Method of treatment of viral hepatitis C in children with contraindications to standard antiviral therapy

The purpose of the work consists in obtaining the methods of treatment of chronic viral hepatitis C even in a situation when the patients have contraindications to the administration of standard antiviral therapy, and in improving the biochemical parameters and reducing the duration of hospitalization of the children with chronic viral hepatitis C. The presented materials demonstrate the effectiveness of an original method of treatment of viral hepatitis C in the case of high cytolysis associated with unbalanced diabetes, renal decompensation, non-viral autoimmune diseases, epilepsy and other diseases, which have contraindications to the administration of antiviral therapy. The basic therapy has been supplemented by the national phytopreparation Pacovirin in capsules with antiviral, immunomodulatory, antioxidant and interferonogenic activity. The efficacy of Pacovirin has been assessed on the basis of clinical, virological, immunological and biochemical indices. At the same time the analysis and evaluation of the results in the context of modern literature sources concerning the treatment of chronic hepatitis C in children with contraindications to standard antiviral therapy has been performed. The obtained results demonstrate an increased effectiveness of the treatment that is manifested by more rapid normalization of clinical and laboratory indices

Evaluation of the influenza, acute respiratory infections and severe acute respiratory infections by the surveillance system in the Republic of Moldova

The article presents a weekly clinical-epidemiological and virological evolution of influenza, acute respiratory infections (ARI) of the upper respiratory tract and severe acute respiratory infections (SARI) in the seasons of 2012-2013. Influenza has been detected mainly in people aged 15 to 64 with its regional distribution and a moderate impact on the health care system. The incidence of influenza in this season has been 7.5 times as much as in the last season. The leading role of the influenza virus A(H1N1)pdm and B with the little involvement of the influenza virus A(H3N2) has been established in the structure of the influenza epidemic. By the antigenic structure, the isolated in the Republic of Moldova influenza viruses have been similar with the influenza viruses strains introduced in the influenza vaccine in 2012-2013 seasons. ARI morbidity beginning from the 40th week of 2012 was increasing, then it slightly reduced in the 1st week of 2013, and again there was its peak in the 8thweek of 2013 followed by a gradual reduction. ARI have been registered in all the regions of Moldova. The highest morbidity level in the country has been registered in Balti and the lowest – in Briceni, affecting mainly the children aged 0 to14. The level of ARI morbidity in the mentioned period has increased the epidemic threshold by 1.5 times in comparison with the same period of the previous season. The SARI morbidity has been registered in all the administrative territories with the highest level of morbidity in Balti and the lowest – in Dubasari, affecting both adults and children. The SARI morbidity level beginning from the 40th week of 2012 was increasing, reaching its peak in the 8thweek of 2013, then it reduced. The SARI morbidity during the evaluated period has been 1.3 times as much as in the same period of the 2011-2012 seasons

Efficiency of the national drug pacovirin in the treatment of infectious mononucleosis in children

National Center of Public Health, the Republic of Moldova, Municipal Infectious Diseases Hospital for Children, Chisinau, Toma Ciorba Hospital of Infectious Diseases, Chisinau, the Republic of MoldovaBackground: In the article are presented the clinical results of the treatment of children with infectious mononucleosis where the basic therapy has been combined with the administration of the local drug pacovirin which has antiviral, immunomodulatory, interferonogenic and antioxidant activity. Material and methods: Pacovirin has been administered for one month by 50 mg capsules 2 times a day per os. The object of study has been presented by 175 patients (84 patients in the experimental group and 91 ones in the comparison group) and the records of the patients surveillance (form 003/e), containing the clinical diagnosis of infectious mononucleosis with Epstein-Barr virus and hepatitis syndrome. The duration of the treatment has been one month, the doses being age-appropriate and applied 2 times a day. Results: The administration of pacovirin as a medicinal remedy in addition to the traditional treatment, in accordance with the method proposed by us, has led to the more intensive normalization of clinical and laboratory indices, decrease of the pathological process and the rapid recovery of the patients, as well as the more intensive normalization of biochemical indices and significant reduction of the duration of the main clinical signs in the experimental group compared with the control group. Conclusions: The drug pacovirin has a positive effect on the main clinical signs of general toxic syndrome and digestive disorders, which have disappeared in a significant number of patients after the treatment. In most patients in the experimental group a decrease in the size of liver and spleen has been observed through palpatory evaluation by the end of the treatment course with pacovirin. In the the experimental group a positive dynamics of paraclinical indices (Alt, AST and γGTP) has been evident

