Human immunodeficiency virus infection results in decreases counts and compromised functions of T-cells and the associated immunodeficiency, opportunistic infections, and cancer. The paradox of HIV infection is that all this occurs upon the activation of the immune system, mainly inborn immunity, and increased production of cytokines leading to chronic systemic inflamma-tion. The immune response to HIV is evoked immediately upon infection; however, it fails to eliminate HIV, partly because of the active resistance of HIV to host immunity. Antiretroviral therapy is able to suppress HIV replication to a minimum and to somewhat restore the immune system; however, in many patients this is associated with serious complication manifested as the immune reconstitution inflammatory syndrome, IRIS. Immunotherapy for HIV infection is meant to prevent HIV infection and spread by preventive and therapeutic vaccination, including passive vaccination with broad-specificity neutralizing mono-clonal antibodies and the use of anti-chemokine drugs and to restore immunity and to mitigate complications.

Depressions negatively affects the patients emotional state and it can determine the development of complications of somatic pathology. Using the «Scale for the Express Psychological Diagnosis of Low-Structured Depressive Disorders» [Bespal’ko I.G., 2004], We have identified masked depressions and apparent depressions accompanying somatic pathology in women in the dynamics of HIV infection, depending on their receipt of antiretroviral therapy. 84 women participated in the experimental psychological study (mean age 32,02±4,36) at different stages and for different duration of the disease. 62 patients received antiretroviral therapy in accordance with domestic and international recommendations, and 22 patients had a natural course of the disease. It was shown that 58% of women in the control group fell into the area of diagnostic uncertainty (the author of this technique consider that the normative group of healthy people occupies an intermediate zone of an indeterminate diagnosis, that is, the area between diseased neuroses and manic-depressive psychosis; that’s, the characterological signs of the scale in the healthy are moderately expressed, and in patients with a clear diagnosis of depression with neuroses or manic-depressive psychosis — to the extreme degree), and 20% in the neurotic spectrum of depression. In the groups of patients with HIV infection, regardless of their receive of antiretroviral therapy, similar results were obtained (to the field of diagnostic uncertainty, depending on the duration of the disease in its natural course, there were 63,64% of patients, against antiretroviral therapy — 58,10%, the neurotic spectrum of depression included 18,2% and 19,35% of patients, respectively). Single cases of depression on the scale I (D-N scale) are probably due to the premorbid properties of the personality of the respondents, both in the study group and in the control group. It is interesting to note the fact that in women with HIV infection both in the absence and in the presence of antiretroviral therapy, the level of endogenous (scale I) in the dynamics of the disease practically does not increase, remaining at the same time significantly higher (p<0,05), than the level of neurotic depression (scale II — manic-depressive psychosis, neuroses scale), except at the stage of AIDS in the case of receiving specific therapy, which may be due to the development of psychoorganic syndrome (synonym: organic psychosyndrome), with asthenic and apathetic traits. Comparing a similar indicators of patients receiving and not receiving antiretroviral therapy, there were no significant differences in the dynamics of the disease (at different stages and for different duration of the disease) (p>0,05). Since the question of the possibility of predicting the likelihood of developing HIV-associated psycho-neurological disorders remains open, this requires careful medical and psychological support of such patients.

Actuality of the problem. The Sverdlovsk Region is a region with a high incidence of HIV infection, occupying a leading position in the Russian Federation for several years. The increase in the number of people who have HIV infection inevitably leads to an increase in the number of people contacting them and the creation of discordant couples. However, the issue of prescribing pre-exposure prophylaxis with antiretroviral drugs for this group of people has not yet been resolved and is not being used as an active prophylactic measure. The results of our study showed a higher risk of contact with male sources compared to female sources, as male sources were characterized by an increased frequency of substance use and a higher viral load. Primarily identified HIV infected women are essentially contact, and men who infect them are identified later as a result of an epidemiological investigation. It is necessary to actively identify individuals who are in contact with HIV infected patients and apply pre-exposure prophylaxis, especially among consumers of psychoactive substances and their partners. Identification of resistant discordant pairs, regardless of the source of infection (male or female), should be an indication for the appointment of each HIV infected ARV therapy, and each contact — ARV-prevention. Implementation of this approach requires revision of the standards of medical care for HIV infected persons and the development of standards for the appointment of ARV prophylaxis to their contacts.

