Clinical efficacy of combination antiviral therapy in patients with Herpes zoster

Pritulina Yu.G., Gankovskaya L.V., Babenkova D.V.

1) Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; 2) Pirogov Russian National Research Medical University, Moscow, Russia

Background: Varicella Zoster Virus (VZV) is a type III herpesvirus infection. Viral reactivation leading to the development of herpes zoster (HZ) is more common in older individuals, especially those with comorbidities, with the potential for severe disease progression and complications such as bacterial superinfection and postherpetic neuralgia. Suppression of innate and adaptive immunity plays a key role in controlling viral latency and reactivation. Standard treatment for herpes zoster includes etiotropic therapy with the antiviral drug acyclovir. However, given the frequency of herpes zoster recurrences and its immunosuppressive effects, immunomodulatory agents are necessary.
Objective: Evaluation of the effectiveness of herpes zoster therapy with the inclusion of the immunostimulant Superlymph® in the traditional treatment regimen.
Materials and methods: Peripheral blood samples were analyzed from 40 patients with recurrent herpes zoster, divided into two comparable treatment groups (receiving only the traditional acyclovir regimen or combination therapy with the addition of the immunostimulant Superlymph) and 10 healthy control subjects matched for age and gender. Soluble toll-like receptor (sTLR) levels were determined in serum using ELISA. In addition, T-cell subset characteristics were determined using flow cytometry, and the cytokine profile was analyzed using ELISA.
Results: The study identified a range of key cytokine profile parameters, determined cellular (T-lymphocyte subsets) and innate (sTLR) immunity in patients with herpes zoster, and developed a differentiated approach to selecting immunocorrective therapy as part of the combination treatment of herpes zoster during the acute phase.
Conclusion: Dysfunction of various T-lymphocyte subsets, cytokine profile imbalance, and sTLR activation are important mechanisms for the development of herpes zoster relapses. These laboratory parameters substantiate the effectiveness of using an immunobiological suppository containing a complex of natural antimicrobial peptides and cytokines in combination therapy in at-risk patients.

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About the Authors

Yu.G. Pritulina, Dr. Sci. (Med.), Professor, Department of Infectious Diseases, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; pritulina1@gmail.com, SPIN-code: 6102-2934, AuthorID: 689965 (corresponding author)
L.V. Gankovskaya, Dr. Sci. (Med.), Professor, Professor at the Department of Immunology, MBF, Pirogov Russian National Research Medical University, Moscow, Russia; lvgan@yandex.ru, ORCID: https://orcid.org/0000-0003-1271-3078
D.V. Babenkova, Teaching Assistant, Department of Infectious Diseases, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; konsti12@mail.ru, SPIN code: 5054-2996, AuthorID: 1022473

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