Репозиторий Университета

© 2021, The Author(s). Background: HIV infection is a major health problem in Russia. We aimed to assess HIV prevalence in different population groups and to compare the characteristics of 4th generation immunoassays from Abbott, Bio-Rad, Vector-Best, Diagnostic Systems, and Medical Biological Unit. Methods: The study included 4452 individuals from the general population (GP), 391 subjects at high risk of HIV infection (HR) and 699 with potentially interfering conditions. HIV positivity was confirmed by immunoblot and by HIV RNA, seroconversion and virus diversity panels were also used. HIV avidity was employed to assess recent infections. Results: The prevalence in GP was 0.40%, higher in males (0.62%) and in people aged < 40 years (0.58%). Patients attending dermo-venereal centers and drug users had a high prevalence (34.1 and 58.8%). Recent infections were diagnosed in 20% of GP and in 4.2% of HR. Assay sensitivity was 100% except for one false negative (99,54%, MBU). Specificity was 99.58–99.89% overall, but as low as 93.26% on HR (Vector-Best). Small differences on early seroconversion were recorded. Only the Abbott assay detected all samples on the viral diversity panel. Conclusion: HIV infection rate in the high-risk groups suggests that awareness and screening campaigns should be enhanced. Fourth generation assays are adequate but performance differences must be considered.

© 2021, The Author(s). Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.

© 2019 The Authors Eighty years after the last published record of human leishmaniasis from Dagestan, Russian Federation, we report two recent cases which were most probably acquired locally: one case of visceral leishmaniasis in a 2-year old child, and one cutaneous leishmaniasis case in a 39-year-old man co-infected with HIV, both resident in Dagestan.

© 2018 Elsevier B.V. Background: Very recently, a novel European hantavirus, Sochi virus, has been discovered which causes severe courses of hantavirus disease with a case fatality rate of about 15 percent. Objectives: We aimed to study to which extent and with which clinical severity children were affected by Sochi virus infection. Study design: Sochi virus infection of patients was confirmed by molecular, serological, and epizoonotic studies. Clinical and laboratory parameters were analyzed for the age group of up to 15 years (n = 6) in comparison to all older patients (n = 56). Results: 9.7 percent of patients with hantavirus disease studied (6/62) were up to 15 years old. The children showed moderate to severe clinical courses similarly to the situation in adults. Conclusions: While children are in general considered to be less affected by hantavirus infections than adults, in case of highly pathogenic hantaviruses, such as Sochi virus, frequency of clinical cases as well as their clinical course are comparable between children and adults. Therefore, hantavirus disease, particularly in regions endemic to highly pathogenic hantaviruses, should be considered in cases of unclear fever and kidney/pulmonary failure in children.

© 2018 Meditsina Publishers. All rights reserved. Results of medico-sociological studying of specifics of social installations of the population concerning HIV-infected citizens are presented in article. The conducted research shows that now the deficiency of objective information on a problem of HIV-infection/AIDS is observed, and negative installations of russians concerning HIV-infected persons still remain widespread social practice. Authors note that despite efforts of the state, medical and public organizations on increase in level of tolerance of the population concerning HIV-infection/AIDS, the fact of establishment of the diagnosis «HIV-infection», besides problems of medical character, causes change of the social status HIV-infected and also attracts extensive social and reputation losses – that, in general, distances the HIV-infection carrier from other population and intensifies social inequality.

© 2018 Meditsina Publishers. All rights reserved. Results of medico-sociological studying of level of readiness of Russians for vaccination against HIV- infection/AIDS are presented in article. The conducted research shows that now HIV- infection is associated at Russians with consumption of drugs and insufficient social responsibility of youth and also with risks at delivery of health care and implementation of cosmetic procedures. Authors note that in spite of the fact that development of vaccine against HIV-infection/AIDS is represented to the interviewed Russians one of possible ways of overcoming epidemic, respondents perceive personal participation in vaccination against HIV- infection/AIDS as a high-risk step.

© 2018 Meditsina Publishers. All rights reserved. Results of the medico-sociological research directed to studying of the ideas of the HIV-infected widespread in modern Russian society are presented in article. The obtained data have allowed to design a modern social portrait of the HIV-infected Russian. Now in representations of Russians the typical HIV-infected - the young childless and single man regardless of sexual orientation who is living in the large city, having an average special educations or being in process of that receiving which level of income we will compare with a living wage. The HIV-infected has been infected as a result of a youth error (the unprotected sexual contact or the intravenous use of drugs) and lives with this diagnosis several years, leads a risk-free life more often, at the same time usually hides the diagnosis and separates from social communications.

