The aim. To analyze anamnestic data, clinical and laboratory parameters, and psychoneurological manifestations in patients in the post-COVID period.

Materials and methods. After the initial survey of 1,200 respondents who had suffered from a new coronavirus infection (COVID-19), a group of 170 patients was identified based on the presence of complaints about the state of somatic and mental health that have a temporary relationship with the SARS-CoV-2 disease. As part of the study, this group of patients underwent a comprehensive laboratory examination with an assessment of general clinical and biochemical parameters, inflammatory markers and the blood coagulation system. All patients were examined by an infectious disease specialist, a neurologist, a psychiatrist-narcologist and a medical psychologist. The main socio-demographic and clinical laboratory data in the post-COVID period, as well as neurological and psycho-emotional characteristics obtained from 130 participants in 2024, were assessed. In order to study cognitive and executive functions, psycho-emotional state, the following methods were used: Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) and SCL-90 Symptomatic Questionnaire. In addition, each respondent was asked to determine the presence and severity of the main psychopathological, neurological, cognitive and general somatic symptoms using the «Not bothered-Weakly-Moderately-Extremely» scale specially developed for the study, which included up to 38 symptoms.

Results and discussion. The majority of the sample were women (80%). Over 2⁄3 of the respondents were of working age, with an average age of 38.2±11.3 years, and 65.3% had mild forms of COVID-19. Repeated cases of COVID-19 were associated with a high risk of blood saturation decrease to ≤93% (p<0.01), while severe COVID-19 was associated with the absence of vaccination (p<0.05). Ferritin levels below 30 μg/L were recorded in 34.1% of women and 9.15% of men, which may indicate a deficiency of iron stores in the body. Hypercholesterolemia was noted in 54.9% of cases, with average total cholesterol levels of 5.52±1.19mmol/L. The total number of NCI cases (2 or more) is associated with a decrease in the number of leukocytes, an increase in the number of platelets in the blood, the percentage of monocytes, a decrease in the level of total protein, an increase in the level of total cholesterol (p<0.05). Neurological symptoms are characterized by pronounced polymorphism, with 15.3% of respondents having exhaustion or absence of superficial abdominal reflexes, 26.9% having mild cognitive impairment, and 7.7% having a significant general decline in cognitive functions. 49.5% of respondents showed signs of anxiety, and 29.4% had depressive phenomena, expressed at the subclinical or clinical level. The severity of distress caused by sensations of bodily dysfunction of a somatic, painful and/or neuromuscular nature is characteristic, as well as mild hypochondriacal tendencies in a separate group of respondents.

Conclusion. Comparison of the results of the questionnaire and in-depth study showed that cognitive and psychoneurological disorders are widespread among patients of different age groups, regardless of the severity of the COVID-19. Given the mechanism of direct and indirect effects of SARS-CoV-2 on the brain, it is the symptoms of damage to the nervous system, including cognitive functions and the psychoemotional sphere, that largely determine the clinical symptoms of post-COVID disorders. The complexity and versatility of clinical and laboratory manifestations of post-COVID syndrome require the involvement of specialists of various profiles in working with patients, the need to develop protocols and recommendations for working with people with manifestations of post-COVID syndrome.

The review analyzes the distribution, clinical manifestations and complications of preventive vaccination against COVID-19 infection, with an emphasis on the incidence and nature of neuromuscular and neurological complications, measures taken and planned to provide persons who have suffered this disease with adequate medical and psychological care, in order to maintain mental health of people and preservation of sanitary well-being of the population.

The aim. To study the results of treatment of patients with HIV infection in Russia and the subjects of the Russian Federation in dynamics for the period from 2016 to 2022.

Materials and methods. Information from the Federal Statistical Observation Form No. 61 for 2016–2022. To find correlations between the indicators characterizing the number of patients with HIV infection who were under dispensary supervision, covered by antiretroviral therapy (ART) and achieved virological suppression, data from 85 subjects of the Russian Federation (RF) for 2016–2022 were used.

Jupiter Notebook interactive computing environment (6.5.2) was used to work with data from 85 subjects of the Russian Federation for the period from 2016 to 2022. Pandas software library (1.5.3) was used for data processing and analysis, compilation and work with structured dataset. The Scipy statistical function module (1.9.3) was used to find the Spearman and t-Kendall correlation coefficients. The Scikit-learn (1.0.2) and Statsmodels (0.13.5) software libraries were used to build a trend line and find linear regression coefficients.

