Features of the Neonatal Period in Perinatally HIV-Exposed Children Receiving Combined Сhemoprophylaxis of mother-to-child Transmission of HIV

The aim. To study the features of the course of the neonatal period in children, perinatally exposed to HIV, who receive an enhanced regimen of chemoprophylaxis of HIV mother-to-child transmission.Patients and methods. A retrospective longitudinal cohort study of mother – child pairs for the period from 2017 to 2019 was carried out. The clinical observation group included HIV-positive women with a high risk of vertical transmission of the immunodeficiency virus (n = 213) and their newborn children (n = 214), who were prescribed an enhanced chemoprophylaxis regimen of HIV transmission from mother to child. Results. According to the results of the study of HIV-positive mothers we revealed a high prevalence of secondary diseases and a high per partum viremia – 1700 (222–18342) copies/ml. 35.9 % of children were born prematurely, 27.5 % – had low birth weight by gestational age. In newborns, diseases of the respiratory (24.3 %) and nervous (17.2 %) systems prevailed. 17.2 % of children developed intrauterine infection; HIV RNA was detected in 3.7 %. Congenital malformations were observed in 7.4 % of children. Symptoms of enteropathy were noted in 24.7 % of newborns. A decrease in red blood counts was found in all children by the 28th day of life (pw < 0.001).Conclusion. The study confirms the need for increased attention and improvement of approaches to medical support of children who were perinatally exposed to high risk of vertical HIV infection

Retrospective of International Serological Studies on the Formation and Dynamics of the Humoral Immune Response to SARS-CoV-2: from 2020 to 2021

Last year the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has started. The new coronavirus is highly contagious and causes severe complications. The mechanisms of humoral immunity and kinetics of SARS-CoV-2 specific antibodies in a population are not well understood. Therefore, we aimed to summarize and analyze numerous global and Russian serological studies for understanding dynamics of the SARSCoV-2 humoral immune response and getting an accurate picture of the seroprevalence to SARS-CoV-2 in the world population. The PubMed and e-library databases were searched from February 2020 to March 2021 using terms “SARSCoV-2”, “antibodies”, “humoral immunity”. At the beginning of the pandemic first studies were cross-sectional by design and were responsible for determination of the seropositivity and for understanding the fundamental humoral immunity parameters of SARS-CoV-2. Since then, longitudinal seroepidemiological studies have been studying antibody kinetics. Seroconversion time for IgM, IgG antibodies varies, but most researchers report the seroconversion of IgM from the 1st to 14th days after the onset of clinical manifestations, and the seroconversion for IgG is around the 14th day with a concentration peak by the 21st day. Regarding seroprevalence we may say about low herd immunity at the COVID-19 pandemic. Thus, global seroprevalence is about 10 %, and more than 20 % for regions with high incidence and among healthcare workers. Seroprevalence studies have to be continued for more accurate monitoring of long-term humoral immunity to SARS-CoV-2, because the majority of the world’s population is still susceptible to SARS-CoV-2 infection

Indicators of the Immune Status in Children after a New Coronavirus Infection

Background. The mechanism of the immune response in patients with COVID-19 is still poorly understood and differs from other respiratory infections. Immunodeficiencies and age-related characteristics of immunity can be regarded as factors influencing reinfection and a predisposition to prolonged persistence of SARS-CoV-2. Most of the studies report about post-infection immunity to SARS-CoV-2 for adults and less for children. However, understanding the dynamics of antibody production to SARS-CoV-2 among children as well as other unique features of immune response is extremely important, because this provides to avoid possible complications and long-term outcomes of COVID-19, and predict the epidemic spread of the new coronavirus in the organized groups of children such as kindergartens, schools, study groups and clubs.Aim: to evaluate the humoral and cellular immunity after SARS-CoV-2 infection in children.Materials and methods. We reported data of the first phase prospective cohort study of immunity among 60 children living in Irkutsk, Russia within a month after SARS-CoV-2 infection, which took place in October and November 2020.Results. Immunity of children one month after SARS-Cov-2 infection was characterized by suppressed cell-mediated and humoral immunity, and phagocytosis dysfunction. Reduced phagocytosis by neutrophils was noted for 61.6 % of individuals.Conclusions. Children after COVID-19 had impaired immunity to SARS-CoV-2, which may be a predictor of chronic infection and other long-term outcomes of COVID-19

