The persistence of Epstein-Barr virus in the gastric mucosa in patients with chronic Helicobacter pylori-induced gastritis with gastric erosions and the effect on the course of the disease depending on the therapy

The leading etiological factor of chronic gastritis is Helicobacter pylori infection. Herpesvirus infection can take part in the development and maintenance of the inflammatory process in the gastric mucosa. A special place among herpesviruses is occupied by the Epstein–Barr virus, 95% of the population is infected with it. The aim was to determine the persistence of the Epstein–Barr virus in the gastric mucosa in patients with chronic Helicobacter pylori-induced gastritis with gastric erosions and to determine the effect on the course of the disease, depending on the therapy. 84 patients with chronic Helicobacter pylori-induced gastritis with gastric erosions were under observation. The Epstein–Barr virus was detected in the gastric mucosa in all patients at the initial treatment except for Helicobacter pylori. The duration of the disease was from 1 to 10 years. Depending on the treatment of chronic Helicobacter pylori-induced gastritis with gastric erosions, patients were divided into 2 groups, between them, 1 year after the initial treatment, the frequency of occurrence of Epstein–Barr virus in the gastric mucosa was compared. The detection of Helicobacter pylori was carried out by three methods: respiratoryurease test, cytological examination of smears and the method of polymerase chain reaction of the biopsy. In patients with chronic Helicobacter pylori-induced gastritis with gastric erosions, when detecting a herpesvirus infection in the gastric mucosa, the use of meglumine acridonacetate in four-component eradication therapy can significantly reduce the number of Epstein–Barr viruses. A comparative assessment of the data obtained on the presence of Helicobacter pylori in the gastric mucosa in patients of two observation groups indicates a good level of eradication therapy: in the 1st observation group, eradication was 91,3%, and in the 2nd observation group – 89,5%. Mixed infection (Helicobacter pylori and Epstein–Barr virus) in the gastric mucosa is a factor that complicates the treatment process of patients.

1. Minushkin O. N. Hronicheskij gastrit: predstavleniya, diagnostika, lechebnye podhody [Chronic gastritis: representations, diagnostics, therapeutic approaches] // Meditsinskii sovet. 2007; 3: 71-76.

2. Vyalov S. S. Hronicheskij gastrit: klinicheskie varianty i lechenie [Chronic gastritis: clinical options and treatment] // Consilium medicum. 2017; 8 (19): 103-109.

3. Bordin D. S., Masharova A. A., Homeriki S. G. Hronicheskij gastrit: sovremennyj vzglyad na staruyu problemu [Chronic gastritis: a modern view of the old problem] // Eksperimentalnaya i klinicheskaya gastroenterologiya. 2012; 5: 99-106.

4. Molostova A. S., Gusev A. S., Svarval' A. V. i dr. Osobennosti zheludochnogo mikro-biocenoza, associirovannogo s helikobakternoj infekciej [Features of gastric microbiocenosis associated with Helicobacter pylori infection] Internal diseases as an integral discipline of modern medicine. Materials of the scientific conference. 2018. Publishing house: Limited Liability Company «Scientia» Publishing House (Saint Petersburg): 43-44.

5. Ivashkin V. T., Maev I. V., Lapina T. L. i dr. Klinicheskie rekomendacii Rossijskoj gastroenterologicheskoj associacii po diagnostike i lecheniyu infekcii Helicobacter pylori u vzroslyh [Clinical recommendations of the Russian Gastroenterological Association for the diagnosis and treatment of Helicobacter pylori infection in adults] // Rossiiskii zhurnal gastroenterologii, gepatologii, koloproktologii. 2018; 28 (1): 55-70.

6. Ponezheva Zh. B., Popova T. I. Klinicheskie formy virusnoj infekcii Epshtejna-Barr [Clinical forms of Epstein–Barr virus infection] // Rossiiskii meditsinskii zhurnal. 2019; 10: 36-41.

7. Danilova N. V., Mal'kov P. G., Olejnikova N. A., Mihajlov I. A. Adenokarcinoma zheludka, associirovannaya s virusom Epshtejna–Barr [Gastric adenocarcinoma associated with Epstein-Barr virus] // Arkhiv patologii. 2019; 81: 74-83.

8. Ajani J. A., Lee J., Sano T., Janjigian Y. Y., Fan D., Song S. Gastric Adenocarcinoma // Nat Rev Dis Prim. 2017; 3: 17036.

9. Matoshina I. V., Livzan M. A., Salamahina O. F. Hronicheskij gastrit, associirovannyj s Helicobacter pylori i virusom Epshtejn–Barr [Chronic gastritis associated with Helicobacter pylori and Epstein–Barr virus] // Eksperimentalnaya i klinicheskaya gastroenterologiya. 2014; 12 (112): 74-78.

10. Isakov V. A., Isakov D. V. Immunomodulyatory v terapii i profilaktike gerpesvirusnyh infekcij [Immunomodulators in the treatment and prevention of herpesvirus infections] // Klonicheskaya meditsina. 2015; №4: 16-24.

11. Afanasenkova T. E., Dubskaya E. E. Vliyanie cikloferona na rezul'taty lecheniya pacientov s hronicheskim erozivnym gastritom, associirovannym s Helicobacter pylori i gerpesvirus-noj infekciej [The effect of cycloferon on the results of treatment of patients with chronic erosive gastritis associated with Helicobacter pylori and herpesvirus infection] // Kubanskii nauchnyi meditsinskii vestnik. 2017; 2: 14-17.

12. Ermak S. Yu., Lyalikov S. A., Zubrickij M. G., Borodavko O. N. Primeneniya preparata cik-loferon v terapii hronicheskih gastroduodenitov u detej [The use of the drug cycloferon in the treatment of chronic gastroduodenitis in children] // Antibiotiki i khimioterapiya. 2014; 7-8 (59): 25-29.

13. Dubskaya E. E., Afanasenkova T. E. Chastota vyyavleniya gerpesvirusnoj infekcii u bol'nyh s yazvennoj bolezn'yu zheludka, inducirovannoj Helicobacter pylori, v zavisimosti ot provodimoj terapii [The frequency of detection of herpesvirus infection in patients with gastric ulcer induced by Helicobacter pylori, depending on the therapy] // Mezhdunarodnyi nauchno-issledovatelskii zhurnal. 2020; 12 (102), part 2: 129-132.