesvirus type-6. Four specific sub-groups were distinguished by PCR and immunohistochemistry: virus-positive (chronic) myocarditis, autoreactive inflammatory DCM, viral DCM, non-inflammatory DCM. The presence of a viral genome in myocardium or diagnosis of inflammatory DCM did not predict the outcome of composite outcome measures (p > 0.05). However, univariate Cox regression and survival function estimation revealed an association between inflammation by a high number of T-cells and poor prognosis.ConclusionsThis study has shown that two markers — cardiotropic viruses and myocardial inflammation — are prevalent among DCM patients. They are also helpful in identifying sub-groups of DCM. An increased number of T-lymphocytes in the myocardium is a predictor of poor mid-term and long-term prognosis.

Inhibition of Human Respiratory Influenza A Virus and Human Betacoronavirus-1 by the Blend of Double-Standardized Extracts of Aronia melanocarpa (Michx.) Elliot and Sambucus nigra L.

Viral and bacterial diseases are among the greatest concerns of humankind since ancient times. Despite tremendous pharmacological progress, there is still a need to search for new drugs that could treat or support the healing processes. A rich source of bioactive compounds with antiviral potency include plants such as black chokeberry and elderberry. The aim of this study was to assess the in vitro antiviral ability of an originally designed double-standardized blend of extracts from Aronia melanocarpa (Michx.) Elliot and Sambucus nigra L. (EAM-ESN) or separated extracts of A. melanocarpa (EAM) or S. nigra (ESN) against four human respiratory tract viruses: influenza A virus (A/H1N1), betacoronavirus-1 (HCoV-OC43) belonging to the same β-coronaviruses as the current pandemic SARS-CoV-2, human herpesvirus type 1 (HHV-1), and human adenovirus type 5 (HAdV-5). Antiviral assays (AVAs) were used to evaluate the antiviral activity of the plant extracts in a cell-present environment with extracts tested before, simultaneously, or after viral infection. The virus replication was assessed using the CPE scale or luminescent assay. The EAM-ESN blend strongly inhibited A/H1N1 replication as well as HCoV-OC43, while having a limited effect against HHV-1 and HAdV-5. This activity likely depends mostly on the presence of the extract of S. nigra. However, the EAM-ESN blend possesses more effective inhibitory activity toward virus replication than its constituent extracts. A post-infection mechanism of action of the EAM-ESN make this blend the most relevant for potential drugs and supportive treatments; thus, the EAM-ESN blend might be considered as a natural remedy in mild, seasonal respiratory viral infections.

Application of magnetic immunofluorescence assay based on microfluidic technology to detection of Epstein-Barr virus

EB病毒(Epstein-Barr virus, EBV)的早期诊断能够降低患者发生重大疾病的风险。临床上常用的EBV抗体的检测方法存在耗时长、试剂消耗大和效率低等缺点。相比于传统的检测方法,微流控(microfluidics)技术具有高通量、试剂消耗少,污染少和自动化程度高等优点,磁免疫荧光技术具有检测效率高、信号强等优点,将两者的优势结合,能够弥补传统方法的不足。鉴于此,采用聚甲基丙烯酸甲酯(PMMA)作为芯片原材料,经过激光切割及真空热压加工工艺能够快速获得芯片。将包被抗原的磁珠及包被抗人抗体的荧光微球经过冷冻干燥工艺快速冻干成小球并嵌入芯片内,经过孵育和清洗后,进行检测。通过图像分析快速得到检测结果。通过精密度、特异性、剂量-反应曲线及检出限测试,进行性能验证。通过与化学发光免疫分析法(CLIA)检测的临床样本比对,进行方法学与临床应用评价。结果显示相对标准偏差(RSD)均小于10%。与多种常见的病原体抗体均无交叉反应。EB病毒衣壳抗原(Epstein-Barr viral capsid antigen, EB VCA)IgG项目的检出限为1.92 U/mL,线性范围为1.92~200 U/mL,阳性符合率为95.77%(68/71),阴性符合率为86%(43/50); EB VCA IgA项目的检出限为2.79 U/mL,线性范围为2.79~200 U/mL,阳性符合率为92%(46/50),阴性符合率为92.96%(66/71); EB病毒核心抗原1(Epstein-Barr nuclear antigen 1, EB NA1)IgG项目的检出限为3.13 U/mL,线性范围为3.13~200 U/mL,阳性符合率为92.96%(66/71),阴性符合率为92%(46/50); EB NA1 IgA项目的检出限为1.53 U/mL,线性范围为1.53~200 U/mL,阳性符合率为90%(45/50),阴性符合率为91.55%(65/71)。4个项目能在20 min内快速完成检测,且与临床上使用CLIA方法测试的结果具有良好的相关性,可以为临床提供一种快速、灵敏、简便、自动化程度高和易于基层推广的检测方法。

Phytochemical Insights into Ficus sur Extracts and Their Biological Activity.