Study objectives: To assess differential peripheral blood lymphocyte counts in infants three months of age who passed neonatal CMV infection. To examine the usability of the results for predicting frequent acute viral respiratory infections (AVRI) in the first year of life. Materials and methods: The study group included 69 infants of whom 54 passed severe neonatal CMV infection, and 15 were healthy according to conventional criteria. Among the 54 children, 30 suffered from frequent AVRI and 24 had no AVRI during the first year of life. CD markers were determined using flow cytofluorometry with a Beckman Coulter Epics XL II instrument. The following antibodies, which were purchased from Immunotest (France), were used: CD3, CD28, CD20, and CD40. Results: In all children after CMV infections in comparison with those who had no CMV infection,CD20+ and CD20+CD40+cell counts were increased.

Study objective was to assess the effectiveness of antiviral therapy for chronic hepatitis C in HIV patients. For this, a group of 60 HIV patients who were treated with PEGylated interferon and ribavirin for chronic hepatitis C was evaluated retrospectively. The patients were examined using general clinical, biochemical, serological, molecular-biological, and genotyping approaches. Treatment results were assessed monthly based on clinical data, viral load, and ALT activity. Sustained virologic response criteria were applied after the completion of the treatment to determine its effect. The results suggest that the use of PEGylated interferon and ribavirin is currently an affordable approach to HIV patient curing of chronic hepatitis C. The independent factors that influence the achievement of sustained virologic response include younger age, increased ALT, and lower replication activities of HCV and HIV.

The evolution of HIV epidemic started with a mono-infection; however, it was soon supplemented with viral hepatitis C and injected drug use epidemics. In recent decades, the severity of conditions in most patients has been being determined by comorbidity associated with the development of opportunistic infections and tuberculosis and somatic, neurologic, and other pathologies. To assess the severity of the conditions of such patients, an integral parameter (IP) has been suggested based on the formula: , where Nn is the sum of scores of comorbid conditions ranging from satisfactory to severe as determined using special tables. Clinical cases of favorable and unfavorable outcomes are described to illustrate this approach, which can help to predict the course and outcome of HIV infection and concomitant diseases and thus make a significant impact on diagnostic and therapeutic procedures.

The aim of the randomized controlled clinical trial was to compare the efficacy of a 3-month regimen of isoniazid and pyrazinamide with that of a 6-month isoniazid in people living with HIV. Results: From the total 624 enrolled patients treatment was completed by 243 patients in short-course group and by 237 ones in IPT group (р=0,9). Adverse events were established in 6,1% of subjects in combined arm and in 6,7% in isoniazid group (р=0,8). After a follow-up 946,2 person-years, 8 person in isoniazid group and 9 person in compared group developed active TB with TB incidence per 100 person-years 1,9 and 1,8 respectively (p>0,05). The Caplan-Meyer TB survival probability for the entire group of participants over the follow up period was 0,1306 without statistical differences. Three subjects were died in isoniazid group and one person — in combined group. Conclusion. Our data may suggest that for preventing tuberculosis in HIV-infected patients, a daily 3-month regimen of isoniazid and pyrazinamide is similar in safety and efficacy to a daily 6-month regimen of isoniazid. This shorter regimen offers practical advantages to patients and tuberculosis control programs, improving patients’ adherence to TB prevention treatment.

Purpose: аnalysis of typical case of complicated course of tuberculous spondylitis in a female patient living with deep immunosuppression. Materials and methods: the Examination and treatment of the patient was carried out in accordance with national clinical guidelines for TB using standardized scales and by the presence of postoperative complications. Conclusion: late referral of the patient for medical care (after 7 months from disease onset), lasting, conservative (6 months) treatment without regard to sensitivity to anti-TB drugs, ineffective surgical on the treatment of tuberculous spondylitis has led to a complicated course of tuberculosis spondylitis. The error in tactics of treatment has led to the need for further multi-stage surgical treatment.

The study of the main regularities of the epidemic process in a closed population was carried out using a simple computer model. In a plane, points move at random. A few points are infected, the rest are not. When an infected and healthy point contacts, infection occurs. It is further assumed that the epidemic process will be controlled if the number of detected HIV infected persons at each time point is equal to or greater than the increment of infections in the previous period of time. An estimate of the minimum screening coverage necessary to perform this task. As a result of the research, it has been established that the rate of the epidemic process slows down due to a decrease in the probability of contact of the infected subject with a healthy individual. As a consequence, the minimum coverage required for screening is also reduced. In Krasnoyarsk Regional AIDS Center during 2011–2014 conducted the identification of early cases of infections among newly identified HIV infected individuals. The information obtained makes it possible to calculate effective screening coverage for a given period of time, which also has the same declining trend as in the model experiment, from 49% to 39%, respectively.

