The lecture addresses the actuality of the current classifications of HIV infection, the diagnostic issues, and the rates of the most prevalent  clinical manifestations to be accounted for in developing a concluding  diagnosis and making decisions concerning HIV treatment. Regarding  the lack of clear cut recommendations for generating a detailed clinical  diagnosis of HIV infection and difficulties in its formulation and making  prognoses concerning HIV patient’s conditions and life, approaches to  evaluating patient’s condition by particular syndromes are suggested  and characterized, and original procedures related to prognoses and patient routing until hospitalization are presented with account of patient’s clinical status.

Lesions in the kidneys and urinary tracts of HIV patients are comorbid conditions, which are usually manifested clinically after a time since HIV contraction, significantly compromise life quality, and contribute to  poor prognosis and death. In the present paper, the epidemiology of  kidney lesions in HIV patients is analyzed, and the classification, clinical  symptoms, the most prevalent and dangerous forms of the lesions, and approaches to their prevention and treatment are discussed.

Modern medicine, relying on a verified strategy and consistent approach, has proved that to date, HIV infection, thanks to effective antiretroviral therapy, has evolved from a category of  incurable and deadly diseases into a nosology potentially controlled  by medical and diagnostic measures. Moreover, as shown by  numerous studies, not only clinical, but also the population effect has been achieved. The life expectancy of HIV-infected people  has increased, its quality has significantly improved, and the number of potential sources of infection has decreased. The concept of  «treatment as prevention» at the present stage becomes an integral  part of the complex of measures to combat HIV infection, since the  early onset of ART can significantly reduce the risk of transmission of the pathogen, as well as the level of AIDS-associated morbidity and  mortality. In addition to ART, the principles of comprehensive prevention remain unshakable, taking into account the modern epidemiological features of HIV infection.

Аim. For the early diagnosis of complications in liver cirrhosis, the degree of interrelation between clinical and biochemical blood indices and cytokines was studied.

Materials and methods. In 107 patients with cirrhosis of viral etiology of classes A, B, C on the Child–Pugh has been studied  indexes of clinical and laboratory syndromes were determined for  liver cirrhosis cases of Class A, B, C according to Chad–Pugh and the degree of their interrelation with IL-2, IL-6 and TNF-a was determined.

Results. Correlation is found between erythrocytes and IL-2, IL-6 in  liver cases of class A, erythrocytes and IL-2, IL-6 in liver cases of  class C. Correlation is found between leukocytes and IL-6 in liver  cases of class A, between leukocytes and IL-6 in liver cases of class  C, between leukocytes and TNF-a in liver cases of class C.  Correlation is found between thrombocytes and TNF-a in liver cases  of class A. Correlation is found between prothrombinand IL-2 in liver  cases of class A, between prothrombin and IL-2 in liver cases of class C, between prothrombin and IL-6, PTT, between IL-2 andfibrinase,  SMFC in liver cases of class A. Conclusion. The correlation of blood  indexes and the level of cytokines was found to be dependent on a  series of factors. 

The aim of the study is to identify immunological markers that may be important to predict drug resistance of patients to HAART.

Materials and methods. Examined 53 patients with HIV infection, virological and immunological HAART failure. All patients underwent  the study of drug resistance genotyping method, determined the  levels of cytokines IL-2, IL-6, IL-16, IL-23, TNF-a, HIV viral load,  CD4+ T-lymphocytes. For building hypotheses about the nature of  the impact of drug resistance on the results of laboratory tests  (CD4+ T-lymphocytes, HIV viral load and cytokines) used imaging  technique in chart form of the scale, correlation analysis. To predict  the patient’s risk of drug resistance built models based on decision  tree and logistic regression.

Conclusion. On the basis of information criterion, Akaike, and the results of the analysis of the predictive capabilities of the model,  were considered the best model to determine the presence of drug resistance on the basis of the level of IL-16.

To define the main risk factors of the unfavorable outcomes of tuberculosis and to propose approaches to minimizing their impact
on HIV patients.

Materials and methods: To define the risk factors, 710 case histories of patients with TB and HIV were examined. Approaches to  minimizing the impact of the risk factors are worked out with  account of international guidelines concerning TB treatment in HIV patients.

Results: The risk factors of unfavorable outcomes of TB in HIV patients are social, including alcoholism and having no family  (spouse), and medical, including living with HIV for three years or  longer, bacterioexcretion, drug resistance of the infectious agent, and CD4 cell counts below 200. The influences of these factors are modifiable and may be minimized upon optimization of preventive  interventions and reinforcement of epidemiological surveillance for  co-infected HIV patients.

Conclusion: Timely identification of risk factors on unfavorable outcomes of TB in HIV patients and the implementation of the  proposed approaches to optimizing measures against TB will allow  avoiding unfavorable outcomes of TB in HIV patients.

Purpose of the study. The aim of the study was to determine the risk of tuberculosis children with perinatal HIV infection compared to  the group of healthy children born to mothers without HIV status; to  evaluate the quality and efficiency of vaccination against tuberculosis in newborns with perinatal HIV infection, vaccinated  due to the late timing of its detection.