This study focused on the biological evaluation and chemical characterisation of Ficus sur Forssk. (F. sur) (Family: Moraceae). The methanolic and aqueous extracts’ phytochemical profile, antioxidant, and enzyme inhibitory properties were investigated. The aqueous stem bark extract yielded the highest phenolic content (115.51 ± 1.60 mg gallic acid equivalent/g extract), while the methanolic leaves extract possessed the highest flavonoid content (27.47 ± 0.28 mg Rutin equivalent/g extract). In total, 118 compounds were identified in the tested extracts. The methanolic stem bark extract exhibited the most potent radical scavenging potential against 2,2-diphenyl-1 picrylhydrazyl and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (475.79 ± 6.83 and 804.31 ± 4.52 mg Trolox equivalent/g extract, respectively) and the highest reducing Cu2+ capacity (937.86 ± 14.44 mg Trolox equivalent/g extract). The methanolic stem bark extract substantially depressed tyrosinase (69.84 ± 0.35 mg kojic acid equivalent/g extract), α-amylase (0.77 ± 0.01 mmol acarbose equivalent/g extract), acetylcholinesterase and butyrylcholinesterase (2.91 ± 0.07 and 6.56 ± 0.34 mg galantamine equivalent/g extract, respectively) enzymes. F. sur extracts were tested for anticancer properties and antiviral activity towards human herpes virus type 1 (HHV-1). Stem bark infusion and methanolic extract showed antineoplastic activity against cervical adenocarcinoma and colon cancer cell lines, whereas leaf methanolic extract exerted moderate antiviral activity towards HHV-1. This investigation yielded important scientific data on F. sur which might be used to generate innovative phytopharmaceuticals.

Protein from Phaleria macrocarpa Fruit Aqueous Extract Inhibits Early and Late Replication Phases of Human Herpes Virus Type-1

Background: Phaleria macrocarpa fruit is known to have protein but the antiviral activity potential has not been explored. Objective: To determine the antiviral activity of Phaleria macrocarpa fruit protein aqueous extract (PMFPAE) and the fractions against human herpesvirus type 1 (HHV-1). Methods: Protein from P. macrocarpa fruit aqueous extract was precipitated using ammonium sulphate and followed by fractionation on Sephadex G-25. Cytotoxicity was determined in Vero cells and followed by determination of antiviral activity by plaque reduction assay against a clinical strain of HHV-1. Effect of PMFPAE on virus replication was determined in pre-treatment, time-addition and time-removal assays. Results: PMFPAE and its fractions were non-cytotoxic to Vero cells with 50% cytotoxic concentration (CC50) values ranged between 96 ± 1.3 to 1450 ± 2 μg/mL. PMFPAE have good anti-HHV-1 activity with Selective Index (SI) of 80.6 but reduces in fractions P1 to P6 ranging between 4.2 and 67.9. Fractions with high SI were P1 and P2 contained high molecular weight (MW) proteins and P6 has the lowest MW suggestively peptides. Treatment with PMFPAE to host cells prior to virus infection had little effect on inhibiting HHV-1 replication. Treatment with PMFPAE affects virus early and late replication phase with plaque inhibition percentage increased during 10th to 16th hour post-infection. Conclusion: PMFPAE contained non-cytotoxic proteins that affects HHV-1 early and late replication phases. Proteins with high antiviral activity resides in fractions with high MW and very low MW peptides. Key words: Phaleria macrocarpa fruit protein, Fractionation, Cytotoxicity, Anti-Human herpes virus type-1.

A comparative study of valaciclovir, valganciclovir, and artesunate efficacy in reactivated HHV-6 and HHV-7 infections associated with chronic fatigue syndrome/myalgic encephalomyelitis.

