The advent of combination antiretroviral therapy (ART) has profoundly modified the oncologic landscape in people living with HIV (PLWH), shifting the burden from AIDS-defining malignancies towards non-AIDS-defining cancers. Against this background, endometrial adenocarcinoma in women living with HIV is gaining clinical relevance as a hormone dependent solid tumour in which classical metabolic and reproductive risk factors intersect with HIV related immune dysfunction and chronic inflammation. The aim. To summarise recent evidence on the epidemiology, risk factors, morphologic and molecular features of endometrial adenocarcinoma in women living with HIV, and on the impact of immune status and ART on disease course and outcomes. Material and methods. A focused search of PubMed, Scopus and Web of Science was performed for 2021–2025 using combinations of the terms «endometrial cancer», «endometrial carcinoma», «HIV infection», «women living with HIV», «nonAIDS-defining cancers», «molecular classification», and «tumor immune microenvironment». Original studies, meta-analyses, systematic reviews and international guidelines were included. Results and discussion. As PLWH age and life expectancy improves under effective ART, the incidence of hormone driven solid tumours, including endometrial adenocarcinoma, is increasing. In women with HIV, endometrial cancer risk is shaped by the combination of traditional determinants (obesity, metabolic syndrome, unopposed estrogen exposure, late menopause) and HIV-specific factors (prolonged immunosuppression, low nadir CD4⁺ count, high historical viral load, chronic immune activation). Contemporary data support the applicability of the four-tier molecular classification (POLE-mut, MMRd, p53abn, NSMP) and ESGO/ESTRO/ESP and FIGO-based integrated risk models to this population, although dedicated validation is lacking. Emerging studies highlight the role of the tumour immune microenvironment, the frequency of MMRd and high tumour mutational burden as prognostic and predictive markers for immune checkpoint inhibitors in selected patients. Conclusions. Endometrial adenocarcinoma in women living with HIV represents an emerging clinicopathologic challenge that requires coordinated management by infectious disease specialists, gynaecologic oncologists and pathologists. Prospective, HIV-focused multicentre studies are needed to refine risk estimates, validate molecularly informed prognostic models and develop tailored strategies for screening, treatment and long-term surveillance in this high risk group.

This analytical review consists of two interconnected parts devoted to human herpesvirus type 4, or Epstein–Barr virus (HHV-4, EBV). The first part examines the characteristics of the epidemic process and spread of EBV infection, the cytomorphological characteristics of the viral particle, and aspects of the etiopathogenesis of EBV-associated diseases in humans. Particular attention is paid to the unique molecular genetic stages and forms of EBV, risk factors that increase susceptibility to the pathogen, and conditions that promote viral reactivation. The presented data demonstrate a complex interaction between the pathogen and the human immune system, including mechanisms that facilitate lifelong persistence of the virus in the body.

The aim of the work is to establish patterns of changes in the taxonomic composition and functional activity of the intestinal microbiota depending on the clinical stage of HIV infection, the level of viral load and the number of CD4-lymphocytes with the determination of prognostic markers of disease progression. Materials and methods. A prospective cohort study of 347 patients with verified HIV infection and 78 healthy volunteers was conducted from January 2021 to December 2023. Taxonomic analysis of the microbiota was performed by high-throughput sequencing of the variable regions V3–V4 of the 16S rRNA gene on the Illumina MiSeq platform with determination of the viral load by PCR and counting of CD4-lymphocytes by flow cytometry. Results and discussion. A progressive decrease in microbial richness was revealed as HIV infection worsened, with a decrease in the Shannon index from 4.12±0.34 in the control to 1.94±0.29 at the terminal stage. A strong negative correlation was established between microbiota diversity and viral load, and a positive correlation with the number of CD4-cells. The relative representation of Proteobacteria increased from 8.1% to 41.7%, while the proportion of Firmicutes decreased from 68.4% to 34.2% with disease progression. Conclusions. The progression of HIV infection is naturally accompanied by the formation of severe dysbiosis with a critical decrease in microbial diversity at a CD4-cell level of less than 200/μl, which allows the use of microbiological parameters as additional prognostic biomarkers of the disease course.

