Horbal N. Features of the immune response in patients with systemic connective tissue diseases and reactivated herpes simplex virus type 1 infection and their management

The dissertation is devoted to the optimization of early detection and development of therapeutic approaches in patients with systemic connective tissue diseases and reactivated herpes simplex virus type 1 infection (CTD+HSV-1) taking into account the molecular genetic and immunological parameters of these patients. Installed peculiarities of the clinical course of CTD in patients with HSV-1 infection compared to patients with CTD using the activity indices DAS28, SLEDAI 2K and functional index HAQ. In patients with CTD+HSV-1 compared to patients with CTD found the following immunological features: elevated levels of CD16+56+-lymphocytes, CD3+HLA+DR-lymphocytes, CD45+56+69+-lymphocytes, IFN-α (in saliva ), IL-4 (in blood serum ) and decreased levels of CD8+28+- lymphocytes and IFN-γ (in blood serum) (p <0,05). Based on the findings of immunological studies, mathematical models have been proposed to determine the reactivation risk of HSV-1 infection for patients with CTD+HSV-1, the prediction of the number of HSV-1 infection relapses during the year - for patients with CTD+HSV-1 and HSV-1 and prediction of CTD activity growth - for patients with CTD+HSV-1 and CTD. The method of treatment of patients with CTD + HSV-1-infection was proposed, which included the antiviral therapy (acyclovir and / or inosine pranobex) against the background of basic therapy with proven clinical, virological and immunological efficacy. Based on determining the dynamics of IFN-α level in blood serum and saliva under the influence of antiviral against the background of basic therapy, it was proved that inosine pranobex therapy had interferon-regulating effects in patients with CTD+HSV-1, but did not contribute to interferon refractoriness.