Recurrent respiratory infections and active herpesvirus infections in children: problems and solutions
DOI: 10.32364/2587-6821-2023-7-11-2
E.V. Melekhina1,2, D.V. Preobrazhenskaia1, A.D. Muzyka1, E.Yu. Soldatova1, A.V. Gorelov1,3
1Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russian Federation
2Khimki Regional Hospital, Khimki, Russian Federation
3I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Background: recurrent respiratory infections (RRI) in children are a relevant medical and social issue. Reactivation of latent herpes simplex virus (HSV) infections is recognized as one of the leading causes of recurrent respiratory infections. Its rate in children is up to 40%. Therapeutic options for recurrent respiratory infections in children are discussed given the activity of HSV infections and immune disorder treatment.
Aim: to assess the efficacy of inosine pranobex (Normomed®) for recurrent respiratory infections and active HSV infection in children.
Patients and Methods: we examined 96 children aged 3–17 years who requested medical care in an outpatient department with complaints typical of recurrent respiratory infections and laboratory-confirmed active HSV infection. Children received inosine pranobex (50–75 mg/kg/day) in three 10-day courses (10-day breaks). 5±1 weeks after finishing therapy, control clinical and laboratory tests and virology were performed. The nature of ARI episodes during the follow-up period and HSV infection activity over time were evaluated.
Results: during treatment, a reduction in the rate and severity of respiratory diseases was reported in 94% of children. Fever severity decreased twice (p=0.035), oropharynx condition improved in 66.7% (p<0.01), and the severity of lymphoproliferative syndrome reduced in 62.5% (tonsil hypertrophy in 52.1%, lymphadenopathy in 50.6%, hepatomegaly in 55.3%, splenomegaly in 66.7%). During treatment with inosine pranobex, a decrease in HSV infection activity was reported in 88.6% of children. The active HSV count also decreased. A significant (p<0.01) reduction in the percentage of patients with active HHV 6A/B (from 78.1% to 12.5%), Epstein– Barr virus (from 45.8% to 7.3%), and HSV type 1 (from 14.6% to 1.0%) was reported.
Conclusion: significant improvement in the somatic and virological status of children with recurrent respiratory infections and HSV infection after a course of inosine pranobex, which is characterized by antiviral and immunomodulatory effects, was established.
Keywords: monthly respiratory infections, recurrent respiratory infections, Epstein–Barr virus, human herpes virus 6A/B, children, inosine pranobex, Normomed.
For citation: Melekhina E.V., Preobrazhenskaia D.V., Muzyka A.D., Soldatova E.Yu., Gorelov A.V. Recurrent respiratory infections and active herpesvirus infections in children: problems and solutions. Russian Medical Inquiry. 2023;7(11) (in Russ.). DOI: 10.32364/2587-6821-2023-7-11-.
About the authors:
Elena V. Melekhina — Dr. Sc. (Med.), associate professor in pediatrics, leading researcher of the Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; pediatrician of the Infectious Diseases Department, Khimki Regional Hospital; 11, Kurkinskoe road, Khimki, 141407, Russian Federation; ORCID iD 0000-0002-9238-9302.
Daria V. Preobrazhenskaia — 2nd year clinical resident, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0009-0000-6152-0251.
Anna D. Muzyka — C. Sc. (Med.), senior researcher of the Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORСID iD 0000-0002-2269-2533.
Evgeniya Yu. Soldatova — junior researcher of the Clinical Department of Infectious Diseases, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; ORCID iD 0000-0002-0683-8010.
Alexander V. Gorelov — Corresponding Member of the Russian Academy of Sciences, Dr. Sc. (Med.), Professor, Deputy Director of Science, Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; 3A, Novogireevskaya str., Moscow, 111123, Russian Federation; professor of the Department of Children's Diseases I.M. Sechenov First Moscow State Medical University (Sechenov University); 8 Build. 2, Trubetskaya str., Moscow, 119991, Russian Federation; ORCID iD 0000-0001-9257-0171.
Contact information: Elena V. Melekhina, e-mail: e.melekhina@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 09.09.2023.
Revised 03.10.2023.
Accepted 26.10.2023.
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