Gerpes viruses and multiple sclerosis

Gf, Zheleznikova; Nv, Scripchenko; Gp, Ivanova; Av, Surovtseva; Ey, Scripchenko

doi:10.17116/jnevro201611691133-143

Cited by 6 publications

(1 citation statement)

References 65 publications

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“…Было выявлено, что у пациентов с РС, как и в группе контроля, наиболее часто встречалась герпесвирусная микст-инфекция в виде различных сочетаний. Многие авторы также подчеркивают роль микст-инфекции, вызванной вирусами герпеса различных типов, не только в провокации обострений, но и непосредственно в инициации демиелинизирующего процесса [10][11][12][13]. Моно-герпесвирусная инфекция была представлена только ВЭБ у трех больных РС.…”

Section: The Ratio Of Different Variants Of Mixed Infectionin Ms Patients and In The Control Group N (%)unclassified

Clinical presentation and course of multiple sclerosis in patients with herpesvirus infection

Gris

Baranova

Спирин

et al. 2021

RJTAO

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To date, the features of clinical presentation, course, and the effectiveness of therapy for multiple sclerosis (MS) in the presence of persistent herpesvirus infection (PHVI) remain poorly understood.Objective: to evaluate the features of clinical presentation and course of MS in patients with PHVI to optimize patient management.Patients and methods. We examined 122 patients with a clinically definite diagnosis of MS according to McDonald criteria (2010) (82 women and 40 men, age: 18–50 years, mean age – 37.74±11.04 years). MS duration at the time of examination was from 6 months to 20 years (mean – 8.53±7.47 years), mean Expanded Disability Status Scale (EDSS) score – 2.91±1.67. 86% of patients had relapsing-remitting MS; 14% – secondary progressive MS. 98 (80%) patients received disease modifying therapies (DMTs). All patients underwent a comprehensive clinical and neurological examination, magnetic resonance imaging (MRI). 30 healthy donors (20 women and 10 men, age: 19–62 years, mean age: 39.1±12.1 years) were included in the control group. Serum levels of type-specific IgM and IgG antibodies to herpes simplex virus (HSV) 1, 2, 6, Varicella zoster virus (VVZ), Epstein–Barr virus (EBV), cytomegalovirus (CMV) were detected, in some patients – blood and cerebrospinal fluid (CSF) polymerase chain reaction, serum and CSF oligoclonal IgG.Results and discussion. We identified two sub-groups of MS patients: with PHVI reactivation (main group, n=29) and without it (comparison group, n=93). There were a significantly higher VZV (72%) and EBV infection rate (100%) in MS patients compared to the control group (50% and 83%, respectively). Mixed herpesvirus infection prevailed over mono-infection in MS patients. In contrast to controls, the most common viral pattern in MS group was a combination of 4 herpes viruses: HSV 1, 2 + VZV + EBV + CMV (χ2=3.9; p<0.05). Patients in the main group had an unfavorable disease course: earlier MS onset, predominantly polysymptomatic onset, significantly higher relapse rate, faster disease progression, and higher EDSS and Functional Systems Scale (FSS) scores (p <0.05). MRI activity was also associated with EBV infection: new T1Gd+ and T2 foci were associated with an increase in VCA-IgM to EBV level. We also observed decreased DMTs effectiveness (χ2=4,6; p=0,033) and worse DMTs tolerability (χ2=5,3; p=0,022) in the main group.Conclusion. MS patients with PHVI reactivation, have a more unfavorable course of the demyelinating process and, therefore, a greater degree of disability, compared with age-adjusted patients without a viral infection and the same disease duration.

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Section: The Ratio Of Different Variants Of Mixed Infectionin Ms Patients and In The Control Group N (%)unclassified