Prediction of the course and consequences of infectious mononucleosis caused by the Epstein-Barr virus

Abstract. The study of the role of Epstein-Barr viral infection in the occurrence of various pathological conditions in humans is of great importance. This is due to the significant epidemiological role, since upon reaching the age of majority, more than 90% of people are infected of Epstein-Barr virus. The steady increase in the number of diseases caused by Epstein-Barr virus both among adults and children, which is associated with its specific tropism for immunocompetent cells, lifelong persistence and latent course necessitates a comprehensive study and development of effective treatment methods. Purpose of the work: to assess clinical and immunological parameters in order to identify a protracted course and predict unfavorable outcomes in patients with infectious mononucleosis caused by the Epstein-Barr virus. Materials and methods: To achieve this purpose, 60 patients with infectious mononucleosis were examined, among them 38 women (63.3%), 22 men (36.7%). The average age of the patients was 24.3±4.3 years. The material for the study was the patient's serum obtained in the dynamics of the disease. The complex of examination of patients with Infectious mononucleosis included clinical and biochemical methods, enzyme-linked immunosorbent assay, polymerase chain reaction method, immunogram. The research results were processed by the method of variation and correlation statistics using the Statistica 10.0 for Windows program. Results. The analysis of the obtained results made it possible to establish that in patients with infectious mononucleosis, changes were revealed in the system of cellular and humoral immunity and its multidirectionality. The progressive nature of changes in immune parameters indicates the formation of a secondary cellular immune imbalance, activation of the humoral link, a change in the balance of immunoregulatory mediators towards Th2 cells. In the acute period, statistically significant violations of the cellular link of immunity were established, which were characterized by an increase in the number of cells with killer activity: mature T-lymphocytes (CD3+), cytotoxic T-suppressor cells (CD8+), cells expressing the activation marker CD25+ (IL-2 receptor ) and increased Th1/Th2. Conclusions. Thus, changes in the cellular and humoral links of immunity in a favorable course of myocardial infarction are characterized by activation of the cellular and humoral links of immunity, which is manifested by an increase in the content of lymphocytes in the peripheral blood with the [CD3+; CD4+; CD8+; CD16+; CD20+], Th1 cells, IgA and IgM; (p<0.05) with a tendency to normalization during the period of convalescence. With the formation of chronic forms of Epstein-Barr viral infection, a progressive nature of changes in immune parameters is noted, 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+; CD8+; CD16+]; an increase in the content of CD20+; IgG levels; Th2 (IL-4+) Th1/Th2 (p<0.05) due to an increase in the relative content of Th2 cells.