Management of patients with systemic autoimmune diseases with the active phase of chronic herpes simplex infection

Aim. To study the effectiveness of acyclovir in patients with systemic autoimmune diseases caused by active chronic herpes simplex 1/2 infection. Material and Methods. Among 380 patients with systemic autoimmune diseases (systemic lupus erythematosus, systemic vasculitis, rheumatoid arthritis, psoriasis) in 45 (11.8%) patients was diagnosed active phase of chronic HSV1/2 infection with help of viral DNA identification by polymerase chain reaction. These patients received acyclovir in three courses with a one-month interval between them. The effectiveness of treatment was monitored before and after treatment with help of virus DNA results in three bioenvironments (blood, saliva and swab from the lesion), of general and specific IgM, IgG antibodies concentration; levels of IgE, cryoglobulins, circulating immune complexes, alpha-interferon, C3-component of complement, the number of lymphocytes populations/subpopulations and of activated cells. Results and Discussion. After the treatment, it was fixed as significant decrease of specific IgM, IgG antibodies concentration as of the level of total IgE, cryoglobulins and cryofibrinogen. In addition it was observed as significant decreased level of alpha-interferon in the serum and saliva, as of the natural killers and number of lymphocytes, expressing the low-affinity receptor IL2 (CD25+) and lymphocytes with suppressive activity (CD4+25+). After the treatment it was observed by polymerase chain reaction a decrease of virus replication in 66.7% of cases. Conclusions. The results of the study indicate, that the use of acyclovir for the treatment of active phase of chronic HSV 1/2-infection might contribute as to the decrease in the virus replication, reducing the viral load, as to the suppression of aggressive autoimmune reactions, reducing the risk of allergopathology development. Key words: systemic autoimmune diseases, herpes simplex viruses, antiviral therapy