Active forms of Epstein-Barr virus infection in children with catarrhal-respiratory syndrome: specificities of clinical signs and therapy
The objective. To study specificities of the course of Epstein-Barr virus infection (EBVI) in children during its activation occurring with catarrhal-respiratory syndrome, and to assess the effectiveness of its therapy. Patients and methods. We analysed the clinical signs of active forms of EBVI in children with infection reactivation, its age-related specificities and the outcomes of isoprinosine treatment following the observation of children for 6 months after the administered therapy. Results. 95.8% of children had an adverse premorbid background, 87.5% could be referred to patients with recurrent ARI. The clinical picture was characterised by the prevalence of lymphoproliferative syndrome: hypertrophy of palatine tonsils in 95.8%, chronic tonsillitis was more often recorded in schoolchildren, adenoiditis (59.6%) and hyperplasia of adenoid tissue -in preschool children (78.9%), hepatomegaly - in children under 5 years (83.3%). The clinical signs of ARI in EBVI did not have specific characteristics. The effectiveness of isoprinosine depended on the replicative activity of virus in blood (PCR+) at the start of therapy. In active replication of virus (43 children), 3 months afterwards the share of children with tonsillar hypertrophy decreased twofold, with adenoid hypertrophy by 1.8 times and with generalised lymphadenopathy by 3 times, no astheno-vegetative syndrome was recorded. The share of children with recurrent ARI decreased from 86.0% to 41.9% within 6 months _| (p < 0.01). In the group of children without DNAemia (PCR-) (29 children) no significant differences have been obtained. Conclusion. Reactivation of EBVI might occur both with catarrhal-respiratory and lymphoproliferative syndrome, more often in children with an unfavourable premorbid background, recurrent diseases. Improvement of respiratory manifestations comes in advance of clinical and laboratory recovery. The effectiveness of therapy is significantly higher if EBV DNA is present in blood of patients at the start of therapy.