This study aimed to compare the efficacy of valaciclovir, valganciclovir, and artesunate in treating chronic reactivated human herpesvirus type 6 (HHV-6) and human herpesvirus type 7 (HHV-7) infection associated with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). From 255 patients (192 cases) with reactivated HHV-6 and HHV-7 infections (confirmed based on blood leukocyte PCR), valaciclovir, valganciclovir, or artesunate was administered at a dose of 3000, 900, and 100 mg/day, respectively, for 3 months (study group). The control group consisted of similar patients with ME/CFS (n = 63) not taking any antiviral drugs. The significance of differences was evaluated by Student's t-test and the nonparametric criterion-the number of Z-signs. Negative PCR results in patients with HHV-6 and HHV-7 treated with valaciclovir was achieved in 26% and 23% (first month), 34%, and 28% (second month), 37% and 34% of cases (third month), respectively (P < 0.05; Z < Z0.05 ). The same results with valganciclovir were obtained in 35% and 33% (first month), 44% and 39% (second month), 48% and 45% of cases (third month), but with artesunate in 44% and 41% (first month), 57% and 53% (second month), 68% and 63% of cases (third month), respectively (P < 0.05; Z < Z0.05 ). Artesunate is more effective than valganciclovir and valacyclovir in patients with ME/CFS with reactivated HHV-6 and HHV-7 infections.

До питання про герпетичну інфекцію як актуальну проблему сьогодення

Серед персистуючих внутрішньоклітинних агентів провідне місце за поширеністю посідає група герпесвірусів. Всесвітня організація охорони здоров’я (ВООЗ) застерігає світове співтовариство про небезпеку прихованої пандемії герпетичної інфекції. За даними ВООЗ, від 70 до 90 % населення світу інфіковано одним або декількома типами вірусу герпесу і у 50 % з них через відсутність стійкого імунітету щорічно спостерігаються рецидиви захворювання. До родини герпесвірусів, що виявлені у людини, належать віруси простого герпесу 1-го і 2-го типів, герпесу Zoster, цитомегалії, Епштейна — Барр, герпесу людини 6, 7, 8-го типів. Так, у патогенезі герпетичної інфекції 1-го і 2-го типів виділяють чотири основні фази: проникнення в клітини епітелію → проникнення в нервові закінчення і паравертебральні ганглії → елімінація вірусу з тканин і органів → реактивація вірусів простого герпесу і його переміщення до воріт інфекції. Герпетична і цитомегаловірусна інфекція, що належить до групи TORCH-інфекцій, є найпоширенішою причиною інфікування плода, що може спричинити народження дитини з вадами розвитку. Герпесвірусні інфекції зараховують до групи інфекцій, асоційованих із синдромом імунодефіциту людини, вважають частою причиною ураження центральної нервової системи і внутрішніх органів в осіб зі вторинним імунодефіцитом. Практично всі відомі зараз герпесвіруси людини здатні спричиняти ураження нервової системи. У зв’язку з цим герпесвірусні інфекції стали однією з провідних медико-соціальних проблем і набувають загальнодержавного значення.

Особенности вирусных энцефалитов у детей по данным Киевской городской детской клинической инфекционной больницы с 2011 по 2016 год

Проведен ретроспективный анализ 46 историй болезни детей, находившихся на стационарном лечении в Киев­ской городской детской клинической инфекционной больнице с 2011 по 2016 год. Была проанализирована этиология энцефалита у детей в зависимости от возраста и выявлено, что в этиологии вирусного энцефалита у детей первых 3 лет жизни преобладали цитомегаловирус и ассоциация Эпштейна — Барр вируса (EBV) с цитомегаловирусом — по 25 %. У подростков в этиологии превалировали EBV — 31 % и герпесвирус (HHV) 6-го типа — 31 %. У детей в возрасте 3–6 лет в этиологии преобладал EBV — 30 %, у детей 6–12 лет — HHV 6-го типа и EBV — по 27 %. В клинической картине энцефалита у подростков преобладал общемозговой синдром, а у детей первых 3 лет жизни — общеинфекционный. Очаговая неврологическая симптоматика отмечалась у больных всех возрастных групп. У детей старшего возраста начальными проявлениями заболевания были головная боль, недомогание, тошнота, рвота, у детей первых трех лет жизни — сонливость, раздражительность и отказ от еды. Частыми очаговыми симптомами у детей были афазия, атаксия, парезы, параличи, миоклонии.

