Specificities of juvenile arthritis in children with herpes virus infection
The objective. To study the etiological structure of HVI in children with inflammatory diseases of the joints, to compare the form and variant of arthritis, age-related and gender specificities in patients with HVI and without such. Patients and methods. The etiological structure of HVI was studied in 163 patients with juvenile arthritis (JA). Active HVI was determined by identification of DNA of herpes viruses types 1, 3, 4, 5 and 6 (HSV-1, VZV, EBV, CMV, HhV-6) using qualitative PCR blood test (total screening), and also in the presence of clinical manifestations of herpes virus infection at the moment of examination (orofacial herpes, varicella, herpes zoster). Groups of children with JA were compared: 81 children (49.7%) with active HVI and 82 children (50.3%) without HVI. Results. Among patients with the systemic form of juvenile idiopathic arthritis (JIA) there were significantly more children with HVI (62%, р < 0.001). Girls more often have a systemic (65%, р < 0.001) and articular form of JIA (64%, р < 0.001), and also reactive arthritis (ReA) - 78% (р < 0.001), boys - juvenile spondyloarthritis (JSA) - 82% (р < 0.001) and juvenile chronic arthritis (JCA) - 63% (р < 0.001). Among children with HVI the 1-to 6-year-old age group prevails (65%, р < 0.001), and without HVI -7-11 years (67%, р < 0.001). In the structure of positive markers of HVI, VZV mono-infection prevails (59%, р < 0.05), and also HHV-6 mixed infection (65%, р < 0.001). No active CMV infection was diagnosed in the patients. Conclusion. The most severe systemic forms of JIA occur against the background of active HVI, mainly in the form of mixed infection.