Results and discussion. The study of the relationship between the number of patients with HIV infection who were registered at the dispensary (HIV-infected contingents) and who received ART in 85 subjects of the Russian Federation in 2016–2022 showed that in 2016 the share of subjects of the Russian Federation with low coverage of ART of HIV-infected contingents was 38.8% of their total number. However, by the end of 2022, in all 85 regions of the Russian Federation, contingents with HIV infection were proportionally covered by ART.

An analysis of the distribution of 85 subjects of the Russian Federation in 2016–2022, depending on the relationship between the natural logarithms of the number of HIV-infected contingents who achieved virological suppression (effective ART) with the number of contingents covered by ART, revealed 11 subjects of the Russian Federation in which the percentage change in the number of contingents with effective ART exceeded the calculated value and did not correspond to the percentage changes in the number of contingents covered by ART. The results indicated the presence of defects in assessing the effectiveness of the treatment, since in these subjects of the Russian Federation the number of contingents with effective ART exceeded the number of contingents covered by ART. In 18 subjects of the Russian Federation, on the contrary, the percentage change in the number of HIV-infected patients with effective ART was lower than the calculated value and did not correspond to the percentage change in the number of patients covered by ART, that is, the effectiveness of the treatment was insufficient.

Conclusion. Currently, there is an urgent need in Russia to develop a methodology and criteria for evaluating the results and effectiveness of treatment of patients with HIV infection.

Aim of the study: conducting a comparative analysis of the socio-demographic characteristics of patients with the acute phase of HIV infection at different periods of the epidemic with a difference of 10 years (2008–2013 and 2018–2022).

Materials and methods. A retrospective analysis of 142 inpatient case histories of the Botkin Clinical Hospital and outpatient cards of the St. Petersburg AIDS Center of patients in whom HIV infection was detected in the period from 2008–2013 and 110 outpatient cards of patients in whom HIV infection was detected in 2018–2022 was carried out. A comparative assessment of social and epidemiological data of patients in the acute stage of HIV infection at different periods of the epidemic was carried out.

Results and discussion. The social profile of a person who became infected with HIV in the period 2018–2022 has changed significantly compared to the period 10 years ago. The proportion of women has increased from 33% to 38%. The average age has increased from 32.5 to 35.9 years. The parenteral route of infection has significantly decreased from 23% to 5%. The percentage of officially employed people (from 68% to 91%) and those with higher education (from 27% to 45%) has increased.

Conclusion. We conducted a comparative analysis of the socio-demographic characteristics of patients in the acute stage of HIV infection at different periods of the epidemic, as well as those infected in the periods 2008–2013 and 2018–2022. The data obtained indicate significant changes in the «portrait» of a person infected at the present stage. The average age of the patient has significantly increased. As a rule, this patient is employed and has a good education. All this must be taken into account when carrying out preventive measures.

The aim: to determine the impact of a new coronavirus infection on the course of pneumocystis pneumonia in patients with HIV infection.

Materials and methods. A retrospective analysis of 45 medical records of patients who died in the intensive care unit of the S. P. Botkin Clinical Infectious Diseases Hospital between March 2020 and January 2023 was conducted. Of the 45 patients with Pneumocystis pneumonia, the new coronavirus infection was also verified in 26 patients. Anamnestic and clinical data, laboratory and instrumental research results, pathological findings were compared in groups of patients with Pneumocystis pneumonia with/without co-infection with COVID-19.

Results and discussion. The patient groups were comparable in terms of gender, age, duration of HIV infection, severity of immunodeficiency, and intensity of HIV viremia. The main clinical manifestations (fever level, cough, signs of respiratory failure, auscultatory picture in the lungs), as well as the indicators of routine laboratory tests (hemogram, concentration of LDH, CRP, ferritin, D-dimer) did not differ statistically in the groups. The radiological picture of changes in the lungs was similar, as well as the duration of hospital stay (bed days) in the groups did not differ. Analysis of the results of pathological reports showed that in most cases (²⁄3of patients), COVID-19 did not have a significant impact on the course and outcome of the disease, being a concomitant pathology. However, in every third patient, signs of viral pneumonia were postmortem along with specific Pneumocystis cystic lung damage.