Оценка роли микробиоты носоглотки в формировании хронического лимфопролиферативного синдрома ЛОР-органов у детей младшего возраста

To assess the nasopharyngeal microbiota role in the development of chronic lymphoproliferative syndrome of ENT organs in young children, 40 children aged 2–3 years were examined. Cytological and cultural bacteriological studies of nasopharyngeal smears were carried out. Serological and molecular genetic analyzes of markers of herpesvirus infections (Epstein–Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus type 6 (HHV-6)) in the blood, polymerase chain reaction (PCR), and immunofluorescence reaction (RIF) were performed with generic antiherpetic sera of the same name in scrapings of the pharyngeal tonsil. In the rhinocytogram, 57,14% of children had poor gram-positive cocci, characteristic of the normal state of the mucosa. In nasopharyngeal smears, the growth of microorganisms of opportunistic and saprophytic microbiota was not detected in a diagnostically significant amount in 19,44% of children; isolated growth of normal aerobic and/or facultative anaerobic microbiota was observed with the same frequency. Opportunistic microbiota was detected in 61,11% of cases, including associations of saprophytic microbiota and opportunistic microorganisms were detected in 27,78% of children. Most often, Staphylococcus aureus 54,55% was detected in children; known respiratory pathogens were found less frequently: Streptococcus pneumoniae 31,82%, Haemophilus influenzae 13,64%, Moraxella catarrhalis 13,64%. In the majority of patients, 77,27%, one type of pathobiont was identified. 100% infection with herpesvirus infections was established, including EBV 66,67%, CMV 56,41%, HHV-6 61,54%. Mixed infections dominated 69,23%, EBV infection prevailed among mono infections. The active stage of herpesvirus infection was established in 56,41% of children, of which 77,27% were mono infections, and 22,73% were mixed infections, among which 80% were EBV + HHV-6. Most frequently, there were detected the signs of active EBV infection 46,15%, HHV-6 reactivation was detected in 20,51% of cases, active CMV persistence was much less common 7,69%. The active stage of herpesvirus infections was confirmed by the study of brush-smears of the nasopharyngeal mucosa with immunofluorescence test and PCR. In general, the traditional semi-quantitative studies of cultures of bacterial colonies from samples of the pharyngeal tonsil biotope did not reveal a unified causative agent (pathogen) of chronic lymphoproliferative syndrome of ENT organs in young children.

РОЛЬ в- И Y-ГЕРПЕСВИРУСОВ В РАЗВИТИИ ИНФЕКЦИОННОГО МОНОНУКЛЕОЗА У ДЕТЕЙ

The purpose of the work is to assess the participation of в- and y-herpes viruses in the development of infectious mononucleosis in children. The study observed 47 children aged from 10 months to 10 years. Determination of the genome of herpes viruses was carried out by the method of quantitative polymerase chain reaction in "real time". According to our data, the causes of infectious mononucleosis in children are Epstein-Barr virus (EBV) in 21.4 % of cases, human herpesvirus 6B (HHV-6B) — in 15 % of cases as monoinfection or in combination with EBV and/or human herpes virus type 7 (HHV-7). HHV-7 monoinfection, as well as cytomegalovirus (CMV) as a cause of infectious mononucleosis, was not recorded in our study. In 14.3 % of children, HHV-6B can manifest itself as an acute respiratory disease. The HHV-6B strain of the virus is predominantly circulating in our region.

Herpes Virus Reactivation in Lymphoma Patients During and After Autologous Hematopoietic Stem Cell Transplantation

