The dynamics of immune response in Epstein-Barr virus infectious mononucleosis in children
Aim. Is to characterize the dynamics of the immune response of children with Epstein-Barr viral infectious mononucleosis depending on the age. Materials and methods. A prospective study of 98 children with infectious mononucleosis from 3-17 years old (group I - children 3-6 years (n = 29), group II - children 7-11 years (n = 24), group III-children 12-17 years (n = 45) had been pursued. Immunological examination was conducted twice, on the 1st and 3rd week of the disease. Statistical processing of obtained data was performed using the software package «Microsoft Office» and «Statistica10». Results. In the initial period of the disease, the following changes were found: the absolute level of CD3+, CD8+, CD16+, CD38+, CD54+, HLA-DR+ were significantly increased, CD4+ count remained within the standard values, the number of CD71+ - decreased. Relative values responded less exponentially and in some cases not proportionally. The decrease in CD20+, CD23+, the increase in the content of immunoglobulins, circulating immune complexes, primarily due to complexes of medium and small sizes, good absorption capacity of neutrophils with the preservation of metabolic potential to phagocytosis were found out. Most of the indicators in the 1 group sought to normative values in the 3 week. Such dynamic reverse development of immunological shifts in 2 and 3 groups was not recorded. This trend has been exacerbated in proportion to the age of the child. Conclusion. In the analysis of immunograms, it is necessary to pay attention not only to the relative, but also to the absolute content of the indicators, given the high lymphocytosis characteristic of the typical EBV infection. The rapid dynamics of immunological parameters in children 3-6 years old correlates with a visual clinical manifestation of infectious mononucleosis in this group. Immunological changes that persist for a long time in children older than 7 years in the 3rd week may be risk factors for the formation of a prolonged course of EBV infection.