Flu in children: Clinical, laboratory indicators and cytokine profile parameters

Introduction. Respiratory diseases occupy a leading place in the structure of pathology of childhood. The proportion of influenza and acute respiratory viral infections among all infectious diseases is 90 %. The literature describes gender differences in the immune response to respiratory infections in children, but there is a gap in  the  description of the cytokine profile in  children with influenza depending on gender and age.The aim. To analyze clinical and laboratory parameters as well as cytokine profile parameters in children with influenza.Materials and methods. A single-stage descriptive study was conducted with the participation of 50 children from 1 to 11 years of age with a diagnosis of influenza who were on inpatient treatment at the Irkutsk Regional Infectious Diseases Clinical Hospital from December 2018 to January 2019. The clinical and laboratory features of the course of influenza in children, the duration of treatment were determined. The concentration of cytokines interleukin (IL)  1β, IL-4, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), interferon alpha and gamma (INF-α, INF-γ) in blood plasma was determined by enzyme-linked immunosorbent assay (ELISA) using diagnostic test systems manufactured by Vector-Best (Novosibirsk, Russian Federation) on the analyzer Multiscan EX (Thermo Electron, Germany).The control group consisted of practically healthy children without signs of acute respiratory viral infection (n = 50; mean age 5.3 ± 2.6 years).Results. When comparing clinical and laboratory data and cytokine profile parameters in children with influenza, no gender differences were found. There was a statistically significant increase in the level of pro-inflammatory cytokines IL-1β, IL-6, IL-8, TNF-α, INF-α, as well as CRP, anti-inflammatory cytokine IL-4 in influenza in all age categories, in contrast to the control group (p < 0.05).Conclusion. Influenza in children of different sexes proceeds classically without a statistical difference in clinical and laboratory parameters and in the level of cytokines

Comparative characteristics of clinical, laboratory and instrumental indicators in children with seasonal influenza depending on the virus strain

Introduction. According to the literature, it is known that clinical signs and symptoms of influenza may differ depending on age, the state of the human immune system, the serotype of the virus and its virulence. Intoxication, catarrhal and hyperthermia are main symptoms of influenza, but the disease does not always proceed classically, it may hide under the mask of other infections.   The aim was to conduct a comparative analysis of clinical, laboratory and instrumental parameters in children with influenza A(H1N1) and A(H3N2).   Materials and methods. A single-stage retrospective comparative study was carried out with the participation of 96 children from 1 month of age up to 13 years old with a diagnosis of influenza, who were hospitalized at the Irkutsk Regional Infectious Clinical Hospital from December 2018 to January 2019. Clinical and laboratory features of the course of influenza in children were determined depending on a viral strain.   Results. The structure of morbidity: influenza A(H1N1) – 70 people (73 %), influenza A(H3N2) – 20 children (21 %), influenza A clinically unvaccinated – in 3 people (3 %), mixed viral infection influenza H1N1 + adenovirus infection – 2 cases (2 %), mixed viral infection H1N1 flu + RS-virus – 1 case (1 %). In the clinic of both strains of the virus, symptoms prevailed: runny nose, dry cough, fever, intoxication. Muscle pain and pharyngeal hyperemia were significantly more common in influenza A(H1N1), the duration of symptoms did not differ. Lymphocytosis was more often observed in influenza A(H1N1), monocytosis – in influenza A(H3N2) (р < 0.05). In 64 % of cases, patients with influenza A(H1N1) had a high leukocyte index of intoxication (odds ratio – 2.2).   Conclusion. The symptoms of different influenza A viral strains virus in children are the same, however, muscle pain and hyperemia of the pharynx prevails in children with influenza A(H1N1)

Informative significance of serum cytokines and their importance for development of metabolic syndrome with arterial hypertension in elderly persons

Metabolic syndrome (MS) is among the main public health challenges worldwide, leading to significant labor losses, increased costs for treatment and rehabilitation of the patients. The aim of the present study was to identify the informative serum interleukins, by determining the odds ratio in elderly patients with MS and hypertension. The main group of 86 patients with MS and arterial hypertension (AH) aged 60-75 years was examined under clinical conditions. The inclusion criteria were as follows: age of 60-75 years, presence of MS, primary hypertension (grade II-III), absence of acute myocardial infarction, malignant neoplasms, disorders of cerebral circulation, kidney failure over last 6 months. Diagnostics of MS and hypertension was carried out in accordance with Expert Guidelines from the Russian Research Society of Cardiology on the MS Diagnosis and Treatment. Our first study of a large range of serum interleukins in elderly patients with MS and hypertension allowed us to reveal the inversely directed changes in pro- and anti-inflammatory cytokine contents. Combined AH/MS in elderly persons is accomplished by sufficient increase of the most proinflammatory cytokines, and vice versa, by significant decrease in anti-inflammatory cytokines in blood serum. This finding clearly points to importance of immunological regulatory systems for initiation of AH with MS at older age. Pro- and anti-inflammatory serum interleukins are actively involved into the AH/MS development in elderly accompanied by their pronounced imbalance. The mentioned immune reactions could underlie the MS/AH condition. High risk of this disorder is connected with changed production of proinflammatory cytokines (IL-8, IL-1β), like as anti-inflammatory serum interleukins (IL-4, IL-10), with predominance of the former. The above interleukins should be considered dominant diagnostic markers of AH/MS in elderly persons. Measurement of serum interleukins and discriminant-based approach allows highly reliable differentiation of elderly patients with AH/MS from similar individuals without this disorder