The aim of the study was to evaluate the informative value of the HCV core antigen in the diagnosis of HCV infection. Materials and methods. HCV core antigen was detected by immunoassay using an ARCHITECT ABBOTT i1000SR automated immunoassay analyzer (Abbott, USA, 2013) in three groups of patients: group 1 — 201 patients with HCV monoinfection without HIV or HBV coinfections and without prior antiviral treatment for HCV infection with direct-acting antiviral drugs (DAA); group 2 — 53 patients with HIV/HCV coinfection and no prior DAA treatment; group 3 — 51 patients with HCV monoinfection without HIV or HBV coinfections after DAA antiviral treatment. The diagnosis of HCV infection was confirmed by PCR isolation. Results and discussion. The sensitivity of the HCV-sAG test in the study group for confirming the diagnosis of HCV infection in anti-HCV-positive individuals was 87.8%, and the specificity was 58.8%. Discrepancies between the results of HCV-sAG and HCV RNA determination were observed in patients with low HCV viral loads — Me (Q1; Q3) — 1100 (0; 4450) IU/ml. No influence was found on the accuracy of of the HCV core antigen determination by parameters such as patient age, gender, HCV genotype, stage of liver fibrosis, liver cirrhosis, AST, ALT, bilirubin levels, or blood test parameters. Conclusion. A positive of the HCV core antigen result can be used as a confirmatory test for HCV infection in anti-HCV-positive patients. If a negative of the HCV core antigen result is obtained, individuals with a positive anti-HCV test should be tested for HCV RNA (PCR) to exclude false negative results.

Aim of the study. To determine the possibilities of monitoring tuberculosis infection among kidney transplant candidates and kidney transplant recipients using modern radiological examination methods. Materials and methods. In the period from 2012 to 2025, 63 patients with stage 5 CKD were examined at the Central Research Institute of Tuberculosis for tuberculosis infection of varying degrees of activity. According to the activity of the tuberculosis process, the patients were divided into 2 groups: patients with active tuberculosis — 23 people (36.5%), patients with residual post-tuberculous changes — 40 people (63.5%). A retrospective analysis of the results of radiation examination methods before the diagnosis of tuberculosis and at the time of diagnosis was carried out to identify residual post-tuberculosis changes (RPTC). For patients with RPTC, an analysis of the radiation examination methods results was also carried out before the diagnosis of the process and then for a long time with regular monitoring by the CT of the chest once every 6 months under the   supervision of specialists. Results and discussion. Among CKD 5 stage patients with active tuberculosis, patients with widespread and complicated clinical forms of tuberculosis prevailed 17/23 people (73.9%): polyorgan tuberculosis — 6/23 people (26.1%), infiltrative pulmonary tuberculosis in the decay phase or with signs of complications (with bronchial damage) — 6/23 people (26.1%), disseminated pulmonary tuberculosis 3/23 people (13%) and others, which indicated late detection of the disease. It was found that the majority of patients (16/23 people (69.6%) had signs of RPTC at the time of active tuberculosis process diagnosis. When assessing the volume of RPTC, it was determined that large changes — 10/16 people (62.5%) prevailed. When assessing the localization of the tuberculosis process reactivation, it was found that in most cases 13/16 people (81.3%) the zone of inflammation development corresponded to the location of the transferred tuberculosis process signs. In this case, patients with CKD stage 5 with RPTC (40 people) were observed by specialists of Central Research Institute of Tuberculosis for a long time (more than 1 year, on average 3.86 years) with the performance of CT chest 1 time in 6 months, having received a course of chemoprophylaxis in a timely manner. 39/40 people (97.5%) did not have signs of tuberculosis reactivation, even after kidney transplantation or other events that aggravate the immunodeficiency state. Conclusion. In most patients with CKD stage five (69.6% of observations), the RPTC presence preceded the development of active tuberculosis, and in most cases (73.9%) of widespread and/or complicated tuberculosis processes. In this case, the zone of reactivation of the tuberculosis process in the observed patients mainly coincided with the localization of RPTC (81.3%). While observation of CKD stage 5 patients with RPTC using CT of the chest as a radiological examination made it possible in 97.5% of observations to promptly prescribe additional examination and carry out prevention of tuberculosis   reactivation in patients with CKD stage 5.

