ИНТЕГРАЦИОННЫЙ ПОДХОД К ИЗУЧЕНИЮ ЗАБОЛЕВАЕМОСТИ ТУБЕРКУЛЕЗОМ И ВИЧ-ИНФЕКЦИЕЙ НАСЕЛЕНИЯ ПРИМОРСКОГО КРАЯ

Primorsky Kray has one of the highest tuberculosis incidence in Russia and one of the highest HIV incidence among the regions of the Far Eastern Federal District. Understanding of interfacing mechanisms of two epidemics is necessary for planning tuberculosis control activities in the regions with high speed of increase and high prevalence of HIV infection. Applying this integrated approach allows detecting presence of such correlations when they are manifested on the population level during epidemic development. This interfaced epidemiological analysis of tuberculosis and HIV incidences resulted in concluding that current epidemic of tuberculosis is assessed as emergency and HIV epidemic as unstable. It has been proved that dissemination of HIV infection promotes tuberculosis epidemic in Primorsky Kray and mechanism of formation of tuberculosis and HIV incidences is interdependent.Приморский край занимает лидирующие позиции как по заболеваемости туберкулезом в РФ, так и ВИЧ-инфекцией среди субъектов Дальневосточного федерального округа. Понимание механизмов взаимодействия двух эпидемий является необходимым для планирования мероприятий по борьбе с туберкулезом в регионах с высокими темпами роста и высокой распространенностью ВИЧ-инфекции. Применение интеграционного подхода позволяет выявить наличие таких взаимодействий по их проявлению на популяционном уровне эпидемического процесса. В результате сопряженного эпидемиологического анализа заболеваемости туберкулезом и ВИЧ-инфекцией установлено, что в современный период эпидемическая ситуация по туберкулезу расценивается как чрезвычайная, а по ВИЧ-инфекции - как неустойчивая. Показано, что распространение ВИЧ-инфекции оказывает влияние на интенсивность эпидемического процесса туберкулеза в Приморском крае, а механизм формирования заболеваемости туберкулезом и ВИЧ-инфекцией носит взаимообусловленный характер

SIGNIFICANCE OF IMMUNE MECHANISMS IN PATHOGENESIS OF SOME ACUTE AND CHRONIC VIRAL INFECTIOUS DISEASES

Abstract. In the last years immunological aspects are studying in the pathogenesis of infectious diseases. The influence of immune response to the infectious processes of acute and chronic virus infectious (Hemorrhagic Fever with Renal Syndrome and Chronic Viral Hepatitis C, as an example) has been revealed. Misbalance of system and local cytokine status characterizes the direct influence of immune system to all organs and systems of human organism. It determines the severity of the disease and its outcomes

Psoriasis and porphyria cutanea tarda, associated with chronic hepatitis C in HIV-infected patients (clinical observation)

The continued growth of HIV-infected patients is associated on the one hand, with increase of life expectancy because of antiretroviral therapy, and the other - with high incidence of new cases of HIV-infection. It is important to remember that almost every HIV-infected patient has concomitant disease. The presence of comorbidity increases days of hospitalization, disability, impedes rehabilitation and leads to polypharmacy. Moreover, polypharmacy, particularly in HIV-patients, contributes to a sharp increase of adverse local and systemic side effects of drugs. This article presents the clinical examples of skin diseases in patients with HIV-infection

CHARACTERISTICS OF CYTOKINE PROFILE LEVEL (TNFα, IL-6, IL-10) AND THEIR SOLUBLE RECEPTORS (SRр55 TNFα, SRр75 TNFα, SR IL-6) IN THE PATIENTS WITH HIV, HIV-ASSOCIATED TUBERCULOSIS AND PULMONARY TUBERCULOSIS