Conclusion. COVID-19 coronavirus infection in patients with pneumocystosis does not significantly change the clinical picture, laboratory and radiological manifestations of pneumonia and in most cases does not affect its course and outcome. However, in a third of cases, coronavirus pneumonia was the cause of death along with pneumocystis.

The aim. Analysis of the development of the disease and complications, similarities and differences in clinical and radiation signs of non-Hodgkin’s lymphomas (diffuse B-large cell lymphoma, Burkitt’s lymphoma, plasmoblastic lymphoma), both in HIV-positive and immunocompetent patients.

Materials and methods. Within the framework of this study, data obtained by radiological examination methods of 125 patients with non-Hodgkin’s lymphomas who were treated in the period from 2016 to 2023 at the hematology department of the Surgut District Hospital were studied and analyzed.

Results and discussion. In the group of patients with HIV infection, complaints upon admission were most often nonspecific and indicated an inflammatory process. HIV-NHL was characterized by: atypical localization, in most cases it was an extranodal lesion; the development of urgent conditions against the background of lymphoma. During the initial examination, HIVNHL was diagnosed at stage 3–4 of the malignant process. During the dynamic observation, a high frequency of secondary infection was noted: tuberculosis, CMV infection and fungal lesions. In the group of immunocompetent patients, the main location of NHL was the lymph nodes of the mediastinal group, the abdominal cavity. The malignant process was diagnosed mainly at 1–2 stages of the disease. The exception in this group was PBL, which in all cases was detected at stage 4 of the disease, was characterized by a large lesion volume, a high frequency of secondary infections and 100% mortality.

Conclusion. When managing patients with HIV-NHL, it is necessary to perform multi-slice computed tomography (MSCT) with intravenous contrast, which is highly sensitive, allows clinicians to accurately assess the extent of tumor spread, plan excisional biopsy, and evaluate the results of treatment.

A significant proportion of HIV-infected deceased persons are autopsied in forensic medical examination institutions. However, a detailed analysis of such observations is not carried out.

Aim of the study. The study was conducted to identify medical and social characteristics and causes of death of patients with HIV infection based on the results of independent epidemiological monitoring based on the work of the forensic medical bureau of St. Petersburg.

Material and methods. The analysis and detailing of the structure of mortality from HIV infection in dynamics over the past five years from 2018 to 2022 was performed. Quantitative indicators were obtained reflecting the forensic diagnosis of HIV infection as the main (initial) and concomitant diseases, with distribution by gender and age, the frequency of occurrence of HIV-associated diseases.

Results and discussion. Of the 268 deceased HIV-infected patients over the analyzed five-year period, the proportion of women was 22.4%, men — 77.6%, there is a tendency towards an annual increase in the number of deaths in older age groups. The main causes of death were: «external causes» (poisoning with psychoactive substances, various types of injuries, suicides)— in 101 (37.8%), HIV infection in the AIDS stage (TB, HIV-associated cancer) — in 73 (26.9%) new coronavirus infection (in 2020–2022) — in 13 (10.7%) people. Concomitant diseases against the background of HIV infection were identified in 262 (98%) patients, the most common being chronic viral hepatitis (37%), fatty liver disease (23.4%), cardiovascular diseases (23.2%), pneumonia (16.4%), and oncopathology (4.2%).

Conclusion. Thus, the analysis of the obtained data demonstrated an annual decrease in the number of patients with HIV infection admitted to the BSME for determining the cause of death. Nevertheless, a detailed analysis of the autopsy materials conducted in the forensic medical service system over the past 5 years made it possible to identify the key signs and significance of HIV infection when considering the causes of death, and to obtain information on the structure of concomitant and opportunistic diseases in patients.

The aim of the study. The comparison of genetic diversity of Rev protein in HIV-1 sub-subtype A6 in people living with HIV (PLHIV) with different stages of the disease.

Materials and methods. 227 whole blood clinical samples received from PLHIV who have not had previously treatment and observed in Moscow Regional Center for the Prevention and Control of AIDS and Infectious Diseases were analyzed. The extraction of proviral DNA, the amplification of the first and the second rev exons with the followed sequencing was carried out. Subtyping was conducted by analyzing the rev second exon. Then the conservatism and amino acid substitutions in Rev sequences were compared in patients from different groups.