Evolution of epidemical process of acute viral hepatitis B, C and D in the context of realization of National Programs for viral hepatitis B, C and D prevention

This scientific article discusses particularities of modern evolution of epidemic process of viral hepatitis B, C and D in the Republic of Moldova. Three national programs for viral hepatitis B, C and D prevention have been implemented in the Republic of Moldova. As a result of the introduction of these programs the morbidity of parenteral viral hepatitis has decreased significantly, but the implementation of all preventive measures is necessary for viral hepatitis diminution. In order to further reduce the incidence of acute viral hepatitis to the indicators registered in most European countries and the incidence of chronic hepatitis, cirrhosis and primary liver cancer, as well as to improve the epidemiological situation and the health status of the population of the Republic of Moldova and to reduce the economic impact the Ministry of Health together with the National Centre of Health has developed a National Program on the fight against viral hepatitis B, C and D for 2012-2016. The materials and results of the research on the epidemiology of viral hepatitis, conducted over a period of many years by the staff of the laboratory of the National Centre of Public Health, have been used. The epidemiological, analytical and statistical methods have been applied in the study

The clinical evolution and dynamics of laboratory indices in HIV/AIDS infected patients who are treated with first-line antiretroviral therapy

Department of Infectious Diseases, Parasitology and Tropical Medicine, Nicolae Testemitsanu State University of Medicine and Pharmacy, National Center of Public Health, Republic of MoldovaThe clinical, immunological, virological and epidemiological data obtained from 48 adult patients diagnosed with HIV/AIDS infection have been estimated. The late diagnostics is defined by the presence of AIDS associated diseases and/or the level of T-lymphocytes CD4 < 350 cells/μl. More than half (66.67%) of the investigated patients showed severe immunity suppression and/or clinical AIDS associated diseases. The most frequent AIDS related diseases were tuberculosis, oropharynx candidiasis, HIV depletion, Herpes Zoster, HIV encephalopathy and Kaposi’s sarcoma. The effectiveness of the applied antiretroviral therapy (ART) schemes appreciated in terms of virological response is higher for the scheme Tenofovir+Emtricitabin+Efavirenz, and in terms of immunologic response it is higher for the second scheme Zidovudin+Lamivudin+Nevirapin. The dissociated virological and immunological response to highly active antiretroviral therapy (HAART) registered for some of the patients is in many cases the result of insufficient susceptibility to the treatment, which increases the risk of the progression of the disease. Оценены клинические, иммунологические, вирусологические и эпидемиологические данные 48 взрослых пациентов с ВИЧ/СПИД инфекцией. Поздняя диагностика определяется наличием СПИД–ассоциированных заболеваний и/или уровенем Т-лимфоцитов CD4 < 350 кл/μл. У более половины (66,67%) обследованных пациентов обнаружено наличие тяжелого иммунодефицита и/или СПИД–ассоциированных заболеваний. Наиболее распространенными СПИД–ассоциированными заболеваниями были туберкулез, кандидоз ротоглотки, ВИЧ истощение, oпоясывающий герпес, ВИЧ-энцефалопатия и саркома Капоши. Эффективность применяющихся схем высокоактивной антиретровирусной терапии (ВААРТ) с точки зрения вирусологического ответа оказалась выше для схемы Tenofovir+Emtricitabin+Efavirenz, а с точки зрения иммунологического ответа она оказалась выше для схемы Zidovudin+Lamivudin+Nevirapin. Диссоциированный вирусологический и иммунологический ответ на ВААРТ, зарегистрированный у некоторых больных, во многих случаях является результатом плохой восприимчивости организма к лечению, что повышает риск прогрессирования заболевания

Эпидемиологические и вирусологические аспекты гриппа, острых респираторных вирусных инфекций и тяжелых острых респираторных инфекций в Республике Молдова, сезон 2018/2019

