Herpetic infection in otorhinolaryngology as a multimorbidity factor
Authors:   Institute of Experimental Medicine, Saint Petersburg, 197376, Russia, Shabrov A. V. , Gorbacheva I. A. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Fominykh Yu. A. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Sycheva Yu. A. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Donskaya O. S. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Kulikova Yu. R. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Mekhtiev S. N. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Ivanovskii V. A. ,   Pavlov First Saint Petersburg State Medical University, Saint Petersburg, 197022, Russia, Koshel’ I. V. ,   Stavropol State Medical University, Stavropol, 355017, Russia
Published: May 2021

The search for common links of etiology and pathogenesis in the formation of comorbid pathology in modern patients opens up additional opportunities for increasing the effectiveness of their treatment and is an important problem in scientific and practical medicine. The extreme prevalence of chronic persistence of immunotropic viruses, such as herpes genotypes 4,5,6 types, requires a study of its consequences in the human body and the involvement in its infectious-dependent morbidity, such as the formation of multiple chronic foci of infection in the ear, nose and throat with frequent and prolonged exacerbations. The work shows that chronic sinusitis, nasopharyngitis, tonsillitis associated with chronic herpesvirus persistence form the status of frequently and long-term ill people against the background of pronounced immuno-compromise with quantitative and functional T- and B-cell deficiency, insufficient resources of α and γ- interferon. The study presents a positive experience of replenishing the deficiency of α and γ-interferons with recombinant drugs of the same name in comorbid ENT patients. The aim of the study was to increase the efficiency of treatment of patients with concomitant chronic focal infection in the ear, nose and throat against the background of chronic persistence of herpesvirus infection. Materials and methods: Comprehensive clinical and laboratory examination of 45 carriers of herpes simplex virus genotypes 4,5, 6 at the age of 29 to 52 years made it possible to establish in them a comorbid chronic focal infection in the LOR organs: chronic sinusitis, chronic nasopharyngitis, chronic tonsillitis. Results: The observed patients had a statistically significant (p < 0.01) deficiency of NK cells with receptors CD16+, CD56+ and B cells with markers CD19+, CD5+ against the background of peripheral blood lymphocytosis with an increase in the content of cytotoxic T lymphocytes (CD8 +) marker in some patients. All patients showed a significant decrease in interferon system resources (p < 0.01). Replacement therapy with recombinant preparations of α- and γ-interferons led to restoration of interferon system parameters and was accompanied by improvement of immunological blood indices, both quantitative and functional characteristics of T-and B-lymphocytes, mononuclear phagocytes, this dynamics was matched by improvement of patients, confirmed by results of questionnaire. Conclusions: Thus, the positive experience of antiviral therapy by restoring the resources of the interferon system and immune recovery with recombinant interferon drugs indicates the important role of herpes virus carrier in the formation of comorbidity and the need for etiological treatment to improve the condition and quality of life of patients.