HERPETIC INFECTION AS AN INDUCTOR OF SECONDARY IMMUNODEFICIENCY: CLINICAL FEATURES AND IMMUNE STATUS PARAMETERS

Aim: To characterize the clinical features and laboratory parameters of the immune status in patients with signs of secondary immunodeficiency state (SID) against the background of herpes infection. The study included 42 patients with clinical signs of SID associated with infection induced by herpes viruses. Analysis of the structure of herpesvirus infection showed that the absolute majority of patients in this group were diagnosed with infection caused by the herpes simplex virus (HSV-1/2) - 41 (97.6%). Some patients - 10 people (23.8%) were diagnosed with mixed infection, and the majority of them had a combination of HSV-1/2 - 7 (16.6%), less common was a combination of HSV-2 and VZV - in 2 (4.8%), HSV-1 and VZV - in 1 (2.4%) patient. Localized herpes infection was diagnosed in 70.7% of patients (n=29), while disseminated herpes infection, which involves two or more foci of the pathological process, was observed in 24.4% of patients (n=10). Thus, skin and genital lesions were recorded in 8 patients (19.6%), skin and gastrointestinal tract lesions were observed in 1 patient (2.4%), and skin and eye lesions were also observed in 1 patient (2.4%). Generalized visceral herpes infection (endocervicitis, endometriosis) was observed in 2 patients (4.9%). Severe herpes infection was observed in 33 people (80.5%), while continuously recurring disease was registered in 31 patients (75.6%). Analysis of immune status parameters showed that both the relative (16.6 [13.4; 20.4] %) and absolute number of NK cells (276.22 [207.36; 415.48] in 1 μl) corresponded to the reference values. However, when assessing humoral factors of innate immunity, a significant decrease in induced interferon production was found: the IFN-α level did not exceed 70 [40; 120] a.u. with the expected values ​​of more than 640 a.u. Also, IFN-γ was reduced more than 5 times - 12 [12; 16] a.u., which probably was the basis for the development of SID. Analysis of adaptive immunity parameters revealed a tendency towards a decrease in CD8+ lymphocytes. In addition, a decrease in phagocytic activity was noted in the phagocytosis test - 60 [55; 63] %.