The analytical review allows us to look at the problem of long-term consequences of coronavirus infection from the standpoint of synergistic interaction of herpesvirus pathogens and SARS-CoV-2. The authors provide data of the incidence of long-term post-COVID syndrome (Long COVID), the prevalence of herpesvirus diseases, and possible pathogenetic and clinical intersections in the formation of post-viral consequences in humans. The variety of clinical manifestations of Long COVID, possible causes of these symptoms are described, and data of the potential role of human herpesviruses in the development of central nervous system lesions and the formation of cognitive impairment are presented. Particular attention is paid to the immunological link in the pathogenesis of a number of herpes-associated diseases and Long COVID. Currently, not all mechanisms of damage to organs and systems in post-COVID syndrome have been studied and discovered, especially with the mutually aggravating effects of coronaviruses and human herpesviruses. Further research will provide new information and a more complete picture of cause-and-effect relationships in describing and explaining the immediate and long-term consequences of the viral infections under consideration, the formation of Long COVID, as well as potential targets for in-depth examination of patients and therapeutic measures.

The aim: to analyse of the clinical manifestations of the effects of COVID-19 in residents of the Osh region of the Kyrgyz republic.

Materials and methods. During the study, Osh city and the Osh region of the Kyrgyz republic were selected, where the COVID-19 pandemic began. The study included patients diagnosed with COVID-19 who received treatment in the infectious diseases department of the Osh interregional clinical hospital for the period 2020–2022. To study the post-COVID syndrome, 252 patients were followed up for a long time, some of them dropped out of observation, mainly people over 70 years old, due to refusal to constantly visit a medical institution and due to death. The observed group of patients contacted medical institutions when they had any complaints and felt worse. The patients were examined by doctors of family doctor centers at the place of residence, if necessary, they were consulted by doctors of narrow specialties. the patient data after extraction from the electronic medical record were aggregated for statistical analysis. The R-studio software (version 4.0.3) was used for statistical processing of the results. The calculation and visualization of clinical symptoms in a comparative aspect, depending on the strain and by week, were carried out using the following indicators: median (IQR); n (%), Wilcoxon rank sum test; Pearson’s Chi-Squared Test.

Results and discussion. Monitoring of the condition of patients after acute COVID-19 at the 12th, 24th, 48th, 96th week established the preservation of almost all syndromes of the acute phase of coronavirus infection and the multisystem clinical manifestations with the appearance of new symptoms. The most common consequences of COVID-19 were asthenic syndrome (69.04%), neurological disorders (55.9%) and respiratory manifestations (56.3%). Less pronounced symptoms of the acute form of COVID-19 had a significant impact in the post-ovarian period, manifested by gastrointestinal syndrome (36.1%), mental disorders (28.1%) and cardiovascular disorders (26.6%). New clinical symptoms that were not observed in the acute period were identified: metabolic syndrome (19.4%), problems of the musculoskeletal system, sweating, allergies, leg swelling, dandruff (16.6%). Patients who had an infection caused by the B strain were more likely to develop heartburn, hypomnesia, ageusia and allergic reactions. While after the disease associated with the Omicron strain, patients were more likely to complain of arthralgia, hand and foot anesthesia, headache, snoring in their sleep, fatigue, hypertension and hyperglycemia. A direct influence on the occurrence of the consequences of COVID-19 was exerted by: the Omicron strain, the severity of the disease, severe pneumonia with extensive lung damage (CT-3 and CT-4), high inflammation (CRP), self-medication with early use of antibiotics and corticosteroids (70.1% and 78%, respectively).

Conclusion. Long-term follow-up of patients who underwent COVID-19 showed the development of post-COVID syndrome in 69% of cases with multisystem manifestations. Our results complement the growing number of studies on the study of postovoid syndrome. The dominant clinical consequences of COVID-19 are neurological and asthenic syndromes. The occurrence of post-COVID syndrome was influenced by the strain of the SARS-CoV-2 virus, the severity of clinical and instrumental changes and methods of treatment of the acute phase. A wide range of clinical symptoms of post-COVID syndrome require further research to better understand the long-term effects of infection caused by SARS-CoV-2 and to form recommendations for the treatment of people with post-COVID syndrome.

The aim. To evaluate age/gender differences in life losses and losses related to decrease in social and labor functioning, caused by HIV among population in Russia.

Materials and methods. In ecological study, losses caused by premature mortality adjusted for decrease in labor and social functioning (DALY), caused by HIV were calculated, using adapted methodology among men and women of different ages in Russia for 2016 and 2022. HIV morbidity and mortality data obtained from FEDERAL statistical observation forms were used.

