Herpes simplex viruses: from pathogenesis to effective treatment using immunomodulators

Zakharova I.N., Berezhnaya I.V., Pupykina V.V., Churilova V.D.

Russian Medical Academy of Continuous Professional Education, Moscow, Russia

Herpes simplex viruses (HSV) are extremely common infectious agents characterized by a high degree of contagiousness. Infections caused by HSV types 1 and 2 are often asymptomatic but can cause a range of clinical manifestations, including primary and recurrent vesicular lesions of the oral and labial mucosa, ophthalmological and genital lesions, and viral encephalitis. HSV poses a particular danger to patients in high-risk groups. High susceptibility to herpes infections is typical in newborns due to the physiological immaturity of the immune system, as well as in patients with immunodeficiency conditions of various origins. The immunological response to HSV is a complex process that activates components of both innate and adaptive immunity. Recurrent herpesvirus infections are characterized by an immunological imbalance, characterized by a decrease in the number of CD3+ and CD4+ lymphocytes, a decrease in the immunoregulatory coefficient, and suppression of the functional activity of natural killer cells and antibody-dependent cellular cytotoxicity. Over the course of evolution, HSVs have developed adaptive immunomodulatory mechanisms specifically aimed at evading the T-cell immune response, ensuring lifelong persistence of the pathogen in the host body. In pediatric practice, when clinical markers of immune system deficiency are identified, characterized by recurrent infectious and inflammatory conditions and resistance to conventional treatment methods, the use of pharmacological agents with immunotropic properties is justified. This article discusses the mechanisms of action of inosine pranobex and its efficacy against infections caused by HSV types 1 and 2.

For citations: Zakharova I.N., Berezhnaya I.V., Pupykina V.V., Churilova V.D. Herpes simplex viruses: from pathogenesis to effective treatment using immunomodulators. Pharmateca. 2025;32(9):15-23. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.9.15-23

Authors’ contribution: All authors participated equally in the preparation of the publication: development of the article concept, obtaining and analyzing factual data, writing and editing the article text, checking and approving the article text.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.

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About the Authors

I.N. Zakharova, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the G.N. Speransky Department of Pediatrics, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; zakharova-rmapo@yandex.ru, ORCID: https://orcid.org/0000-0003-4200-4598
I.V. Berezhnaya, Cand. Sci. (Med.), Associate Professor, G.N. Speransky Department of Pediatrics, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; berezhnaya-irina26@yandex.ru, ORCID: https://orcid.org/0000-0002-2847-6268 (corresponding author)
V.V. Pupikina, Teaching Assistant, G.N. Speransky Department of Pediatrics, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; vika-pupykina@mail.ru, ORCID: https://orcid.org/0000-0003-2181-8138
V.D. Churilova, Postgraduate Student, G.N. Speransky Department of Pediatrics, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; vika.churilova.2020@yandex.ru, ORCID: https://orcid.org/0009-0009-0335-0704

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