Therapeutic effect of intravenous acyclovir in children with infectious mononucleosis and immune function

To explore the application value of intravenous acyclovir in children with infectious mononucleosis (IM) and its effects on immune function.

The data of 136 children with IM treated in Anhui Provincial Children's Hospital from March 2019 to March 2022 were retrospectively analyzed. According to the inclusion and exclusion criteria, 98 children were selected. Among them, 45 children treated with routine ribavirin were assigned to the control group, and the other 53 children treated with intravenous acyclovir were enrolled into the observation group. The two groups were compared in terms of efficacy, incidence of adverse reactions, recovery time of clinical symptoms, and immune function indexes, IgG, IgA, IgM, white blood cell (WBC) count and lymphocyte proportion, before and 10 days after the treatment. Independent risk factors affecting efficacy were analyzed by multivariate logistic regression analysis.

The observation group showed a significantly higher overall response rate than the control group (P=0.025). The control group experienced significantly longer recovery time of body temperature returning to normal, cure time of isthmitis, time for lymph node reduction, and alleviation time of hepatomegaly than the observation group (P<0.05). Additionally, the control group presented with a significantly higher incidence of adverse reactions than the observation group (P=0.028). After treatment, the observation group showed significantly lower levels of IgG, IgA, IgM, WBC count and lymphocyte proportion than the control group (all P<0.010). Longer average course of disease (OR: 1.449, 95% CI: 1.095-1.918), higher admission temperature (OR: 6.996, 95% CI: 1.350-36.257), higher admission IgA level (OR: 4.735, 95% CI: 1.357-16.520) and higher admission IgG level (OR: 1.470, 95% CI: 1.012-2.134) were independent risk factors for ineffective efficacy, while acyclovir (OR: 0.058, 95% CI: 0.005-0.729) was an independent protective factor.

In the treatment of IM, intravenous acyclovir can substantially improve the overall clinical response rate for patients, with less adverse reactions, and can greatly alleviate various clinical symptoms and signs including fever, isthmitis, cervical lymph node enlargement, and hepatosplenomegaly, with obvious regulating effects on the immune function, so it is worth popularizing and applying in clinical practice.