© 2018 The Authors. Objective: This study was conducted to evaluate the use of genetic tests, before prescribing drugs to reduce not only the level of side effects but also the costs associated with changing therapy. In this paper, the authors analyze the economic efficiency of HLA*5701 prospective screening of hypersensitivity to abacavir (ABC) in the treatment of HIV-infected patients. Methods: A retrospective study was conducted among HIV-infected patients taking first-line antiretroviral therapy and further, based on the results obtained with the ABC-hypersensitivity reactions, analyzed the costs that affect on healthcare system. Results: In the study group of HIV-infected patients, most of the cases belonged to a young, socially active part of the population. Among the study population of patients (n=637), 171 patients were assigned ABC-containing antiretroviral therapy. An increase in costs was found in 67% of cases when ABC-containing first-line therapy was replaced due to the occurrence of undesirable reactions. Conclusion: The results show that, using this screening, we could reduce the costs associated with replacement therapy.

© 2018 Russian Academy of Sciences. Wide circulation of HIV-infection/AIDS is a socially important problem for the majority of the countries of the world now. Against the background of the remaining high rates of infection spread beyond the borders of risk groups, a series of the negative phenomena aggravating an epidemiological situation on HIV-infection and other socially important diseases is observed (tuberculosis, hepatitises, etc.): depression of the general indicators of health of the population, urbanization, complicating of life rhythm, wide circulation of dependences on psychoactive agents, and, above all - serious transformation of institute of family, liberalization of sex behavior, of traditional family values. Now in representations of Russians the typical HIV-positive-a young childless and single man regardless of sexual orientation who is living in the large city, having an average special educations or being in process of its receiving whith level of income comparable to average one. The HIV-positive has been Infected as a result of a youth error (unprotected sexual contact or the intravenous use of drugs) and lives with this diagnosis several years, leads a risk-free life more often, at the same time usually hiding the diagnosis and separated from social communications. Existence of this diagnosis involves social trouble and the social not approved behavior, but if the disease affects the loved one, many Russians are potentially ready to give moral and psychological support (56%), financial support (including in purchase of drugs), the help in search of necessary experts and visit of the medical organizations (6,9%) and also to care for the HIV infected and their children (6%). According to authors, the widespread negative perception of people with "HIV-infection" diagnosis is in many respects caused by insufficient informing the population on HIV-infection/AIDS problems.

RESEARCH OBJECTIVES: the analysis of a specific and strains drift of Candida in HIV/AIDS patients with oropharyngeal candidiasis and the analysis of Candida sensitivity dynamics to reference antimycotic drugs. The study comprised 49 HIV-infected patients aged 20-69 years. The study revealed candidiasis treatment provides specific and strains drift of Candida. Eradication of fluconazole sensitive C. albicans leads to growth of more resistant strains (C. glabratae, krusei, tropicalis) thus lowering antimycotic therapy efficacy. The efficacy improvement requires selective approach to candidiasis treatment with azol agents.

© 2018 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved. The development of mesenteric lymphadenitis is typical for patients with HIV infection at the stage of secondary diseases. The purpose of our study is to decipher the etiology of lymphadenitis in patients with HIV infection at the stage of secondary diseases. The analysis of disease histories of 113 HIV infection patients at the stage of secondary diseases with the use of statistical processing was carried out. The article presents examples that characterize the polymorphism of clinical variants of the development of mesadenitis in HIV-infected patients with stage 4B, which has developed as a result of the influence of various etiological factors.

© 2018 Dynasty Publishing House. All rights reserved. The objective. To perform a budget impact analysis of a novel antiretroviral drug elsulfavirine (ESV) compared with currently used medical technologies. Materials and methods. The pharmacoeconomic model was based on the studies of efficacy and safety of two non-nucleoside reverse transcriptase inhibitors: ESV and rilpivirine (RPV) combined with standard basic tenofovir/ emtricitabine (TDF/FTC) therapy for 48 weeks. The studies were performed in similar clinical settings. The budget impact analysis assessed only direct medical costs of antiretroviral drugs within the chosen strategies of first-line antiretroviral therapy (ART). Results. It was shown that the treatment of ART-naive HIV patients with ESV is associated with 61,234.88 RUB less costs per patient in a 48-week course compared with RPV treatment. The analyzed values of cost effectiveness were lower for ESV strategy than for the strategy with the use of RPV. It makes ESV a more cost-efficient option within the developed model. Conclusion. The use of ESV is a preferable strategy of a first-line treatment of HIV. It is associated with less financial costs and more preferable cost effectiveness rate.