Abstract. Three groups of patients were investigated as follows: 1st group, HIV-infected patients, 2nd group, patients with HIV-associated tuberculosis, the 3rd group, persons with pulmonary tuberculosis. The amounts of cytokines (TNFα, IL-6, IL-10) and their soluble receptors (SRp55 TNFα, SRp75 TNFα, SR IL-6) were evaluated in blood serum by solid-phase immuno-enzyme technique. The patients did not receive antiviral therapy before, or during the investigations. Some features are revealed reflecting a direction and significance of changes in immune reactivity of the patients. In the patients with tuberculosis, IL-10 and IL-6 levels were increased, along with pronounced rise of srIL-6, relatively low index of SRp75 TNFα and deficiency of SRp55 TNFα, associated with moderate increase in TNFα. In the patients with HIV and HIV-associated tuberculosis, the direction of alterations were found to be similar, except of IL-10, i.e., a hyper-production of TNFα and its soluble type I and II receptors, increased IL-6 level in combination with lack of its soluble receptor. Correlation analysis showed a strict dependence between TNFα and viral load in the patients with IVB and V stage of HIV, and HIV-associated tuberculosis that argues for significance of TNFα in pathogenesis of HIV-infection and its progression. We have found differential trends in dynamics of cytokines under study and their soluble receptors in the course of HIV-infection progression in the groups I and II of patients, that allowing us of elaborating additional diagnostic criteria of HIV-associated tuberculosis. (Med. Immunol., vol. 10, N 6, pp 519-526)

Chitosan–hydroxyapatite composite biomaterials made by a one step co-precipitation method: preparation, characterization and in vivo tests

A series of biocompatible chitosan/hydroxyapatite composites has been synthesized in an aqueous medium from chitosan solution and soluble precursor salts by a one-step coprecipitation method. The composite materials were produced in dense and porous variants. XRD and IR studies have shown that the apatite crystals in the composites have structural characteristics similar to those of crystals in biogenic apatite. A study of in vivo behaviour of the materials was carried out. Cylindrical rods made of the chitosan/ hydroxyapatite composite material were implanted into the tibial bones of rats. After 5, 10, 15 and 24 days of implantation, histological and histo-morphometric analyses of decalcified specimens were undertaken to evaluate their biocompatibility and the possibility to apply them in bone tissue engineering. The calcified specimens were examined by scanning electron microscopy combined with X-ray microanalysis to compare the elemental composition and morphological characteristics of the implant and the bone during integration. Porous specimens were osteoconducting and were replaced in vivo by newly formed bone tissue

EXTRACELLULAR MATRIX CONDITION IN CASE OF HCVASSOCIATED LIVER FIBROSIS

Imbalance of the proteolysis/antiproteolysis system is known to be among key components of immunofibrogenesis of liver in cases of chronic hepatitis C. To evaluate these aspects, we studied several factors of liver tissue remodeling in blood serum and local samples from HCV patients associated with liver fibrosis. We determined the levels of matrix metalloproteinase-9 (MMP-9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), MMP-9/TIMP-1 and MMP-9/TIMP-2 complexes. Clinical, laboratory and instrumental examinations have been made for 81 patients with chronic hepatitis C who did not receive antiviral therapy, and 22 healthy volunteers. Extracellular matrix protein (ECM) profile was studied in 103 serum blood samples and 32 liver supernates using ELISA technique. Statistically significant increase of MMP-9 contents (p < 0.05) and its complexes with TIMP-1 (p < 0.05) and TIMP-2 (p < 0.01), as well as low levels of type 1 inhibitor (p < 0.05) were revealed in blood serum of HCV-infected patients, as compared with control group. Protein assays in liver supernates of hepatitis C patients reflecting extracellular matrix state revealed an eight-fold increase in MMP-9/ TIMP-1 complex, as compared with control group (p < 0.05). The values of other proteolytic/antiproteolytic factors proved to be low (p < 0.05). An imbalance in protease contents in blood serum and liver biopsies was revealed, showing differently directed changes. I.e., serum values of MMP-9, TIMP-1 and MMP-9/TIMP-2 during transition of liver fibrosis to cirrhosis (F0 to F4) became decreased (p < 0.05), associated with increased liver concentrations of these proteolytic enzymes (p < 0.05). In summary, we conclude that the data obtained in our study suggest an imbalance of proteolysis/antiproteolysis system leads to a dysregulated liver tissue remodeling in patients with chronic hepatitis C