The aim of the study was to analyze the dynamics of primary HIV infection rates in the Republic of Tatarstan (RT) over the years 2010–2024 and identify specific patterns of its spread based on socio-demographic characteristics as well as place of residence. Material and methods. Data for analysis were obtained from the State Autonomous Healthcare Institution «Republican AIDS Prevention Center» under the Ministry of Health of RT using the ASIDNET system for the period 2010–2024, supplemented with data from the Federal Service for Supervision of Consumer Rights Protection and Human Welfare (Rospotrebnadzor) branch in RT. The research method employed was a retrospective epidemiological analysis utilizing an illustrative indicator. Results and discussion. Over the studied period, HIV prevalence in RT gradually decreased from 32.6 per 100,000 inhabitants in 2010 to 22.24 per 100,000 in 2024. The highest rate was observed in 2015 at 34.6 cases per 100,000 people. Men were infected approximately 1.5–2.25 times more frequently than women. Peaks occurred among males in 2015 (47.78 per 100,000) and females in 2014 (23.95 per 100,000). Up until 2019, most new HIV cases involved individuals aged 30–39, later shifting towards those aged 40–49, with a consistent increase noted among those older than 50. Urban dwellers experienced a decrease in HIV infection rates from 25.41 per 100,000 in 2010 to 19.13 per 100,000 in 2024. Rural residents initially saw an increase followed by stabilization but remained consistently lower compared to urban areas. Individuals without stable relationships had higher infection rates. Social status had minimal impact on infection risk except for a significant rise in infections among employed citizens in 2023. Conclusion. Although overall HIV rates have declined in RT, there is an increasing trend among elderly and working populations. This necessitates revising preventive measures and enhancing public awareness efforts.

Despite the global success of antiretroviral therapy in increasing the life expectancy of patients with HIV infection, the co-occurrence of HIV and tuberculosis remains a dominant factor in mortality and significant socioeconomic losses in the working-age cohort. Despite the overall decline in tuberculosis incidence, uncertainty remains regarding the factors determining the long-term prognosis and mortality risk of patients with TB/HIV coinfection in the post-treatment period. The use of multivariate statistical modeling methods to identify independent risk factors will enable the development of scientifically validated patient stratification algorithms, which is relevant for optimizing healthcare resources and personalizing follow-up protocols. The aim. A comprehensive analysis of mortality and survival in patients with pulmonary tuberculosis combined with HIV infection. Materials and methods. A single-center, retrospective, two-stage cohort study was conducted among patients who completed treatment at the Moscow Regional Clinical Tuberculosis Dispensary in 2024. The first stage included 268 patients with TB/HIV coinfection to determine factors increasing the likelihood of a fatal outcome among TB/HIV patients. The second stage, to assess the survival of patients with TB/HIV coinfection, included 172 patients with TB and TB/HIV who died from anti-tuberculosis therapy. Statistical analysis was performed using IBM SPSS Statistics v.27.0 (USA). Survival analysis was conducted using life tables and the Kaplan-Meier method. Results and discussion. The greatest impact on the likelihood of death in patients with TB/HIV coinfection was demonstrated by low CD4 counts, predominantly disseminated TB, the presence of multidrug-resistant or extensively drug-resistant Mycobacterium tuberculosis, extensive lung disease, and the absence of positive radiographic dynamics. A statistically significant difference in survival time between patients with TB/HIV coinfection and TB after initiation of therapy was identified. After the ninth month of therapy, a sharp decrease in the number of successfully cured patients with coinfection and a multiple increase in the likelihood of death (1.5-fold at the twelfth month, 2-fold at the fifteenth month) were observed. For patients with TB, the risk of death during the recommended follow-up period is minimal. Conclusion. A survival analysis revealed that TB/HIV patients requiring longer anti-TB therapy (an extended intensive phase) are at increased risk of death. These findings highlight the importance of active early screening of patients with TB/HIV coinfection, as well as timely clinical and radiographic examinations.

The aim. Modeling the spread of HIV infection in three main risk groups for predicting the number of people living with HIV at various stages of HIV infection and assessing the contribution of the introduction of mass antiretroviral therapy. Materials and methods. The main source of data for the study was the statistical observation form N61 «Information on HIV infection», Federal Register of persons infected with the human Immunodeficiency virus, using Federal State Statistics Service data on the dynamics of the Moscow population. The epidemiological model was developed on the basis of the Russian theory of epidemic modeling «Epiddynamics» by O. V. Baroyan — L. A. Rvachev. Results and discussion. Computational experiments have shown that if current trends in the spread of HIV and the level of antiretroviral therapy coverage continue, the total number of people living with HIV, registered and living in Moscow, will gradually decrease and may reach approximately 35.6 thousand people by the end of 2030. According to modeling data, the introduction of mass antiretroviral therapy has so far prevented more than 40,000 cases of HIV infection and about 8,000 deaths from the effects of HIV infection among residents of Moscow. Conclusion. An adequate epidemiological model developed based on the ideas of the theory of «Epiddynamics» is an effective tool for conducting predictive studies of the dynamics of the epidemic process of HIV infection, as well as for assessing the contribution of various scenarios in terms of antiretroviral therapy coverage.