Results and discussion. In Russia the DALY due to HIV decreased overall by 1.5 times in 2016–2022. In DALY structure, the YLL was prevailed among 35–44 age group and mostly in men, amounting to 1870.6 in 2016, and 1341.4 per 100 000 of corresponding age/gender population in 2022. Among women the YLD was prevailed, with the YLD/YLL ratio in 2016 being 1:1.5; in 2022 this ratio became equal. There is increase in the YLL and YLD among group aged 45 years and older. Among women and men of working past age, the YLL in 2016–2022 increased by 1.5 and 1.3 times respectively, when among women and men of working-age, the indicator, on the contrary, decreased by 1.1 and 1.2 times respectively. Among girls, the YLL in 2022 was more than 4 times (p < 0.001) higher, than similar indicators among young men.

Conclusion. Prevailing of losses caused by HIV/AIDS premature mortality (YLL) among working-age population is unfavorable factor, worsening public health quality in terms of preserving human resources, it indicates the need of strengthening measures to reduce HIV burden in country.

Introduction. At the present stage, the main goal of treating children with HIV infection is to significantly improve the quality and life expectancy of an infected child, reduce morbidity and mortality, and create and maintain at a high level all conditions and opportunities for full and productive life in adulthood. In 2023, the proportion of adolescents among children with HIV infection increased and reached 57%. This group of children requires special attention from specialist doctors due to their agerelated physiological and psychological characteristics, which affects their commitment to monitoring and treatment. Children with HIV infection have a high degree of immaturity of the central nervous system at birth, HIV disrupts the formation of important structures such as myelination, synapse formation, and cortical maturation. Neurocognitive deficits can be detected in HIV-infected children both in preschool and school age. ART does not lead to an improvement in cognitive processes, even with normalization of indicato immunity and undetectable viral load. According to literature data, the constant use of ART in young people and the absence of substance abuse were significant factors influencing suppressed viral load and employment.

The aim: to present the clinical and socio-psychological characteristics of patients with perinatal HIV infection.

Materials and methods. 100 patients with perinatal HIV infection were monitored, of which 44 were male (44.0%) and 56 were female (56.0%). The average age was 20.6±1.6 years (the patients ranged in age from 17 to 24 years). HIV infection was diagnosed between the ages of one month and 15 years (7.0±0.5 years). ART was also started at the age of one to 15 years (6.2±0.6 years). According to the stages of HIV infection, patients were distributed as follows: stage 4A — 28 (28.0%), stage 4B — 6 (6.0%) and stage 4B-66 (66.0%) (Russian classification, 2006).

Results and discussion. All observed patients receive ART, and with 86 young people (86.0%) have a high commitment and undetectable high blood pressure, while 14 (14.0%) take therapy irregularly. Patients with low adherence, compared with young people who regularly take ART, have significantly higher levels of HIV RNA in their blood, low CD4 lymphocyte counts (moderate immunodeficiency), and all patients in this group have stage 4B HIV infection with CNS damage, later diagnosis of perinatal HIV infection, and are being educated in government institutions. or in foster families with only basic general education, neurocognitive impairments are noted during psychological tests. Despite regular use of ART medications, in the group of patients with a high commitment to monitoring and treatment, almost one in three young people has a low commitment, according to the Morisky-Green questionnaire, which requires more careful monitoring by doctors, relatives, psychologists and social services.

Conclusions. The group of young people with perinatal HIV infection with low commitment to follow-up and treatment is the most vulnerable in terms of the unfavorable course and prognosis of HIV infection, employment, as well as the risk of HIV transmission to sexual partners and their children.

The aim of the study: to assess the vascular endothelial status (based on brachial artery ultrasound data and the Celermajer test) and glucose metabolism markers (insulin, glucose levels, HOMA-IR index) in young patients with perinatal HIV infection.

Materials and methods. The study included 83 young HIV-infected patients aged 18 years or older registered at the St. Petersburg AIDS Center. The main group (n=57) consisted of patients with perinatal HIV infection (PHIV), while the control group (n=26) included individuals infected via sexual transmission.

Results and discussion. In the main group, 46 patients (80.7%) had normal blood glucose levels (3.3–5.5 mmol/L), compared to 11.6% in the control group. Normal insulin levels were observed in 84.2% of the main group and 77% of the control group. A pathological HOMA-IR index was significantly more frequent in the main group (p0.05). Both groups exhibited early signs of endothelial impairment at ages 20–25, with intima-media thickness (IMT) within normal ranges. However, males with PHIV showed significantly more frequent deviations toward increased IMT (p=0.049).

