Epidemiological dynamics of nephropathia epidemica in the Republic of Tatarstan, Russia, during the period of 1997-2013

Copyright © Cambridge University Press 2015.This report summarizes epidemiological data on nephropathia epidemica (NE) in the Republic of Tatarstan, Russia. NE cases identified in the period 1997-2013 were investigated in parallel with the hantavirus antigen prevalence in small rodents in the study area. A total of 13 930 NE cases were documented in all but one district of Tatarstan, with most cases located in the central and southeastern districts. The NE annual incidence rate exhibited a cyclical pattern, with the highest numbers of cases being registered once in every 3-5 years. The numbers of NE cases rose gradually from July to November, with the highest morbidity in adult males. The highest annual disease incidence rate, 64·4 cases/100 000 population, was observed in 1997, with a total of 2431 NE cases registered. NE cases were mostly associated with visiting forests and agricultural activities. The analysis revealed that the bank vole Myodes glareolus not only comprises the majority of the small rodent communities in the region, but also consistently displays the highest hantavirus prevalence compared to other small rodent species

Факторы, ассоциированные с развитием рецидива туберкулеза

The objective: to identify socio-demographic, clinical and laboratory factors associated with tuberculosis recurrence.Subjects and Methods. Clinical and laboratory data of 208 TB patients treated at the National Scientific Center for Phthisiopulmonology of the Ministry of Health of the Republic of Kazakhstan were analyzed.IL-2 to the AlaDH was assessed using test platforms Lionex GmbH (Germany) according to the manufacturer's instructions. SPSS 23.0 software was used for statistical processing of obtained data. To assess the significance of differences in groups, the Pearson Chi-Square test was used. To determine the factors associated with of the tuberculosis relapse, а multiple binary logistic regression analysis was carried out.Results. Multivariate logistic regression analysis confirmed that male gender (OR = 2.086, 95% CI 1.001-4.350, p = 0.050), drug resistance (OR = 4.910, 95% CI 1.923-12.534, p = 0.001), fibrosis cavernous tuberculosis (OR = 6.362, 95% CI 2.178-18.585, p = 0.001) and low level of sensitized T cells that synthesize IL-2 in response to exposure to the AlaDH antigen in IGRA in vitro (OR = 2.155, 95% CI 1.060-4.379, p = 0.034) were significantly associated with tuberculosis recurrence.Цель исследования: выявить социально-демографические и клинико-лабораторные факторы, ассоциированные с рецидивом туберкулеза.Материалы и методы. Проанализированы клинико-лабораторные данные 208 больных туберкулезом легких, находившихся на лечении в Национальном научном центре фтизиопульмонологии Министерства здравоохранения Республики Казахстан.Оценка уровня антиген-специфической продукции IL-2 к антигену AlaDH M. tuberculosis проводилась с использованием тест-платформ Lionex GmbH (Германия) согласно инструкции производителя.Для статистической обработки полученных данных использована программа SPSS 23.0. При оценке значимости различий в сравниваемых группах применен критерий хи-квадрат Пирсона. Логистический регрессионный анализ в двумерной и многомерной моделях проведен для идентификации факторов, ассоциированных с развитием рецидива туберкулеза.Результаты. Многофакторный логистический регрессионный анализ подтвердил, что мужской пол (OR = 2,086, 95%-ный ДИ 1,001-4,350, p = 0,050), лекарственная резистентность (OR = 4,910, 95%-ный ДИ 1,923-12,534, p = 0,001), фиброзно-кавернозная форма туберкулеза (OR = 6,362, 95%-ный ДИ 2,178-18,585, p = 0,001) и низкий уровень сенсибилизированных Т-клеток, отвечающих продукцией IL-2 в ответ на воздействие антигена AlaDH в IGRA in vitro (OR = 2,155, 95%-ный ДИ 1,060-4,379, p = 0,034), были статистически значимо связаны с рецидивом туберкулеза

Interaction of hepatitis C virus with the immune system in pregnant women with chronic hepatitis C