Aim. To assess the detection rate of human herpes virus DNA (of cytomegalovirus, herpes simplex virus types 1 and 2 [HSV-1/2], human herpes virus type 6 [HHV-6], and Epstein-Barr virus) in different biological environments at different stages of autologous hematopoietic stem cell transplantation (auto-HSCT) as well as the effect of immune factors on reactivation of viruses under study. Materials &amp; Methods. From 2019 to 2021 the study enrolled 87 lymphoma patients during and after auto-HSCT. Virological monitoring was performed on biological fluids (blood, saliva, urine, etc.) prior to conditioning regimen on Day 0 as well as on Day +5 and Day +10 after auto-HSCT. On these days (Day 0, Day +5, and Day +10) the immune factors (IgM, IgG, and IgA levels and pattern of lymphocyte subpopulation in peripheral blood) in 15 % (14/87) of patients were assessed in terms of their effect on herpes virus reactivation. Results. The overall rate of viral DNA detection increased from 26 % (26/87) to 42 % (37/87) of cases in the period of granulocytopoietic recovery. The most frequent were HHV-6 and HSV-1/2 reactivations reported in 23 % (20/87) and 16 % (14/87) of cases, respectively. The median B-lymphocyte proportion in peripheral blood of patients with herpes virus reactivation was 0.26 %, whereas in patients without reactivation it was 6.7 % (p = 0.019). The median absolute B-lymphocyte count in the cohort of patients with detected viral DNAs was 0.001 &lt;sup&gt;x&lt;/sup&gt; 10&lt;sup&gt;9&lt;/sup&gt;/L, whereas in patients without them it was 0.098 &lt;sup&gt;x&lt;/sup&gt; 10&lt;sup&gt;9&lt;/sup&gt;/L (p = 0.026). Conclusion. A high rate of herpes virus DNA detection in lymphoma patients after auto-HSCT affected neither transplant engraftment nor transplantation mortality. Immune predictors of virus infection reactivation were the decreasing proportion of B-cells in the total lymphocyte count and the absolute B-lymphocyte count in the peripheral blood prior to auto-HSCT.

Disseminated Kaposi sarcoma with osseous metastases in patients with HIV infection. Case report

Background. Kaposi sarcoma is a low-grade vascular tumor affecting blood and lymphatic vessels associated with the human herpes virus type 8 (HHV-8). As a rule, the skin of the lower extremities is involved in the process first of all, and then other organs and lymph nodes are involved. There are 4 various types of the disease with different clinical picture: the classic, the endemic, the epidemic and immunosuppression subtype. The epidemic subtype is the most common and has the most aggressive course, with specific lesions of a multiple kind, including the skin, mucous membrane layers, the lymph nodes, the gastrointestinal tract, the lungs and the spleen. Osseous metastases are extremely rare.&#x0D; Aim. Show the case of Kaposi sarcoma with osseous metastases in patient with the human immunodeficiency virus (HIV) infection.&#x0D; Results. We observed a 43-year-old patient with HIV infection and stage 4b Kaposi sarcoma against the background of the irregular antiretroviral therapy in the progression stages. The duration of the anamnesis was 32 months. The clinical debut of the cancer process was noted with skin lesions on the shoulder. Histological and immunohistochemical analysis of skin biopsies showed the morphological picture of Kaposi sarcoma. HHV-8 was expressed in tumor cells. During the endoscopic examination the lesions of oral mucosa, stomach and proximal colon were confirmed morphologically, and spiral computed tomography of the chest revealed the lesions in the lungs. On this point, the patients received oxaliplatin-based chemotherapy and aetoposidum for 6 months and against the background of this treatment we observed the disease progression associated with the involvement of the retroperitoneal lymph nodes, the left adrenal gland and the penis. Circumcision was performed in the case associated with the involvement of the penis. The treatment was continued. The lytic left iliac bone lesion, the retroperitoneal lymph nodes, the iliac lymph node groups, as well as the left inguinal lymph nodes, the left adrenal gland and the lungs were characterized by a high F-18 FDG uptake after 3 months of the treatment, according to the results of Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography combined with computed tomography (PET/CT).&#x0D; Conclusion. Kaposi sarcoma in patients with HIV infection had an aggressively course with disseminated skin lesions and internal organ involvement, including bones as showed in this clinical case. In this case, the axial skeleton was more commonly involved. PET/CT is a diagnostic imaging method in the differential diagnosis and determination of the prevalence of the cancer process.

Epstein–Barr Virus-Induced Acute Hepatitis, Pancreatitis, and Pneumonitis in a Young Immunocompetent Adult: A Case Report

Epstein–Barr virus (EBV) is a common herpes virus (human herpesvirus type 4) that usually manifests as infectious mononucleosis or persists asymptomatically for life. EBV can also be associated with different types of malignancy such as T cell lymphoma, B cell lymphoma, Hodgkin lymphoma, and oropharyngeal squamous cell and nasopharyngeal carcinoma. Pneumonia is a very rare complication of EBV infection, but it has been reported to occur even in the absence of mononucleosis. This article highlights the case of 35-year-old female who developed acute pancreatitis and acute respiratory failure related to EBV infection. The patient progressively recovered on antiviral therapy and steroids.