A multifactorial in-depth study of 78 placentas obtained during delivery of HIV infected women in St. Petersburg between 2009 and 2011. We studied clinical anamnestic and laboratory parameters on the basis of the retrospective analysis, respectively, in 78 HIV-positive postpartum women (mean age 27,1±4,1 years) and their newborn children, of whom 12 have mother-to-child transmission of HIV. Most of the women who gave birth to infected children who were users of psychoactive drugs all took place co-infection with hepatitis C virus, about half of them were observed chronic urogenital infections. The complexity of communication, contacts instability did not allow any of the women who have realized the vertical transmission of HIV, antiretroviral therapy to conduct in full. In obstetrical establishment turned 11 women, but due to the onset of labor and/or premature rupture of membranes that are not allowed to use the elective caesarean section as a method of prevention of vertical transmission of HIV. All infants were signs posthypoxic encephalopathy. It was noted that in HIV infection in the placental tissue is imbalance between pro-angiogenic (VEGF, bFGF, CD31) and anti-angiogenic (TGF-β1, Tsp-1) factors in favor of the latter, which is the basis of a dissociated maturation chorionic villi and chronic placental insufficiency. With the implementation of intrauterine infection of HIV in placental tissue sharply reduced macrophage content, primarily CD68+ and, to a lesser extent, CD14+. Violation placental barrier greatly facilitates and determines the penetration of HIV to the fetus. In this case, targeted prevention, treatment for opportunistic infections and drug correction of placental insufficiency in HIV-infected women should, obviously, be regarded as justified pathogenetic approaches to reduce mother-to-child transmission of HIV.

The paper is a review of literature on the assessment of factors that determine the infectious safety of keratoplasic materials where cadaveric cornea is used and on the effectiveness of serological tests employed to examine cadaveric blood. The objective of the review is to delineate the main problems and directions of efforts aimed to improve the infectious safety of keratoplastics using cadaveric cornea. It is revealed that the rejection rate of donor material is high because of false-positive results obtained with immunochromatographic and immunoenzyme methods. Proposals for improving the infectious safety of keratoplasics are put forward.

In Russia, the population of people living with HIV and thus in need for antiretroviral therapy increases each year. The early onset and an optimal long-term adherence to therapy help to suppress HIV replication and to reduce the risk of its transmission. Therefore, it is expedient to assess HIV patients’ adherence to therapy and to determine the main factors that contribute to therapeutic success at the early stages of therapy. Our study group included 100 HIV patients followed-up at Saint-Petersburg AIDS Center and having indications for ART. The endpoint was the percent of patients having undetectable viral loads six months after ART onset, i.e., of the cases of a success achieved at the start of ART. Based on data collected before the therapy, the factors that were associated with the success were determined. Most of study subjects (96%) commenced the therapy, 80% adhered to their therapeutic regimens, and 71% of them were found to have undetectable viral loads at the end of the follow-up. The optimal adherence to ART was associated with older ages and higher education levels (p<0,05). None of factors accounted of, including psychotropic drug abuse and physician’s prognoses regarding adherence, was associated with the success of ART soon after its onset. The findings may be useful for improving the outcomes of ART.

The objective of the study was to determine blood serum trypsin levels in children with mild viral hepatitis B and their correlations with the clinical and laboratory manifestations of the disease. Studied were 48 children aged 3 to 15 years. The first group comprised 33 patients with mild hepatitis B. The second (control) group comprised 15 healthy children. All hepatitis patients had significantly increased blood trypsin levels suggesting that their disease was combined hepatopancreatitis. Blood trypsin levels were found to correlate with the clinical and laboratory manifestations of the disease and its enzymatic exaggerations associated with delayed recovery. Blood serum trypsin levels were found to correlate linearly with the specific markers of hepatitis: HBs antigen level at patient’s admission and the duration of increases in HBs and HBe levels. This suggests that serum trypsin may be the earliest prognostic marker of lingering and chronic disease. It is recommended to treat the icteric forms of hepatitis B in children as combined conditions (hepatopancreatitis) and to follow-up and cure such patients in collaboration of infectiologists with gastroenterologists in order to reduce the incidence of complication and adverse outcomes and to timely recognize lingering and chronic pancreatitis in children.

The objective of the present work was to study the dissemination pathways of specific hepatitis B virus (HBV) genotypes and their subtypes and to determine the genetic interrelationships of HBV in patients ascribed to different risk factors of HBV infection in different regions of the Republic of Belarus. The molecular-epidemiological characteristics of HBV subtypes were determined using the phylogenetic analysis of the P region of viral genome. Possible HBV entry and dissemination pathways in different areas of Belarus were inferred. The comparison of genetically related HBV variants and reference sequences from different parts of the world shows that the D2, D3 and D4 subtypes of HBV from patients in Belarus form significantly different clusters. The data suggest that these variants spread predominantly via domestic pathways. The A2 and D1 subtypes disseminated independently via HBV entries from epidemiologically independent sources. The C2 and B4 subtypes originate from Southeast Asia and circulate among migrants from this area. Phylogenetic analysis made it possible to obtain objective information about the development of viral hepatitis B in the Republic of Belarus.

Study objective: The retrospective analysis of HIV incidence in the Republic of Tajikistan in 2009-2015, the period of the rise of HIV epidemic. Materials and methods: Epidemiological investigations and sentinel surveillance data obtained at the Republican Center for Prevention and Control of AIDS of the Ministry of Health and Social Protection of Population of the Republic of Tajikistan were analyzed. The data included the results of HIV testing using ELISA followed by immunoblot confirmation. HIV incidence per 100 000 population was found to increase from 10,7 in 2012 to 13,6 in 2015. The proportion of reproductive-age women (15-49 years) among the newly found HIV cases increased from 36,6% in 2012 to 40,8% in 2015. The significance of the sexual route of HIV transmission increased in 2012-2015 making it the leading cause of HIV infection. The proportion of HIV cases associated with the injection route decreased twofold in 2012-2015.

Resuscitation and intensive care units (RICU) of general hospitals are at a high risk of hospital-acquired purulent-septic infections because of the critical conditions of patients and because of the routine use of invasive instruments and antimicrobial preparations. The objective of the present study was to reveal the specific features of the epidemic of hospital-acquired infections in RICU of a general hospital in order to improve preventive interventions. The epidemiological approach used in the study included the prospective analysis of the incidence of purulent-septic conditions among RICU patients. The results included the estimates of the incidences of specific purulent-septic conditions, the identification of their causative agents, and the estimates of time and risk of infecting depending on the duration of patient’s stay in a ward. Measures aimed at ameliorating the epidemiological situation were taken. К. pneumoniae and A. baumannii strains were found to be the most rapidly spreading, compared to other Gram-negative bacteria, among RICU patients.

The objective of the present study was to investigate HIV outbreaks among injection drug users in Minsk using molecular epidemiological approaches and to find the phylogenetic relationships between HIV isolates from different patients in order to determine common HIV infection sources. Phylogenetic analysis showed that HIV outbreaks among IDUs in Minsk were caused by HIV entries from different sources. At least seven IDU groups were distinguished. It was also found that hepatitis C virus was in most cases present in the IDUs before they became HIV infected. In two cases, HIV patients acquired hepatitis B virus from the same source.