FEATURES OF THE COURSE OF INFECTIOUS MONONUCLEOSIS CAUSED BY THE EPSTEIN-BARR VIRUS
Aim of the study: assessment of clinical and immunological parameters of the course of infectious mononucleosis caused by EBV in order to identify protracted forms of the course and predict adverse conconsequences in patients with infectious mononucleosis caused by EBV.
Materials and methods. 110 patients were examined in whom infectious mononucleosis was found, caused by EBV, among which 58 women (52.7%), men – 52 (47.3%).
Results. An imbalance in subpopulations of CD4+-lymphocytes, which regulate and control the development of cellular and humoral reactions, was revealed in the studied group of patients. This, in turn, may determine the high frequency of the formation of a chronic persistent form of infectious mononucleosis and indicates significant changes in the cellular and humoral immunity in patients with infectious mononucleosis. Clinical improvement observed in patients in the period of convalescence is not accompanied by normalization of immunological parameters, which may determine the high incidence of chronic persistent form of infectious mononucleosis.
Conclusions. Based on the results of the study, we identified changes in the cellular and humoral components of immunity. So, with a smooth course of infectious mononucleosis, activation of cellular and humoral immunity was observed and was characterized by an increase in the content of lymphocytes with the phenotype [CD3+; CD4+; CD8+; CD16+; CD20+], Th1 cells, IgA and IgM; (p<0.05) with a tendency to normalization in the period of convalescence. During the formation of chronic forms of EBV infection, we revealed a progressive nature of changes in immune parameters, which indicates the formation of a secondary lymphocytic cellular imbalance, activation of the humoral link, a change in the balance of immunoregulatory mediators towards Th2 (a decrease in the content of [CD3+; CD4+; CD4+; CD8+CD28+/ СD8+CD28–, increase in CD20+, IgG, Th2 (IL-4+), Th1/Th2 (p<0.05) levels due to the increase in the relative content of Th2 cells mononucleosis and analysis of the identified changes in the immune system will help improve the diagnostic algorithm and promptly correct violations.