Conclusion. Markers of glucose metabolism disorders, insulin resistance, and vascular endothelial dysfunction were identified in young patients with perinatal and sexually acquired HIV. However, PHIV patients demonstrated earlier and more pronounced changes.

The aim of the study. Identification of psychological characteristics of HIV-infected patients in a penitentiary institution using the Shmishek questionnaire.

Materials and methods. A total of 629 results of psychological testing of individuals in the penitentiary system were examined using the Shmishek questionnaire: 2 groups: the first — 110 (17.5%) patients with HIV infection; the second — 519 (82.5%) without HIV infection.

Results. Patients with HIV infection, in comparison with the second group, differ in their psychological characteristics (according to the Shmishek questionnaire, the type of character accentuation): excitable less often by 10–15%, hyperthymic more often by 3–3.5%, demonstrative less often by 3–3.5%, dysthymic less often by 15%, stuck — equally likely, anxious less often by 10– 15%, cyclothymic — equally likely, exalted more often by 3–3.5%, emotive less often by 3–3.5%, pedantic less often by 3–3.5%.

Conclusion. A study conducted jointly by scientists in the field of medicine and psychology showed the importance of including psychologists in the staff of departments specialized for patients with secondary diseases of HIV infection.

The aim: to characterize modern epidemic trends of viral hepatitis C and its outcomes in the Russian Federation and NorthWest Russia.

Material and methods. The retrospective epidemiological analysis of hepatitis C incidence in the Russian Federation and Northwestern Federal District was carried out according to the data of state statistical reporting (Form No 2 and Form No 65), analytical tables (Saint Petersburg Pasteur Research Institute of Epidemiology and Microbiology, Central Research Institute of Epidemiology of Rospotrebnadzor). The study included 700 patients with HCV in the day hospital of S. P. Botkin Clinical Infectious Diseases from 2016 to 2022. Epidemiological and statistical methods of research (statistical package SPSS, software product «WinPepi») were used in the work.

Results and discussion. After a strong tendency of decline in the incidence of HCV in the Russian Federation in 2001–2021, a statistically significant increase to 0.75 and 0.95 per 100,000 population (2022–2023) is observed. Since 2011 in the Russia Federation — predominance of HCV among first-time registered cases of chronic viral hepatitis (78.7% in 2023). During the postpandemic period, there is an increase in the incidence rate of HCV (in 2023 exceeds HBV by 3.7 times), but below the annual average by 13.7%, with an increase in the cumulative number of patients. Similar trends are also noted in the Northwestern Federal District. According to the data of Form 65 in the Russia Federation, Northwestern Federal District and our own observation, a quarter of patients require urgent treatment (F3, F4 according to METAVIR) with prevalence of 1b and 3a genotype. In 2021–2023 increase in the incidence of fatal outcomes from liver diseases caused by HCV. In 2023 in the Russia Federation specific therapy for HCV 7% of those in need, but for the first time the number of those treated exceeded the number of those detected.

Conclusion. Effective prevention measures may include strategies for minimizing harm, such as safe injection practices. When highly effective antiviral drugs become available, focus should be placed on the availability of screening and treatment for atrisk patients. The ideal prevention solution would be a hepatitis C vaccine, but due to the genetic diversity of the virus and the poor understanding of the immune response, its development is still at an early preclinical stage.

The aim of the study was to study the prevalence of latent tuberculosis infection (LTBI) and the incidence of active forms of tuberculosis (TB) depending on the implementation of preventive therapy for tuberculosis (PT) in patients with HIV infection.

Materials and methods. As part of a retrospective analysis of the registry information of regional TB surveillance system, the data of 33,414 patients with HIV infection who first visited a tTB doctor in 2016–2023 were studied. The observation period ranged from 1 to 8 years. In 2016–2023, 745 cases of tuberculosis were identified among patients. To solve the research aims, three samples were made. An assessment of the characteristics of patients who visited a tuberculosis specialist in 2016–2023 was carried out based on the data of 31,614 patients with HIV infection who were not TB diagnosed or suspected of having tuberculosis during the initial screening and who were not registered with a TB institution as a patient with active forms of the disease. To assess the detection of LTBI during the first visit to the office, an analysis of data from 25,848 patients was performed, in whom tuberculosis was not detected during the first visit registered in 2016–2023, and the immunological test results using the recombinant tuberculosis allergen were known. Among 24,581 patients from the above-mentioned persons, in whom LTBI was not detected during the first visit to the office, an assessment of LTBI detection was performed during repeat visits to a TB specialist. To analyze the incidence of tuberculosis depending on the implementation of preventive therapy (PT) in 2017–2023, data from 30,195 patients who first visited a TB specialist in 2016–2022 and who had no TB history either before the first visit or during the first three months after the first visit were reviewed. The annual incidence of tuberculosis was compared in patients who did not receive PT, with a one-year observation period 90 days after the first visit to a TB doctor; and in those who received PT, with a one-year observation period 6 months after the start of the PT course.