The paper presents the results of the qualitative stage of development of the online secondary HIV prevention program for people living with HIV (PLWH). The modern state of development of information and communication technologies offers new opportunities to expand social-behavioral preventive programming. HIV incidence and prevalence are increasing in Russia, which lead to the increasing numbers of people living with HIV (PLWH). However, this target group lacks prevention initiatives. The program under development is directed towards prevention of high risk sexual behavior, improvement of psychological well-being and adherence to treatment among PLWH. Thirty two in-depth interviews were conducted with PLWH and experts, working with PLWH (physicians, psychologists, NGO staff) to assess the needs of target audience. These data allowed to identify the structure, content and technical characteristics for online intervention. The program has six complementary thematic sections (adjustment to the HIV-status, sexual behavior, legal issues, treatment adherence and lifestyle) united by the major topic of the attitude towards own health. Another additional part concerning drug use is for people who inject drugs. Each thematic section motivates program participants to improve their health behavior. Motivation for changes is reached by demonstration of the advantages and disadvantages of different behavior types, which should help participants to make a conscious decision concerning own behavior. The program is organized in the form of short demonstrational and training videos, text information and interactive tasks. Next, the developed online program for PLWH will be tested to show its feasibility and efficacy.

The WHO global burden of disease study methods were used to estimate the burden of HIV infection in Omsk region. Such estimates as DALY, YLL and YLD were used. Both incidence and mortality in the population of Omsk region had a trend to increase during 2011–2015 from 46,8 to 123,5 and from 5,5 to 17,2 per 100 000 population respectively. The burden of HIV infection in Omsk region in 2015 has risen 4,9 fold compared with 2011 and was 12 735,1 DALY, burden of mortality due to HIV infection, has risen 5,6 fold to 11 763,1 YLL and burden of HIV sequel has risen 1,9 fold to 972,0 YLD. The substantial part of burden of mortality was on males and it has risen from 67,2% to 76,9%. And the greatest part of this burden in males was on ages 30–34 years in 2011 and on 35–39 in 2015; the same was seen in females — 25–29 years in 2011 and 30–34 in 2015. The burden of mortality per one death was 52,5 years and was bigger in females. The study of HIV infection burden has a great social and economic meaning, and it is a way to choose foreground ways of prophylactics.

The analysis of perinatal mortality among HIV infected pregnant women in 2015. The number of births to HIV infected women in Russia increased by 5,7 times in 14 years. Set the excess perinatal mortality rate in HIV infected contingent on the population level in Russia in 2 times and in the Central Federal district 3,3 times. In the structure perinatal mortality in our study was dominated by stillbirths.

Study objective: To assess the influences of socioeconomic factors on HIV prevalence and HIV-related mortality in the administrative subjects of the Russian Federation and to define the clusters of the subjects. Materials and methods: Data on HIV prevalence and HIV-related mortality and socioeconomic data available at Federal State Statistics website were subjected to correlation, regression, factorial, and cluster analyses. Mortality rates were found not to depend on the mean per capita monetary income, investments into healthcare, the wages of healthcare personnel, and the proportion of population having income below the living wage. Diagnostics has been found to becomebetter with increasing abundance of medical doctors. HIV prevalence is influenced by the mean per capita income, the abundance of medical doctors of all specialties, and the incrementof migration. HIV prevalence decreases with increasing mean per capita income, the regression coefficientbeing — 0,302. The results may be helpful for the organization of HIV prevention and for allocation of funds used to optimize healthcare and the postgraduate training of healthcare personnel.

The results of the molecular epidemiological analysis of HIV-1 variants circulating in Sakhalin Oblast were presented. The HIV-1 viruses belonging to subtype A were dominated (81,14%). Besides these variants, viruses of another subtypes such as B, G and recombinant forms CRF63_02A1, URF02_AG, CRF11_cpx were identified. According to phylogenetic analysis, subtype A sequences formed the common branch with nucleotide sequences of A6 strains found in other regions of Russia. The recombinant strain CRF63_02A1 formed the common branch with HIV-1 sequences from Siberia and Russian Far East. Additional analysis using the jpHMM program revealed two unique recombinant forms (URF02_AG) formed by HIV-1 subtypes A and G. Among the viruses of subtype B, the BFSU strain, which is now widely distributed in Ukraine, has been identified. For the first time in Russia, the recombinant CRF11_cpx was detected on the Sakhalin region territory.