Agenția Națională pentru Sănătate Publică, Congresul al VIII-lea al specialiștilor din domeniul sănătății publice și managementului sanitar 24-25 octombrie 2019 Chișinău, Republica MoldovaSezonul de gripă 2018/2019 a debutat mai devreme în comparație cu sezoanele precedente. Perioada epidemică a debutat în săptămâna 03/2019, atingând apogeul în săptămâna 06/2019 și s-a terminat în săptămâna 11/2019. Virusul gripal A(H1)pdm09 a fost predominant, fi ind detectat în 79,8% din cazurile de gripă confi rmate de laborator. Virusul gripal A(H3) a fost detectat în 20,2% cazuri. Virusurile gripale de tip B nu au fost detectate în acest sezon. Toate (4) virusurile gripale A(H1)pdm09 caracterizate genetic aparțin subgrupei 6B.1 (reprezentată prin A/Michigan/45/2015). Principalele caracteristici ale virusurilor din grupa 6B.1 sunt prezența substituțiilor aminoacizilor S84N, S162N (cu apariția unui nou loc potențial de glicozilare) și I216T în HA1. Virusurile gripale A/H3 detectate aparțin subclaselor 3C.2a1b și 3C.2a2. În ceea ce privește virusurile H3N2 circulante în prezent, caracterizarea lor antigenică prin reacția de hemaglutinoinhibare rămâne dificilă din cauza aglutinării instabile a globulelor roșii de cobai, curcan și umane. Nivelul morbidității prin gripă a sporit de 2,2 ori față de sezonul 2017/2018. Nivelul morbidității prin IACRS în sezonul 2018/2019 s-a majorat de 1,07 ori, iar prin SARI – de 1,17 ori față de sezonul precedent. Începând cu săptămâna 40/2018, virusurile respiratorii negripale au fost detectate în 37,7% (130/345) din probe colectate în timpul monitoringului în sistemul de tip santinelă. Au predominat rinovirusurile, adenovirusurile și virusul respirator sincițial.The influenza season started earlier that previous seasons. The epidemic period started at week 03/2019, peaked in week 06/2019 and ended in week 11/2019. Influenza A(H1)pdm09 was the predominant virus detected in 79,8% of ILI cases. Influenza A(H3) was detected in 20,2%. Influenza B viruses were not detected this season. All (4) of the A(H1)pdm09 viruses genetically characterized, belonged to the subgroup 6B.1 (represented by A/Michigan/45/2015). The main characteristics of viruses in the 6B.1 group are that the viruses carry the amino acid substitutions S84N, S162N (introducing a new potential glycosylation site) and I216T in HA1. Detected influenza A/ H3 viruses belonged to subclades 3C.2a1b and 3C.2a2. In the case of currently circulating H3N2 virus’s antigenic characterization continues to be difficult by HI assay due to variable agglutination of red blood cells from guinea pig, turkey and humans. The level of influenza morbidity increased 2,2 times compared to 2017/2018 season. The level of ARI morbidity in this season increased 1,07 times and the SARI recorded increased 1,17 times compared to the previous season. Since week 40/2018 other respiratory viruses were detected in 37,7% (130/345) of samples in sentinel surveillance. Rhinovirus, adenovirus and respiratory syncytial virus was detected in higher level during this season.Сезон гриппа 2018/2019 начался раньше, чем в предыдущие сезоны. Эпидемический период начался на неделе 03/2019, достигнув максимума на неделе 06/2019, и завершился на неделе 11/2019. Вирус гриппа A(H1)pdm09 был доминирующим и выявлен в 79,8% случаев гриппа. Вирус гриппа A(H3) был обнаружен в 20,2% случаев. Вирусы гриппа B не были выявлены в этом сезоне. Все (4) вирусы гриппа A(H1)pdm09б охарактеризованные генетически, относятся к подгруппе 6B.1 (представленную вирусом A/Michigan/45/2015). Основные характеристики вирусов из подгруппы 6B.1 – это наличие аминокислотных замен S84N, S162N (с появлением нового потенциального места гликозилирования) и I216T в HA1. Выявленные вирусы гриппа A/H3 относятся к подклассам 3C.2a1b и 3C.2a2. В случае циркулирующих в настоящее время H3N2, их антигенная характеристика с помощью реакции торможения гемаглютинации по-прежнему затруднена из за нестабильной агглютинации эритроцитов морской свинки, индейки и человека. Уровень заболеваемости гриппом повысился в 2,2 раза по сравнению с сезоном 2017/2018. Заболеваемость ОРВИ в сезоне 2018/2019 увеличилась в 1,07 раз по сравнению с предыдущим сезоном, а количество случаев ТОРИ увеличилось в 1,17 раз. Начиная с недели 40/2018 другие респираторные вирусы были выявлены в 37,7% (130/345) образцов, собранных во время дозорного надзора. Риновирусы, аденовирусы и респираторно-синцитиальные вирусы выявлялись в большом количестве в течении этого сезона