INTEGRATED APPROACHES TO INVESTIGATION OF TUBERCULOSIS AND HIV INCIDENCE AMONG POPULATION OF PRIMORSKY KRAY

Primorsky Kray has one of the highest tuberculosis incidence in Russia and one of the highest HIV incidence among the regions of the Far Eastern Federal District. Understanding of interfacing mechanisms of two epidemics is necessary for planning tuberculosis control activities in the regions with high speed of increase and high prevalence of HIV infection. Applying this integrated approach allows detecting presence of such correlations when they are manifested on the population level during epidemic development. This interfaced epidemiological analysis of tuberculosis and HIV incidences resulted in concluding that current epidemic of tuberculosis is assessed as emergency and HIV epidemic as unstable. It has been proved that dissemination of HIV infection promotes tuberculosis epidemic in Primorsky Kray and mechanism of formation of tuberculosis and HIV incidences is interdependent

РАСПРОСТРАНЕННОСТЬ МУТАЦИЙ РЕЗИСТЕНТНОСТИ ВИЧ-1 К ПРЕПАРАТАМ АРВТ В ПРИМОРСКОМ КРАЕ

Because of drug resistant HIV-1 variants have become widely spread, HIV isolate genotyping is important in order to find out mutations associated with HIV resistance. We performed HIV sequencing in 53 blood plasma samples of patients. Almost half of the cases diagnosed subtype B. Genotyping of the samples revealed recombinant forms CRF01_AE/A, CRF02_AG and form В/А. Resistance to protease inhibitors not detected in most cases. Most of the results were consistent with resistance to nucleoside inhibitors of reverse transcriptase and non-nucleoside inhibitors of reverse transcriptase.Учитывая широкое распространение лекарственной устойчивости ВИЧ-1, большое значение приобретает генотипирование с целью выявления мутаций резистентности. Исследовано 53 образца плазмы пациентов методом секвенирования. В половине случаев выявлен субтип В; отмечены единичные случаи обнаружения циркулирующих рекомбинантных форм (CRF) - CRF01_AE/A, CRF02_AG и формы В/А. Резистентность к ингибиторам протеазы в большинстве случаев не обнаруживается. У большинства пациентов выявлена резистентность к нуклеозидным и ненуклеозидным ингибиторам обратной транскриптазы (НИОТ и ННИОТ)

ВИЧ-ИНФЕКЦИЯ СРЕДИ ЖЕНЩИН ПРИМОРСКОГО КРАЯ

The objective of this report is to analyse the clinical, epidemiological and laboratory characteristics and also obstetrical history in women with newly diagnosed HIV infection according to the Centre for the AIDS. The results of the study revealed a tendency to increase the number of women with HIV infection, which is associated with a high rate of heterosexual transmission rate and the high number of women who use drugs. Furthermore, there is an increase in the proportion of births among pregnant women with HIV infection, resulting in the need for chemoprophylaxis of perinatal transmission of HIV. From 2012 to 2014 has been a clear trend to increase the number of women who received chemoprophylaxis in full.Проведен анализ клинико-эпидемиологических и лабораторных характеристик, а также акушерского анамнеза у женщин с впервые выявленной ВИЧ-инфекцией, по данным Центра СПИД. По результатам исследования выявлена тенденция к увеличению количества женщин с ВИЧ-инфекцией, что связано с высокой частотой гетеросексуального пути передачи, а также с более массивным вовлечением женщин в процесс наркотизации. Кроме того, отмечается увеличение удельного веса беременных женщин с ВИЧ-инфекцией, идущих на роды, что обусловливает необходимость проведения химиопрофилактики перинатальной передачи ВИЧ. С 2012 по 2014 год отмечается четкая тенденция к увеличению числа женщин, получивших химиопрофилактику в полном объеме