Imbalance of acquired immunity factors in newborns with cytomegaloviral infection depending on the severity of the disease.

OBJECTIVE

to assess the imbalance of the parameters of the immune status at the time of manifestation of CMVI in newborns in order to predict the development of a severe form of the disease.

METHODS

133 newborns with CMVI were examined. Depending on the severity of the condition, all children were divided into two groups: 1 - CMVI, severe form - 60 people (45.1%); 2 - CMVI, moderate form - 73 people (54.9%). An immunological examination was carried out, including the determination of T and B lymphocytes, as well as intercellular interaction between them. Using the "classification trees" method, we compared two differentiated approaches to the prediction of severe CMVI: based on a study of the relationships between T-lymphocytes (CD3+), T-helpers (CD4+), the content of cytotoxic lymphocytes (CD8+) and B lymphocytes (CD20+) and by studying the interaction of co-stimulation molecules CD28, CD3 + CD28 +, CD3-CD28 +, CD3 + CD28-.

RESULTS

In this study, it was demonstrated that the "standard immunogram", limited to the definition of CD3+, CD4+, CD8+, CD20+ lymphocytes, shows less information in predicting the development of a severe form of the disease in this patient population than the combination of markers, including CD3 + CD28-, CD20 + CD40 +.

FINDINGS: A model for predicting a severe form of cytomegalovirus infection in newborns based on the analysis of the content of CD 28 costimulation molecules has a higher information content, which makes it possible to start specific therapy on time.