Aim: to analyze the relation between hepatitis C virus (HCV) load, the immune reactivity, and the immune-mediated lesions in the liver during pregnancy in women with chronic hepatitis C (CHC). Materials and methods. The study included 1690 pregnant women, 107 of whom had IgG antibodies to HCV; in addition, 68 women (63.5 %) were diagnosed with chronic hepatitis C and had a positive test for HCV RNA. The diagnosis of CHC was confirmed by determining serum total anti-HCV IgG antibodies using an enzyme immunoassay. The qualitative and quantitative determination of HCV RNA in the blood was performed by polymerase chain reaction. The virus replicative activity was qualitatively assessed by the viral load: low - the level of HCV RNA was up to 103 lU/ml, moderate - from 103 to 106 lU/ml, and high - above 106 lU/ml. To quantify the results, we used the positivity index, i.e, the ratio of the serum optical density to the critical optical density (cut-off) in each test. Results. In the early stages of pregnancy, signs of severe immune-mediated hepatocyte injury persisted. In the II and Ill trimesters, there was an unusual discrepancy between the severity of viral load and the degree of hepatocyte injury as the course of CHC remained usual. Another evidence of the liver involvement in this immune-pathological mechanism was an 87 % decrease in alanine aminotransferase activity with an increase in the viral load in patients with CHC in the Ill trimester of pregnancy. Conclusion. Suppression of anti-HCV humoral immunity, but not cellular immunity, begins from early stages of pregnancy and is accompanied by a significant increase in hepatocyte lesions without an increase in the severity of the inflammatory process

Epidemiological dynamics of nephropathia epidemica in the Republic of Tatarstan, Russia, during the period of 1997-2013

Copyright © Cambridge University Press 2015.This report summarizes epidemiological data on nephropathia epidemica (NE) in the Republic of Tatarstan, Russia. NE cases identified in the period 1997-2013 were investigated in parallel with the hantavirus antigen prevalence in small rodents in the study area. A total of 13 930 NE cases were documented in all but one district of Tatarstan, with most cases located in the central and southeastern districts. The NE annual incidence rate exhibited a cyclical pattern, with the highest numbers of cases being registered once in every 3-5 years. The numbers of NE cases rose gradually from July to November, with the highest morbidity in adult males. The highest annual disease incidence rate, 64·4 cases/100 000 population, was observed in 1997, with a total of 2431 NE cases registered. NE cases were mostly associated with visiting forests and agricultural activities. The analysis revealed that the bank vole Myodes glareolus not only comprises the majority of the small rodent communities in the region, but also consistently displays the highest hantavirus prevalence compared to other small rodent species

Epidemiological dynamics of nephropathia epidemica in the Republic of Tatarstan, Russia, during the period of 1997-2013

Copyright © Cambridge University Press 2015.This report summarizes epidemiological data on nephropathia epidemica (NE) in the Republic of Tatarstan, Russia. NE cases identified in the period 1997-2013 were investigated in parallel with the hantavirus antigen prevalence in small rodents in the study area. A total of 13 930 NE cases were documented in all but one district of Tatarstan, with most cases located in the central and southeastern districts. The NE annual incidence rate exhibited a cyclical pattern, with the highest numbers of cases being registered once in every 3-5 years. The numbers of NE cases rose gradually from July to November, with the highest morbidity in adult males. The highest annual disease incidence rate, 64·4 cases/100 000 population, was observed in 1997, with a total of 2431 NE cases registered. NE cases were mostly associated with visiting forests and agricultural activities. The analysis revealed that the bank vole Myodes glareolus not only comprises the majority of the small rodent communities in the region, but also consistently displays the highest hantavirus prevalence compared to other small rodent species

Cytokine storm combined with humoral immune response defect in fatal hemorrhagic fever with renal syndrome case, Tatarstan, Russia

