THE PREVALENCE OF HERPES VIRUS INFECTIONS IN CHILDREN WITH HYPERTROPHY OF THE GLUTAL MINDALINE

Objective: to evaluate the clinical and epidemiological features of chronic adenoiditis and adenotonzillitis in children with nasopharyngeal carriage of the Epstein-Barr virus, cytomegalovirus and human herpesvirus 6. We conducted open comparative study, which involved 200 patients undergoing conservative and surgical treatment (adenotomy, adenotonzillotomy) at the ENT department of the Medical Center “Mart” (Kazan).

Results. We obtained positive result of herpesvirus test in 65% (95% CI 58.4–71.6), 130/200 cases. There were registered 92 cases of the Epstein-Barr virus infection (70.8% [95% CI 63–78.6]), 46 – cytomegalovirus (35.4% [95% CI 27.2–43.6]) and 56 – human herpesvirus 6 (43.1% [95% CI 34.6–51.6]). 100% of patients with herpesvirus 6 had recurrent respiratory diseases, an increase in the cervical group of lymph nodes; 36.4% (95% CI 16.4–56.4%), 8/22 of these patients did not need operative treatment.  Patients with the Epstein-Barr virus, cytomegalovirus and their combination more often complained of hypertrophy of the pharyngeal tonsil, recurrent otitis and a decrease in hearing, p<0.01. Patients with Epstein-Barr virus infection (11.9% [95% CI 2.2–21.6]), 5/42) were more often dissatisfied with the treatment results.

Conclusion: effective options of treatment and prevention of hypertrophy of the lymphoid tissue of the pharyngeal ring should include etiotropic therapy of herpesvirus infections.

1. Andriyanova I.V., Vahrushev S.G., Kashirceva I.F., Kazakova O.Eh. Results of comparative study of microbiome of nasopharynx inchildren with chronic adenoiditis in accordance with data of the microbiological study and mass-spectrometry by microbial markers. Ros otolaringol 2015; 5 (78): 9–15. (in Russ)

2. Pokrovskaya E.M., Khaliullina S.V., Khaliullina K.R., Rahmanova O.A., Skvortsova N.N., Kozlova V.T. The etiological structure of the causative agents of adenotonzillitis in children. Prakticheskaya meditsina 2016; 3: 58–63. (in Russ)

3. Martins R.B., Rocha L.P., Prates M.M., Gagliardi T.B., Biasoli B., Leite M.J. et al. Respiratory DNA viruses are undetectable in nasopharyngeal secretions from adenotonsillectomized children. PLoSOne 2017; 12(3): e0174188. DOI: 10.1371/journal.pone. 0174188

4. Buzatto G. P., Tamashiro E., Proenca-Modena J.L., Saturno T.H., Prates M.C., Gagliardi T.B. et al. The pathogens profile in children with otitis media with effusion and adenoidhypertrophy. PLoSOne 2017; 12(2): e0171049. DOI: 10.1371/journal.pone.0171049

5. Seishima N., Kondo S., Wakisaka N., Kobayashi E., Imoto T., Moriyama-Kita M. EBV infection is prevalent in the adenoid and palatine tonsils in adults. J Med Virol 2017; 89(6): 1088–1095. DOI: 10.1002/jmv.24737

6. Faden H., Callanan V., Pizzuto M., Nagy M., Wilby M., Lamson D. et al. The ubiquity of asymptomatic respiratory viral infections in the tonsils and adenoids of children and the irimpact on airway obstruction. Int J Pediatr Otorhinolaryngol 2016; 90: 128–132. DOI: 10.1016/j.ijporl.2016.09.006

7. Byars S.G., Stearns S.C., Boomsma J.J. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood. JAMA Otolaryngol Head Neck Surg 2018; 144(7): 594–603. DOI: 10.1001/jamaoto.2018.0614