Results and discussion. 220/227 (96.9%) samples contained HIV-1 sub-subtype A6. In patients with IV stage of the disease the conservation in Rev was significantly lower. There were found two substitutions (L13I, S113P) with a statistically significant difference in occurrence in PLHIV with different stages of HIV infection.

Conclusion. The results obtained confirm the hypothesis of correlation between Rev structure and course of HIV infection and indicate the necessity for further research on this field.

The aim of our study was to assess the prevalence of serological and molecular biological markers of parenteral viral hepatitis B and C among international migrants in the North-West Federal District (NWFD).

Materials and methods. The study included 537 blood plasma samples obtained from foreign nationals from 46 countries who underwent medical examination to obtain a work permit in the Migration Department of the North-West Federal District. We assayed for the presence of serological (anti-HCV IgG, HBsAg, anti-HBs IgG, anti-HBs IgG) and molecular biological (HCV RNA, HBV DNA) markers.

Results and discussion. More than 80% of the examined citizens belonged to 11 out of 46 represented countries. The analysis revealed 6.1% of persons with anti-HCV IgG antibodies and 2.6% with HBsAg. HCV RNA and HBV DNA were detected in 2.79% and 8.19%, respectively. Among HCV RNA-positive individuals, four (0.74%) were undetectable for anti-HCV. 6.15% of HBsAg-negative hepatitis B patients were detected. The contribution of migrants’ countries of origin to the frequencies of serological and molecular biological markers of hepatitis B and C identified in the surveyed group is discussed.

Conclusion. The study of migration processes and associated flows of socially significant infections plays a key role in controlling the spread of infectious diseases on the territory of the Russian Federation, including the strengthening of the Russian Federation’s strategy for the elimination of viral hepatitis.

HIV infection has been a global medical and social problem for all mankind for several decades. In recent years, significant changes have occurred in the structure of patients in Russia— the incidence decreases slightly, the effectiveness of treatment increases, but at the same time, with an increase in the length of the disease, the number of patients with comorbid conditions increases.

The aim of the study was to present the gender characteristics of HIV patients in a region with a high prevalence of HIV infection.

Materials and methods. 396 patients registered at the dispensary at the Center for the prevention and control of AIDS for at least a year were examined. Statistical processing was performed using the IBM SPSS Statistics 22.0 program.

Results and discussion. Males made up the majority — 66.41%. More than half of the patients were aged 36–45 years (53.79%). The majority of the surveyed were unemployed — 61.87% (n=245). Among 396 patients with HIV infection, 12.63% (n=50) were users of injectable narcotic drugs at the time of the examination. 44.95% (n=178) had previously accepted IDUs. In men, the parenteral route of HIV transmission is 4.8 times more frequent than the sexual one (²=197.37, p=0.0000), in women the sexual one prevails (²=9.06; p=0.026). Most have stage 4A HIV, and adherence to treatment is twice as high in women. The opportunistic infections characteristic of HIV did not differ between men and women. The majority of patients (92.42%; n=366/396) had several diseases associated with HIV infection.

Conclusion. The disease still affects young people and mainly men (p=0.01) — injecting drug users, unemployed people who were previously in prison. It is necessary to optimize measures not only for the preventive treatment of tuberculosis, but also to reduce addictions, primarily narcotic and tobacco, treatment of opportunistic infections and increase adherence to ART.

The number of patients with HIV infection in the Russian Federation is increasing, which requires wider implementation of antiretroviral therapy and, accordingly, criteria for assessing its effectiveness.

Purpose of the study. To present for consideration a clinical case of tuberculosis combined with HIV infection, with a paradoxically high increase in the number of CD4 lymphocytes in the inflammatory syndrome of immune reconstitution, which does not meet the accepted criteria for assessing the effectiveness of treatment.

Materials and methods. Dynamic monitoring of the results of treatment of a patient with tuberculosis combined with HIV infection. Research methods: clinical, radiological, laboratory and microbiological.

Results and its discussion. In a patient with tuberculosis combined with HIV infection, a paradoxically high increase in the number of CD4 lymphocytes (15 times) is possible with inflammatory syndrome of immune restoration, followed by a sharp decrease.

Conclusion. Approaches to developing criteria for assessing the effectiveness of treatment for patients with tuberculosis combined with HIV infection require further research and additional recommendations.