The aim of the study. Development of a mathematical model for forecasting the progression of the HIV epidemic in the Ural Federal District of the Russian Federation (hereinafter referred to as the UFD), taking into account socio economic indicators and HIV incidence rates. Materials and methods. The study used HIV incidence rates in the Ural Federal District (UFD) for 1998–2023. An economic indicator — unemployment for the period 1991–2024 — was used as a predictor. To account for time dependence and possible delayed effects of income on incidence, a lagged set of indicators with a shift of up to 6 years was formed. Artificial neural networks (ANN) were used to build a predictive model. The radial basis function (RBF) was used as the basic ANN architecture. Training was performed using the SANN module of the STATISTICA 12 software package. The data were divided into training and test sets (85/15), and cross-validation was used on the latent period 2021–2023 for validation. The coefficient of determination, as well as the mean absolute error and the mean absolute percentage error, were used to assess the forecast accuracy. These indicators were calculated both on the training and test samples, and during cross-validation and extrapolation of predicted values. Result and discussion. To forecast HIV incidence in the Ural Federal District, 1,000 RBF ANN models were built and tested, of which 20 with the best metrics were selected for forecasting. The best model (RBF 3–16–1) demonstrated high accuracy: the determination coefficient R2=0.9, the mean absolute error MAD=6.8. A forecast of HIV incidence through 2028 was generated, which will amount to 81.4^о/оооо. Taking into account other trained RBF ANNs with quality metrics exceeding 0.9, the incidence rate in 2028 is expected to range from 45.9^о/оооо to 112^о/оооо. Conclusion. A forecast of HIV incidence in the Ural Federal District, based on an economic predictor, demonstrated high accuracy based on quality metrics. Accounting for unemployment with a six-year lag allowed for socioeconomic factors to be taken into account. The use of application software with built-in ANN forecasting functions makes the methodology accessible to specialists and provides a basis for preventive strategies and management decisions in healthcare.

The aim of the work was to develop interaction between the phthisiological and therapeutic district services using geoinformation technologies in the organization of preventive work to prevent the spread of tuberculosis. Materials and methods. The work uses databases of medical information systems of polyclinics of the general medical network of the Nevsky district of St. Petersburg, containing information on the attachment of residential buildings to polyclinics and their distribution between the phthisiological sections of PTD No. 14. Spatial data was processed using the open, freely distributed geographic information system NEXT GIS QGIS. The spatial analysis of the district services of the tuberculosis dispensary and district polyclinics was performed with vector analysis tools from the NEXT GIS QGIS. The office applications MS Office PowerPoint and Excel were also used in the work. Results and discussion. To achieve this goal, we used GIS, thanks to which, at the first stage, the mapping of phthisiological sites and departments of outpatient clinics in the Nevsky district of our city was carried out. At the same time, the service areas of these institutions were correlated and information about the district doctors of both services was visualized with their contact information for each of the addresses of the territories, up to a specific house. The second stage was the geocoding of the database of tuberculosis patients in the supervised territories over the past five years, which made it possible to visualize the epidemiological situation of tuberculosis. Visual information about the epidemic foci of tuberculosis showed not only the state of epidemic tension in the whole area, but also at each specific address, and thanks to the mapping of phthisiological and therapeutic sites, direct interaction between doctors of both services became possible. In addition, the information provided caused an increase in the interest of doctors about the epidemic state of tuberculosis in the territories entrusted to them, improved the quality of perception of the submitted material and contributed to the organization of more thorough preventive measures in epidemiologically disadvantaged territories. Conclusion. The introduction of GIS into the work of the tuberculosis dispensary has made it possible to establish work within the phthisiological service and increase the effectiveness of interaction with primary outpatient institutions, which will undoubtedly have a positive impact on the effectiveness of general preventive work in the epidemic focus of tuberculosis.