The paper studies key epidemiological, medical, social and economic, and demographic prerequisites determining the necessity of personalized diagnosis and treatment of patients with HIV-infection and comorbid states. Some regularities and sequence of creation of personalized medical care for patients of the Russian Federation were investigated, common characteristics and aspects of each component of personalized check-up and treatment of patients with HIV-infection were presented, separate groups and cohorts of people for whom such approach is essential and acceptable were selected.

Over the past decade, in Russian Federation there has been a steady increase in the incidence of MAC-infection in patients with HIV (the growth of nosology over the past five years, on average, was 57% per year). This determines the interest in this problem, especially in terms of the high inefficiency of treatment for the disease, the long term and cost of treatment. The history of the study of Mycobacterium Avium Complex-infection (MAC) originates in the early eighties in the United States, when the prognosis for a patient with AIDS and mycobacteriosis was extremely poor: mortality within one year after the detection of pathogen reached 71%. The role of infection in the thanatogenesis of patients was, however, established only by the beginning of the nineties. The detection of macrolide activity against the pathogen significantly improved the prognosis for patients, especially in combination with highly active antiretroviral therapy. The widespread introduction of antiviral drugs into practice and the ability to achieve immune reconstitution prevented the development of opportunistic infections, but did not solve the remaining issues of the treatment of the MAC-infection. The main one is the treatment of patients with a clarithromycin-resistant pathogen. There is no consensus on the sensitivity of non-tuberculous mycobacteria to antibacterials.

Objective. Assessment of tuberculosis (TB) infection conditions for HIV-infected people.

Materials and methods. Еpidemiological survey of 38 epidemic foci of HIV-associated tuberculosis, 28 foci of tuberculosis without HIV infection and 20 foci in which the diagnosis of tuberculosis wasn`t confirmed (control-group) were conducted.

Results and its discussion. As it turns out that in the most cases of the development of HIV-associated TB, the primary diagnosis of HIV infection preceded the primary diagnosis of tuberculosis. According to the results of the case-control analytical epidemiological study, such risk factors of HIV-infected tuberculosis as lack of family, higher education and regular job, the fact of deprivation of liberty and drug users (as a reflection of the low social status of patients), as well as contact with tuberculosis patient were identified. Risk factors for mycobacteria infection in people without HIV infection were only the lack of family and contact with tuberculosis patients.

The aim of the study was to explore the common misconceptions about HIV as a determinant of the HIV epidemic growth and as a factor affecting disease outcomes.

Materials and methods. The study involved 136 persons (50 persons with blood-borne infection route, 50 persons with heterosexual transmission, 36 persons without HIV). As research methods a special clinical map was used, as well as an author’s questionnaire, which allows to register the characteristics of risky behavior in relation to infection and the characteristics of the life situation of the disease. Statistical data processing included the definition of primary statistics, the Fisher criterion, ANOVA.

Study results. A frequent occurrence of distorted representations about HIV was noted in all groups. It has been established that people living with HIV and healthy respondents do not differ in the frequency of HIV testing. The features of the life situation of the disease related to the method of the disease transmission were revealed in the study. It has been established that people living with HIV with different infection route differ in the frequency of late HIV diagnosis, the presence of AIDS, refusal of treatment. The results determine the need to increase public awareness of the disease and correct distorted representations about it.

Objective: this study aims to analyze the use of antiretroviral therapy and its efficacy in HIV-infected patients in 5 regions of Russian Federation.

Materials and methods: the research protocol included a retrospective analysis of the regional Centers for the Prevention and Control of AIDS registers and medical records of patients. Inclusion criteria were a verified diagnosis of HIV infection. The first group included patients (n=1161) receiving antiretroviral therapy regimens at the latest by 01/01/2015, the second group included patients with no antiretroviral therapy before 01/01/2015 (n=1366). The groups were compared with each other by socio-demographic indicators and characteristics of HIV infection, including infection routes, stage of the disease and its natural course.

Results: Group I showed a higher prevalence of patients with an undetectable viral load (60,7%) comparing to group II (p<0,05) where a low (70,9%) and high (8,5%) viral load was observed. There was a dynamic decrease in patients’ numbers with severe immunodeficiency by 12.6% and an increase in the average amount of CD4+ in group I.

Purpose. To analyze the epidemiological situation and perinatal HIV infection in the Vologda region.

Materials and methods. The article provides a retrospective and prospective analysis of data obtained from the forms of state statistical observation and accounting forms of medical documentation, using the Chi-square calculator, Fisher criterion, risk ratio to assess the effectiveness of measures to prevent perinatal HIV transmission in the Vologda region.

The results of the study showed that the detection of HIV infection during pregnancy in the Vologda region tends to increase. At the same time, there are still problems such as adherence to dispensary monitoring and treatment in women who have drug dependence, which requires further improvement of the legal framework and clear implementation of approved algorithms by medical professionals.

Aim objective. The study aimed at determining the facility for bronchoscopic examination and management of HIV-infected patients.

Materials and methods. Results of a total of 1393 bronchoscopic procedures carried out in HIV-infected patients (100%) hospitalized in the pulmonology departments with different pulmonologic disorders. The HIV-infection was a comorbidity at that.

Results. In terms of study process organization two patient flows have been discerned. The first flow included patients with asymptomatic infection/carrier state (138 bronchoscopic procedures [9,91%] for 104 patients), for whom bronchoscopy was performed due to general indications. The second flow comprised patients with a full-scale clinical picture of the disease (1255 bronchoscopic procedures [90,09%] for 1099 patients). The second flow was divided into two groups, namely, patients with earlier diagnosed HIV-infection (group IIА amounting to 523 bronchoscopic procedures [37,54%] for 473 patients) and patients newly diagnosed with HIV infection (group IIВ; 732 bronchoscopic procedures [52,55%] for 626 patients). Common to both groups was the absence of urgent indications for bronchoscopy, although the elective indications were different between the groups. In all instances the endobronchial symptoms were either non-specific or reflected mucosal lesions in the large bronchi related to lung tumor or tuberculosis.

