Objective: To investigate changes of T lymphocytes subsets in children with infectious mononucleosis (IM) and the effects of different interventions.
Methods: Forty-eight children with IM were enrolled, 28 cases were assigned to the group treated with intravenous immunoglobulin (IVIG) 400 mg/(kg x d) for 5 continuous days or IVIG 1 g/(kg x d) for 2 continuous days, the remaining 20 cases were treated with ganciclovir (GCV) 5-10 mg/(kg x d) for 5 consecutive days. All these children were given general supportive therapies. Twenty healthy children from healthcare clinic serviced as control group.
Results: CD4 (%), CD8 (%) and the CD4/CD8 ratio in healthy control group were (34.12 +/- 3.53)%, (26.22 +/- 4.43)% and (1.41 +/- 0.3), in IVIG group were (24.2 +/- 4.3)%, (36.4 +/- 6.8)% and (0.72 +/- 0.12), and in GCV group were (23.7 +/- 5.1)%, (37.3 +/- 7.8)% and (0.67 +/- 0.13), respectively. CD4 (%), CD8 (%) and the ratio CD4/CD8 in the control group were significantly different from those in both groups with IM (P < 0.05). Compared with pre-treatment levels, the 28 cases treated with IVIG had significant improvement, the CD4 (%) increased, CD8 (%) decreased and the ratio of CD4/CD8 increased after treatment (P < 0.05). However, 20 cases in GCV treatment group made less changes (P > 0.05) . Meanwhile, the clinical symptoms and signs in the IVIG group were improved faster than that in the GCV group (P < 0.05). The rate of remission in IVIG group was 88.7% vs. 59.2% of GCV group (P < 0.05); the hospital days in IVIG group were (9.2 +/- 4.3) days vs. (13.8 +/- 5.1) days in the GCV (P < 0.05).
Conclusion: It is indicated that the subsets of T lymphocytes in peripheral blood are obviously abnormal in children with IM caused by EBV infection in acute phase. IVIG can regulate the immunological derangements of T lymphocytes subsets, on which anti-viral therapy alone may have little impact.