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Hemorrhagic fever with renal syndrome (HFRS) is endemic in Tatarstan, where thousands of cases are registered annually. Puumala orthohantavirus is commonly detected in human case samples as well as in captured bank voles, the rodent hosts. The pathogenesis of HFRS is still not well described, although the cytokine storm hypothesis is largely accepted. In this study, we present a comprehensive analysis of a fatal HFRS case compared with twenty four non-fatal cases where activation of the humoral and cellular immune responses, pro-inflammatory cytokines and disturbed blood coagulation were detected using immunological, histological, genetic and clinical approaches. Multiple organ failure combined with disseminated intravascular coagulation syndrome and acute renal failure was the cause of death. Decreased Interleukin (IL)-7 and increased IL-18, chemokine (C-C motif) ligand (CCL)-5, stem cell growth factor (SCGF)-b and tumor necrosis factor-beta (TNF-β) serum levels were found, supporting the cytokine storm hypothesis of hantavirus pathogenesis

Cytokine storm combined with humoral immune response defect in fatal hemorrhagic fever with renal syndrome case, Tatarstan, Russia

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Hemorrhagic fever with renal syndrome (HFRS) is endemic in Tatarstan, where thousands of cases are registered annually. Puumala orthohantavirus is commonly detected in human case samples as well as in captured bank voles, the rodent hosts. The pathogenesis of HFRS is still not well described, although the cytokine storm hypothesis is largely accepted. In this study, we present a comprehensive analysis of a fatal HFRS case compared with twenty four non-fatal cases where activation of the humoral and cellular immune responses, pro-inflammatory cytokines and disturbed blood coagulation were detected using immunological, histological, genetic and clinical approaches. Multiple organ failure combined with disseminated intravascular coagulation syndrome and acute renal failure was the cause of death. Decreased Interleukin (IL)-7 and increased IL-18, chemokine (C-C motif) ligand (CCL)-5, stem cell growth factor (SCGF)-b and tumor necrosis factor-beta (TNF-β) serum levels were found, supporting the cytokine storm hypothesis of hantavirus pathogenesis

Switching to Doravirine/Lamivudine/Tenofovir Disoproxil Fumarate (DOR/3TC/TDF) Maintains HIV-1 Virologic Suppression Through 48 Weeks: Results of the DRIVE-SHIFT Trial

BACKGROUND: Doravirine is a novel, nonnucleoside reverse transcriptase inhibitor with demonstrated efficacy in treatment-naive adults with HIV-1. METHODS: In this open-label, active-controlled, noninferiority trial, adults with HIV-1 virologically suppressed for ≥6 months on 2 nucleoside reverse transcriptase inhibitors plus a boosted protease inhibitor, boosted elvitegravir, or a non-nucleoside reverse transcriptase inhibitor were randomized (2:1) to switch to once-daily, single-tablet doravirine 100 mg with lamivudine 300 mg and tenofovir disoproxil fumarate 300 mg (DOR/3TC/TDF) or to continue their current therapy (Baseline Regimen) for 24 weeks. The primary endpoint was the proportion of participants with HIV-1 RNA <50 copies/mL (defined by the FDA Snapshot approach), with the primary comparison between DOR/3TC/TDF at week 48 and Baseline Regimen at week 24 and a secondary comparison between the groups at week 24 (noninferiority margin, -8%). RESULTS: Six hundred seventy participants (447 DOR/3TC/TDF, 223 Baseline Regimen) were treated and included in the analyses. At week 24, 93.7% on DOR/3TC/TDF vs 94.6% on Baseline Regimen had HIV-1 RNA <50 copies/mL [difference -0.9 (-4.7 to 3.0)]. At week 48, 90.8% on DOR/3TC/TDF had HIV-1 RNA <50 copies/mL, demonstrating noninferiority vs Baseline Regimen at week 24 [difference -3.8 (-7.9 to 0.3)]. In participants on ritonavir-boosted protease inhibitor at entry, mean reductions in fasting LDL-C and non-HDL-C at week 24 were significantly greater for DOR/3TC/TDF vs Baseline Regimen (P < 0.0001). Adverse events occurred in 68.9% on DOR/3TC/TDF and 52.5% on Baseline Regimen by week 24, leading to treatment discontinuation in 2.5% and 0.4%, respectively. CONCLUSIONS: Switching to once-daily DOR/3TC/TDF is a generally well-tolerated option for maintaining viral suppression in patients considering a change in therapy. REGISTRATION: ClinicalTrials.gov NCT02397096.status: publishe