Results and discussion. In 2016–2023, the proportion of people with LTBI at the first visit to a doctor fluctuated between 3.4% (in the «covid» year of the COVID-19 pandemic) to 5.2%, with an average value of 4.6% (95% CI: 4.3–4.8%). During repeat visits to a doctor, LTBI was detected annually in 2.2–2.8% of people. Comparison of the annual incidence of tuberculosis in two groups: those who did not receive and those who received preventive therapy showed that preventive therapy against tuberculosis reduces the chance of developing tuberculosis by almost half (OR=1.9, 95% CI: 1.2–2.9). For people who did not receive antiretroviral therapy, the chance of developing tuberculosis decreases by 3.5 times (OR=3.5, 95% CI: 1.3–9.4). In patients with CD4+ lymphocyte levels less than 350 cells/ml, the probability of developing the disease decreased by 3.5 times (OR=3.5, 95% CI: 2.0–6.1). In patients with HIV/LTBI, in the absence of a full course of preventive therapy for tuberculosis, the chance of developing tuberculosis increased more than 4 times (OR=4.2, 95% CI: 1.5–11.7).

Conclusion: Using a large data set of HIV-infected patients visiting a TB specialist, the prevalence of LTBI was assessed and statistically significant effectiveness of PT was demonstrated, especially in patients with low CD4+ levels and LTBI.

The aim of the study is to describe a clinical case of severe abacavir-associated hypersensitive reaction — a specific side effect of antiretroviral therapy, manifested by various symptoms, requiring treatment in the intensive care unit — and to discuss possible pathogenetic mechanisms of hypersensitivity reaction development. The study methods were clinical observation of the patient and subsequent study of the medical history, as well as examination of scientific publications on the topic of the study. The features of this event are: failure to perform screening diagnostics of HLA-B*57:01 before modifying the antiretroviral therapy regimen — prescribing abacavir; patient’s lack of awareness of possible manifestations of hypersensitivity reaction and the procedure for detecting its symptoms; atypical clinical picture of the hypersensitivity reaction, expressed in the absence of the characteristic and most common exanthema syndrome.

This clinical case presents a combined herpes virus infection (cytomegalovirus and HSV-2) in a 55-year-old female patient after allogeneic hematopoietic stem cell transplantation, which manifested as colitis. Despite prophylactic use of acyclovir, viral reactivation occurred, indicating the need for long-term antiviral prophylaxis. The diagnostic process was complicated by non-specific clinical presentation and negative results of polymerase chain reaction and serological tests, which required morphological and immunohistochemical examination of biopsy specimens. This clinical case demonstrates the peculiarities of diagnosis and treatment of herpes virus infections in immunocompromised patients after bone marrow transplantation.

The relevance of the problem of HIV infection is beyond doubt due to the steady increase in the incidence rate. The aim of the study is to describe generalized cryptococcosis localized in the lungs, spleen, and thyroid gland in a patient with HIV infection. Case description. A patient born in 1985 was admitted to hospital on 12/18/2024 at 7:10 PM in serious condition with a diagnosis of community-acquired interstitial pneumonia. CT-3 (75% lung tissue damage). History of acute HIV infection (stage 2B). Despite the initiated therapy, the patient’s general condition was progressively worsening — the clinical picture of respiratory failure was increasing and on 12/18/2024 at 8:25 PM the patient suddenly experienced respiratory and cardiac arrest. Histological examination revealed leukocyte infiltration, edematous fluid, and hemosiderophages in the alveolar lumen. Foci of granulomas with cryptococci, lymphocytes, histiocytes, macrophages, and multinucleated giant cells were detected in the lungs, liver, and thyroid gland. Conclusion. The patient’s death was caused by HIV infection with the development of cryptococcosis as a secondary disease, the generalization of which caused intoxication, which was the immediate cause of death.