The modern approach to the clinical diagnosis of active herpesvirus infection in children with recurrent respiratory infections

Recurrent respiratory infections (RRI) are observed in 20-65% of children and may be associated with the state of the immune system, features of the intestinal microbiota, the somatic status of the child, the presence of allergic diseases, persistent or active herpesvirus infection (HVI). The identification of a cohort of children who should be examined deeply to verify the presence of active HVI is an urgent problem. Objective. To develop clinical approaches to the diagnosis and prognosis of the presence of active HVI in children with RRI based on clinical data. Patients and methods. 114 children (from 1 to 17 years old) were examined. The main group consisted of 81 children with RRI and active HVI, the comparison group consisted of 33 children without active HVI. Clinical and laboratory examination, diagnosis of HVI by direct and indirect methods were carried out Results. In patients of the main group, oropharyngeal lesions of the type of granulose pharyngitis, tonsillar hypertrophy, adenoid hypertrophy, generalized lymphadenopathy, and hepatolienal syndrome were significantly more often detected and more pronounced. Based on clinical data, integral indicators (II) were developed to quantify the symptoms of the reaction of lymphoid organs in response to antigenic lymphoproliferative effects. The sum of the scores of both II sole proprietors was significantly higher in the main group. The median of (lymphoproliferative) is 5.00 (IQR 3.00–6.00) & 2.00 (IQR 1.00–2.00), p < 0.001; the median of (lymphoproliferative-nasopharyngeal) is 6.00 (IQR 4.00–7.00) & 2.00 (IQR 1.00–3.00), p < 0.001. The threshold values of indicators for the prediction of active HVI were 4 points and 3 points, respectively. Using IP, the clinical efficacy of inosine pranobex (3 courses of 10 days with a 10-day break) was assessed in 81 main groups. A reliable decrease in IP was shown: before the start of antiviral therapy, the median IPl was 6.00 (IQR 4.00–7.00), and after completion – 4.00 (IQR 2.00–6.00), p < 0.001 (Wilcoxon test). Conclusion. Manifestations of active forms of HVI in patients with RRI are represented by the phenomena of granulose pharyngitis, generalized lymphadenopathy, hypertrophy of adenoids and palatine tonsils, hepatolienal syndrome. II can be used to determine the tactics of examination of patients with RRI. Key words: recurrent respiratory infections, herpesvirus infections, integral indicators, children