Prevention of acute respiratory infections in children early age with chronic herpetic diseases infections

Background. Primary viral infection most often results in acute disease, but prolonged persistence with emerging clinical manifestations may be considered a marker of immune malaise. Cytomegalovirus (CMV) and Epstein–Barr virus (EBV) directly suppress interferonogenesis and affect the ability to adequately respond to new viral agents.

Aim. To investigate the efficacy of prophylaxis of acute respiratory infections in infants with chronic herpes infections with interferon α-2b suppositories and aqueous vitamin D solution.

Materials and methods. The comparative study enrolled 214 infants with persistent herpes infections (CMV, EBV). Two observation groups were formed, the main group received interferon α-2b preparations in suppositories, 125,000 mg, 1 suppository 2 times a day, 3 times a week for 1 month, in combination with vitamin 25(OH)D in prophylactic doses depending on serum levels. The control group received no prophylactic treatment after herpetic infections. After completion of vitamin D therapy course quantitative content of CMV, EBV in blood, saliva, urine, concentration of serum level of vitamin 25(OH)D was determined by polymerase chain reaction method, and in case of deviation from normal values the treatment course was continued up to 6 months.

Results. The chosen scheme of prophylaxis significantly (p≤0.05) reduced the number of recurrent respiratory diseases and bacterial complications during a year in the study group. The average duration of acute respiratory infections in the control group was 12.9 days, which was 5 days longer than in the main group of patients. An exacerbation of CMV and EBV infection was more common in the control group, occurring in 31 (48.4%) children. These stabilizing clinical pictures were confirmed by laboratory indexes in the form of reduced viral activity of CMV, EBV, determined by polymerase chain reaction.

Conclusion. Administration of interferon α-2b in suppositories of 125,000 mg and an aqueous solution of vitamin D in infants decreases frequency, duration and severity of new-onset acute respiratory infections in children against the background of underlying pathology. Optimal level of vitamin D increases local reactivity of nasopharyngeal mucous membranes and normalizes immunoreactivity of the child's organism.