Materials and methods. The work involved the monitoring results for HIV AIDS Centre of Primorsky Krai, 1998–2016 over the specified period there were 107 perinatal HIV-infected children,  among them 38 children (36%) had been vaccinated against  tuberculosis (TB). As the main used method of «case-control» with  calculation of odds ratio and confidence interval to it. The  comparison group was children born to mothers without HIV infection. Randomly selected 208 children attached to children’s polyclinic № 2 in Vladivostok, born over the same time period and  matched for age and sex with the experimental group. According to  the materials of history of development of the child all children were  analyzed data on TB disease, the presence and size of post- vaccination scar on the 12-th month after vaccination with BCG or  BCG-M were also evaluated immunological response to the vaccine  (the Mantoux test). Statistical processing of research results was  conducted by conventional methods. 

Conclusion. The problem of perinatal HIV infection in children remains relevant for the Primorye territory and after the introduction of the order of MH of the Russian Federation № 606  dated 19.12.2003 on prenatal chemoprophylaxis to pregnant women with HIV infection, mainly due to weak  commitment of the latter to treatment. The risk of TB perinatal HIV- infected children at 42 times higher than children born to mothers without HIV status. The BCG vaccination on disease risk not affected, and as those, and others,  was quite high. Due to the nature of cellular immunity in HIV- infected children, the results of the Mantoux test they are less  pronounced, making it difficult to identify such children the status of tuberculosis infection.

Nowadays the relevance of questions of comorbidity of different pathologies, including HIV infection diseases of the digestive system. Structural and functional changes in HIV infection can occur in  various organs of the digestive system: mouth, esophagus, stomach, liver and in the intestine.

The aim of the study was to examine features of the social, epidemiologic, somatic and immune status in HIV infected patients  with gastroenterological diseases. Materials and methods. The study  involved 500 HIV infected patients consisting on the dispensary  account in the Center for the prevention and control of AIDS of the Tyumen region.

Results. Sex-age structure and epidemiological history among HIV  infected patients with gastrointestinal pathology did not differ  (p>0,05) of the total cohort of HIV infected Tyumen region —  predominance of males, middle-aged with intravenous by HIV  infection in the non-medical use of psychoactive substances. The  most common gastrointestinal abnormalities in HIV infection are  diseases of the gastroduodenal zone (68,2%) and diseases of the  bile ducts (31,8 per cent). Indicators CD4, CD8, and LN of HIV  infected to determine the diversity and severity of clinical symptoms resulting from lesions of the digestive tract. The prevalence of gastrointestinal disease in HIV infected patients had inverse  correlation of medium strength with immunoregulatory index  CD4/CD8  (r=-0,537; p<0,05).

Conclusion. Pathogenetic defeat of the digestive system in HIV infection may be caused by direct impact of the virus on the  gastrointestinal tract and opportunistic infections, and the indirect  influence during chronic systemic inflammatory response and immunodeficiency condition, and also result from prolonged administration of drugs.

In recent years, the nature of the HIV epidemic has changed towards comorbid and severe forms of the disease. HIV infection
remains the leading cause of death in young people. The level of mortality from advanced stages of the disease, reflects the level
of organization of medical care for such patients.

The aim of the study is to analyze the main causes of deaths in HIV-infected
patients on treatment in a specialized department, taking into account the stage of the disease, secondary and concomitant
pathology.

Мaterials and methods. Аnalysis of statistical form № 61, «Information on contingents of patients with HIV infection» and a retrospective analysis of 143 cases of deceased patients admitted to the hospital of the GOU «Novgorod Regional Infectious Disease Hospital» for the period from 2004 to 2016 were carried out.

The conclusion. In the Novgorod region, the number of people  infected with HIV is increasing every year, and the number of  hospitalizations is increasing, among which there is an increase in the patient’s condition. Late detected cases of HIV infection among the deceased were 14,68%. In late diagnosed patients,  tanatogenesis was preobdali: pneumocystis pneumonia, generalized  tuberculosis, CNS involvement (including one-third of tuberculosis  and one-third of toxoplasmic etiology). 19% of patients had a  combination of two or more AIDS-associated diseases. In 69,2% of patients, several comorbid diseases were observed, which occurred against a background of severe concomitant pathology. In terms of  CD4-lymphocyte content in the blood, the main causes of death  were distributed in the following order: chronic hepatitis in the cirrhotic stage (highest CD4-lymphocyte counts), pneumonia, tuberculosis, cytomegalovirus infection, sepsis, cryptococcosis,  pneumocystic pneumonia, cerebrospiration (the lowest indices CD4 lymphocytes).

The paper presents the analytical review and author’s considerations on the basic components and principles of the effectivepsychological
technologies (programs) focused on HIV prevention. Using the international and local experience of health psychology practice, and  the results of the empirical studies, and the psychological conception of HIV prevention incorporated the main positions of ecological and behavioral approaches the authors present the basic components which should be considered in developing and realization of different  psychological prevention programs in order to reach the highest level of effectiveness in changing HIV risk behaviors on individual and  group levels. The authors describe in details the main targets of  prevention interventions including the level of knowledge, the  attitudes and behavioral skills, social support components and the  principles of the effective behavioral programs. Considering the psychological HIV prevention as the process of interaction between the subjects and objects for prevention intervention the authors  present the main psychological characteristics, behavioral skills and  attitudes which are important for the specialists invol-ved in  prevention activities in terms of their significant influence on successful behavior changes in target populations.