Herpesvirus infection in patients with juvenile arthritis


Soldatova E.Yu., Melekhina E.V., Gorelov A.V.

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow
Based on the data available in the Russian and foreign literature over the last 10 years, the authors consider the role of herpesvirus infection as trigger and/or pathogenetic factors leading to the development of autoimmune processes, juvenile arthritis (JA) in particular. Herpesviruses are pantropic and widely distributed in the human population. The spectrum of the clinical manifestations of herpesvirus infection is very diverse in children: it depends on the localization of the pathological process, its extent, the patient’s immune system, and the antigenic type of the virus. According to the present-day concepts, JA is a heterogeneous group of chronic joint diseases with different etiopathogenesis and immunogenetic origin, nosology, and controversial prognosis. JA includes juvenile rheumatoid arthritis (juvenile idiopathic arthritis) and juvenile spondyloarthritis. The prevalence of JA in different countries ranges from 0.05 to 0.6% and its incidence does from 2 to 19 cases per 100,000 children under 16 years of age. The review discusses the influence of different endogenous and environmental factors on the development and progression of rheumatoid arthritis and the role of the genetically determined and secondary defects in immunoregulatory mechanisms, which lead to rapid transformation of an acute physiological inflammatory response to chronic progressive inflammation. It describes the current theories explaining the development of pathological autoimmune processes, such as the theory of genetic predisposition, the theory of immune dysregulation, the theory of network regulation, and the infection theory (including the relationship to the course of herpesvirus infection). The types of viral and bacterial infections and their impact on the development of severe clinical forms of JA are considered. The paper presents the modern concepts of pharmacotherapy for arthritis, juvenile idiopathic arthritis in particular. It describes the possible effects of biological agents on the reactivation of latent viral infections. Whether antiviral drugs can be used in children and should be administered in different stages and clinical types of JA is discussed.
Keywords: herpesvirus infection, juvenile arthritis, genetic predisposition, antiviral therapy
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About the Autors

For correspondence: Evgeniya Yu. Soldatova, soldatova-e@bk.ru


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