Aim: to conduct analysis of morbidity with different forms of syphilis in Novosibirsk for the period from 2014 to 2018 and to study medical and social features of patients with syphilis and HIV-infection and to identify the main way of infection.

Materials and methods. In order to study the structure of syphilis morbidity in Novosibirsk Clinical Regional Dermatovenerologic Dispensary (SBHI NR NCRDD), the retrospective study of 2175 case histories of patients who had being hospitalized during the period of 2014 to 2018 was conducted.

Results and discussions. 3.4% of patients being hospitalized suffer from syphilis. Herewith, newly diagnosed HIV-infection was found in 21.3% of patients. Half the patients are of socially disadvantaged backgrounds characterized by risky sexual behavior. Authors presented medical and social, and psychological profile of patients with syphilis and HIV-coinfection. Obtained results may be used for developing effective programs of prophylaxis and treatment of specified diseases.

The purpose of the study is to determine the current trends in the development of the HIV epidemic process for individual subjects of the Ural Federal district (UFD) and the possibility of corrective measures to update the practice based on the results of screening tests for HIV antibodies.

Materials and methods. The study used information from form 4 of the Federal statistical observation «Information on the results of blood tests for HIV antibodies» in the amount of 26,1 million studies for 2009–2018, information from 2,488 questionnaires from two biopsychological studies among commercial sex workers (CSR) and persons in prison. Research result. It was found that, despite the increase in the incidence of HIV infection in the period 2009–2018, the estimated Hurst indicator for the studied time period characterized the long-term dynamics of the incidence as antipersistent. Among MSM and patients with STIs, there is a marked tendency to increase the detection of HIV infection. Among commercial sex workers (CSR) and people in prison, the results of a sentinel bio-behavioral study found high detection of HIV antibodies against the background of risky sexual behavior.

According to the indicators of the frequency of detection of antibodies to HIV in screening studies, the territories of the greatest potential risk of HIV infection were determined. In dynamics, there was an increase in the number of studies and the detection of HIV infection among those examined for clinical and epidemic indications (codes 113, 120) and stabilization of the detection of HIV infection among injecting drug users (code 102).

Conclusion. In the period 2016–2018, the sexual route of infection became predominant among HIV-infected people. The greatest intensity of HIV infection was observed among such categories of the population covered by official statistics and who are representatives of groups with a predominant HIV infection, such as MSM and patients with STIs. At the same time, there was a decrease in HIV surveys among these populations with an increase in detection.

The results of behavioral studies among DCS and persons in prison demonstrate high detection of HIV antibodies among them, as well as the presence of risky sexual behavior. Screening for HIV infection requires additional optimization.

The aim of the study was to study comorbidity in HIV (+) and HIV (–) patients with tuberculosis spondylitis (TS) and to assess the influence of certain perioperative risk factors on the formation of early and late postoperative infectious complications.

Materials and methods. A retrospective analysis of 274 patients with TS was performed: 116/43.2% of patients HIV (+) (group 1) and 158/57,7% HIV (–) (group 2). We studied the risk factors for postoperative complications: age, alimentary disorders, concomitant diseases, and the risk of surgical intervention on the ASA scale.

Research result. TC patients in 88,3% of cases had comorbidities (ASA Class 3–4). Early and late infectious complications were 1,5–2 times more common in TC patients with ASA Class 4 than in ASA Class 3. In the HIV (+) group, early infectious complications prevailed, while in HIV (–) patients, these complications occurred with the same frequency. Late postoperative complications were 3–5 times more common in HIV (+) patients (OR=2,84 and OR=8,56, respectively).

Aim objective is to study the relationship between the viability of HIV-infected women and their psychological state, lifelong orientations, and coping strategies for developing psychological intervention.

Materials and methods. The study participants were patients of the St. Petersburg Center for the Prevention and Control of AIDS. The questionnaire includes the socio-demographic characteristics of women. «Resilience Test» S. Muddy, test «Meaningful Life Orientations» (SJO) D. A. Leont’ev, Stress Management Strategies (SACS) Questionnaire C. Hobfall, the SSD-12 scale evaluates the psychological stress associated with somatic symptoms. The Impact of Event Scale is designed to measure specific human responses to stressors, where a common scale measures the degree to which a response to HIV infection is a traumatic event.

Results. The average age of women who participated in the training is 38.9 years. 48,1% (13/27) have higher education. 37% (10/27) have No children. 48,1% (13/27) of women are single (do not have a permanent sexual partner). 33,3% (9/27) of the participants were diagnosed with HIV infection less than a year ago. The training included a complex of three classes. Participants gathered once a week from 6 p.m. to 8 p.m. The group was open. Those who completed a set of three classes were asked to fill out a feedback form. The indicators of the «Resilience» test at a high level of statistical significance are positively associated with the indicators of the LSS «General Intelligence», «Goals in Life», «Life Process», «Life Efficiency», «Locus of Control-I», «Locus of Control-Life». The severity of the perception of the diagnosis of HIV infection as a traumatic event has a two-way connection with psychological tension (at the cognitive, affective and behavioral levels), a negative connection with the meaning of life orientations and the need to find the «source» of the meaning of life at the moment. The traumatic effect of HIV infection is associated with aggressive behavior, difficulties in the meaningfulness of what is happening, with a loss of vigilance and self-confidence.