A novel coronavirus infection COVID-19 in practice of obstetrician-gynecologist: a review of current data and guidelines

In December 2019, a new type of coronavirus was identified in China, called SARS-CoV-2 (COVID-19) that quickly spread not only within the People’s Republic of China, but also far beyond its borders. On March 11, 2020, the World Health Organization announced that the infection caused by novel coronavirus SARS-CoV-2 became a pandemic. Prior to this, two global epidemics were caused by pathogenic coronaviruses: in 2002 – by SARS-CoV that caused severe acute respiratory syndrome (SARS), and in 2012 – by MERSCoV that resulted in the Middle East respiratory syndrome (MERS). All coronavirus infections in humans are characterized by damage of lower respiratory tract with development of severe pneumonia and respiratory distress syndrome. According to reports, males become sick more often than females. It is known that due to developing immunological suppression pregnant women are at higher risk of contracting infectious diseases. However, the clinical course of SARS-CoV-2 infection during pregnancy, its effect on outcome of gestation, and the likelihood of vertical transmission to the fetus still remain unanswered. In this review, we present data on cases of SARS-CoV-2 disease during pregnancy published globally, its effect on outcome of gestation, as well as data on potential routes of infection for fetus and neonates. In addition, we also provide currently available clinical recommendations released by the Royal Society of Obstetricians and Gynecologists (UK), the American Society of Obstetricians and Gynecologists (USA), and the National Institute for Reproductive Health Research (India) on the management of pregnant patients infected with SARS-CoV-2

Prevalence and molecular-genetic characteristics of hepatitis B virus in HIV-positive individuals at the Far Eastern Federal District

Current study was aimed at investigating prevalence of overt and occult hepatitis B infection in HIV-positive individuals as well as molecular-epidemiological characteristics of the circulating hepatitis B virus (HBV) strains in the Far Eastern Federal District (FEFD). A total number of 297 blood serum/plasma samples obtained from HIV-positive patients residing in the FEFD were enrolled in the study. The first control group included 351 blood serum/plasma samples of general population without indication on HIV and HBV-infection that underwent laboratory check up at the Centers for AIDS Prevention and Control. After evaluating the group of HIV-positive patients 20 HIV-HBV positive samples were selected for further detailed analysis. The second control group included 43 patients with chronic hepatitis B. All groups were age and gender-matched. The research included serological and molecular-genetic (real-time PCR, positive for HBV DNA samples underwent clonal sequencing of PCR-amplified HBV P/S gene) assessment of the biological material followed by a phylogenetic analysis of the HBV sequences. Our research revealed that HIV-positive patients are exposed to a higher risk of HBV infection compared to general population enrolled in the study, which is evident from the prevalence of anti-HBcAg antibodies in the groups examined. HIV-positive vs. first control group was positive for anti-HBcAg antibodies at higher rate (35.02%, CI 95: 29.59–40.45% versus 22.22%, CI 95: 17.87–26.57%, p = 0.0003). Abundance of ongoing HBV-infection markers was also higher in HIV-positive individuals compared to general population (6.73%, CI 95: 3.88–9.58% versus 0.85%, CI 95: 0–1.81%, p = 0.0001, respectively). Should be noted, that HBsAg-negative HBV infection in HIV-positive patient cohort comprised 1.01% (CI 95: 0–2.15%) whereas in general population this index was as low as 0.28% (CI 95: 0–0.84%). Virus hepatitis С and D were revealed at higher rate in HIV-positive individuals compared to patients with HIV-negative chronic HBV infection (p = 5.84 × 10–7  and p = 0.000001 respectively). HCV and HDV prevalence rates comprised 50.0% (CI 95: 27.46–77.46%) and 40.0% (CI 95: 17.97–62.03%) in HIV-positive patients. Similar indices in control group were 4.65% (CI 95: 0–10.94%) and 4.65% (CI 95: 0–10.94%), respectively. The phylogenetic analysis of the six isolated HBV sequences showed that the five samples belonged to genotype D, with dominant subtype D2 (verified in 4 cases). Further, HBV genotype С was detected only in one case. The obtained data indicate a necessity for further in-depth diagnostic examination of viral hepatitis in HIV-positive patients to lower a risk of developing life-threatening complications as well as preventing hepatitis spread in human population