© 2018, Media Sphera Publishing Group. All rights reserved. This article was designed as a comparative review of the literature publications pertaining to the two opposite approaches to the surgical treatment of varicose veins of the lower extremities based on the vein-sparing and radical principles. We compare classical phlebectomy (i.e. endovenous treatment of varicose veins including thermal obliteration) and the vein-savings treatment with the use of the methods for the hemodynamic correction of venous insufficiency, such as ASVAL, CHIVA, and short stripping with special reference to its location and extent. Also covered in the article is the issue of the appropriate length of great saphenous vein stripping. The authors emphasize that it should be based on the extent of reflux rather than on the desire to avoid saphenous nerve injury. It is maintained that either partial or complete preservation of the stem of the great saphenous vein (GSV) in addition to the endovenous obliteration techniques is an efficient and safe modification of the surgical intervention. Stripping is indicated when the endovasal intervention is either impossible or undesirable because of clinical, anatomical, and/or technical limitations. Short stripping in the absence of total reflux in the great saphenous vein is a safer procedure in comparison with the total extirpation of the venous stem.

© 2018, Media Sphera Publishing Group. All rights reserved. The present article deals with the problems pertaining to the forensic medical diagnostics of the HIV-associated pathological conditions taking into consideration the materials available from the Moscow City Centre for AIDS Prophylaxis and Control with special reference to the number and structure of the diagnosed HIV-associated diseases. We undertook the analysis of co-morbid HIV/AIDS causes of violent and sudden deaths documented at the Bureau of Forensic Medical Expertise of the Moscow Health Department during the period from 2013 till 2016. The study revealed the tendency toward a rise in the number of deaths from the HIV-associated infections including tuberculosis, pneumonias, chronic immunodeficiency conditions refractory to the treatment, and from malignant neoplasms. A peculiar feature of the aforementioned period was the increased age of the deceased subjects. In the cases of violent deaths, the HIV-associated conditions were diagnosed as the concomitant diseases, with the markedly predominant ones being acute drug and alcohol intoxication, injures, and attempts at suicide. The available results of the studies give evidence of the necessity and importance of the cooperative work of the specialists for the further improvement of forensic medical diagnostics and monitoring of HIV-associated conditions.

© 2018, Bionika Media Ltd. All rights reserved. Aim. To investigate the clinical features of the course and outcomes of pregnancy and placental morphology in HIV-infected pregnant women. Material and methods. This study is a retrospective analysis of 29 pregnant women. The study group comprised 14 pregnant women with antenatal human immunodeficiency virus infection. Fifteen women with a physiological course of pregnancy made up a control group. The mean age of patients in the study and control group was 28.0 ± 2.6 and 21.1±2.3 years, respectively. The analysis included gynecological history, the course of pregnancy and childbirth, and perinatal outcomes of newborns. The morphological study of placenta included macroscopic and histological examinations, and immunohistochemical studies using antibodies targeting CCR5 receptors. Results. Pregnant women in the study group had a gynecological history of sexually transmitted infections. The most frequent complications of the second and third trimesters of pregnancy were anemia (78.6%), the threatened preterm birth (35.7%), and preeclampsia (28.6%). Complications of labor were premature rupture of membranes (35.7%) and uncoordinated uterine activity (14.3%). Placental morphology showed signs of inflammation and hypoxia. Immunohistochemical studies identified a higher expression of CCR5 in chorionic villi. Conclusion. The findings indicate increased levels of CCR5 expression and the development of chronic placental insufficiency in HIV-infected pregnant women, which indicates the need for dynamic monitoring of this group of patients.

© 2018. Modern medicine, relying on a verified strategy and consistent approach, has proved that to date, HIV infection, thanks to effective antiretroviral therapy, has evolved from a category of incurable and deadly diseases into a nosology potentially controlled by medical and diagnostic measures. Moreover, as shown by numerous studies, not only clinical, but also the population effect has been achieved. The life expectancy of HIV-infected people has increased, its quality has significantly improved, and the number of potential sources of infection has decreased. The concept of «treatment as prevention» at the present stage becomes an integral part of the complex of measures to combat HIV infection, since the early onset of ART can significantly reduce the risk of transmission of the pathogen, as well as the level of AIDS-associated morbidity and mortality. In addition to ART, the principles of comprehensive prevention remain unshakable, taking into account the modern epidemiological features of HIV infection.