Aromatic Amino Acids: Phenylalanine and Tyrosine in Patients with Hypertension and Coronary Artery Disease

Aim. To evaluate changes in the profile of aromatic amino acids (AAA) in patients with cardiovascular diseases (CVD): hypertension and coronary artery disease (CАD) in comparison with healthy study participants.Material and methods. One hundred and thirty-one participants were included in the study: 58 participants were included in the hypertension group, 46 in the CАD group, and 27 participants without signs of CVD in the control group. We used ultrahigh-performance liquid chromatography in combination with a triple quadrupole analyzer to measure plasma AAA: phenylalanine and tyrosine (Phe, Tyr) in all study participants. The association of AAA with biochemical blood test parameters, echocardiography (EchoCG) parameters, blood pressure level and clinical characteristics was analyzed.Results. A statistically significant difference in the level of concentration of Phe and Tyr was revealed (p=0,002 and p=0,024, respectively), comparing the three groups. Post-hoc analysis showed differences in the circulating level of both amino acids in patients with CAD vs the control group (Phe p=0,008 and Tyr p=0,020). Also a statistically significant difference in the level of Phe of the hypertension and CАD groups (p=0,017) was found. A negative correlation of low-density lipoproteins (LDL) with the level of Phe (r=-0,685, p<0,05) and Tyr (r=-0,583, p<0,05), as well as the level of Phe with total cholesterol (r=-0,461, p<0,05) was found in the group without CVD. In the hypertension group, only a weak positive correlation was found between very low-density lipoproteins and AAA levels (Phe r=0,326 and Tyr r=0,365, p<0,05), while in patients with CAD, the level of Phe and Tyr was negative correlated with high-density lipoprotein (r=-0,378 and r=-0,543, respectively, p<0,05), and the level of Tyr with LDL (r=0,349, p<0,05). When isolating the group with proven atherosclerosis of peripheral and/or coronary arteries, a statistically significant difference was revealed between the group of patients with CVD and clinical and instrumental signs of atherosclerosis and the group of patients with CVD without proven atherosclerosis in Phe level (p=0,019).Conclusion. Concentrations of AAA were higher in patients with CVD, comparing with the control group. At the same time, an increase of the Phe level was associated with the presence of peripheral or coronary atherosclerosis. The revealed correlations of AAA with EchoCG parameters and lipid spectrum parameters require further study to understand the involvement of AAA in pathogenesis of CVD and its potential role as treatment target

Comparison of attitude of Indian and Russian parents to children’s vaccination

Background. The vaccine preventable diseases outbreaks have become more frequent in recent decades and the lack of global vaccine awareness has been increasing and deteriorating vaccine compliance.   The aim. To assess the attitude towards vaccination of parents from India and Russia.   Methods. 1620 parents from Russia (Irkutsk city) and 214 parents from India (Kerala state) took part in the international cross-sectional multicenter study via survey method.   Results. Parents from both countries showed good adherence to vaccination, only 1 % of Indians and 2 % of Russians did not vaccinate their children. More than 90 % of Russians took information from pediatricians compared with other sources with a prevalence of pediatricians working in the public health system 91.7 % (95 % CI: 90.2–92.9), whereas only 50 % of Indians were informed about vaccination from pediatricians (p < 0.0001). The main source of vaccine information for Indian parents was Internet (52.8 %; 95 % CI: 46.1–59.3) and mass-media (83.6 %; 95% CI: 78.1–87.9), whereas Russians resorted to this source much less (0.3 %; 95 % CI: 0.1–0.7 for Internet; and 4.3 %; 95 % CI: 3.4–5.4 for mass-media; p < 0.0001). Interestingly, while the vast majority of Russians received information about vaccination from a pediatrician, 71.2 % (95 % CI: 68.9–73.3) wanted to know more. Indians suffered from a lack of information too, but not as much (63.1 %; 95 % CI: 56.4–69.3; p = 0.01).   Conclusion. Despite of a good attitude to vaccination of parents from India and Russia the lack of vaccine information was registered