Vol 15, No 3 (2010)


HIV and sexually transmitted infections in the Russian Federation in 1993-2008

Ladnaya N.N., Ivanova M.A.


The paper describes trends in the epidemics of HIV and sexually transmitted infections in the Russian Federation in 1993-2008 and has established a relationship between them.
Epidemiology and Infectious Diseases. 2010;15(3):4-11
pages 4-11 views

Behavioral risks among men having sex with men in Kazan

Taisheva L.A., Khamitova R.Y.


The paper gives the results of surveys among men having sex with men in Kazan. The surveys were made by a structured deep interview (16 respondents) in May 2005 and by a questionnaire (188 respondents) in 2006-2007. The community has been found to include wide age range subjects who have a high educational level and show a responsible attitude towards their health, are well informed about HIV infection, and use protective agents during sexual contacts. Most of them have no constant sexual partner, but lead a rather active sexual life, assess the risk of HIV infection as low, although every three men have a history of sexually transmitted infections.
Epidemiology and Infectious Diseases. 2010;15(3):12-15
pages 12-15 views

Immunological characteristics of persons who were in contact with HIV

Pronin A.Y., Serkov I.L., Zhukova Y.V., Drobyshevskaya Y.V., Orlova-Morozova Y.A., Kaminsky G.D.


By analyzing 329 HIV discordant couples, the authors studied the individual characteristics of subjects who were at risk for HIV infection and uninfected. The findings lead to the conclusion that these individuals have factors that determine the protective nature of their immune response to HIV.
Epidemiology and Infectious Diseases. 2010;15(3):15-18
pages 15-18 views

Analysis of the causes of death in patients with HIV infection in the Russian Federation

Yermak T.N., Kravchenko A.V., Shakhgildyan V.I., Kanestri V.G., Ladnaya N.N., Yurin O.G.


The causes of death are analyzed among HIV-infected patients in the Russian Federation in the past years. There has been a rise in fatal outcomes among the entire population of patients and those with late-stage (4B, 4C, 5) HIV infection, in whom the main causes of death are severe lesions, primarily tuberculosis (66.5%). There has been an increase in the number of patients with new-onset HIV infection with the development of severe secondary diseases; in these cases their treatment is frequently late. The regions of the Russian Federation show a low regular medical check-up and treatment coverage (43.2% patients are given antiretroviral therapy late - when the CD4 lymphocyte count is less than 200 per μl) and a low treatment coverage in patients with chronic hepatitis B and C, who constitute a considerable (13.5-14.5%) proportion in the pattern of fatal outcomes.
Epidemiology and Infectious Diseases. 2010;15(3):19-22
pages 19-22 views

Ritonavir-boosted HIV protease inhibitors in first-line antiretroviral therapy regimens

Kravchenko A.V., Kanestri V.G., Gankina N.Y., Kozyrev O.A., Ibragimova L.E., Khromova I.Y., Minayeva S.V.


The efficiency and safety of antiretroviral therapy (ART) regimens based on ritonavir-boosted HIV protease inhibitors (PIs) were studied in 102 patients with HIV infection. Following 24-week therapy, 65-90% of patients showed a reduction in HIV RNA levels below the threshold of detection by a test system. In the first 6 months of therapy, the increment in the CD4 lymphocyte count was 60-130 cells/μl. The ART regimens comprising ritonavir-boosted PIs were also highly effective in patients with a high baseline HIV RNA level (more than 100000 copies/ml) or a low CD4 lymphocyte count (less than 200 cells/μl). The use of ritonavir-boosted PIs was safe in the absolute majority of patients. The most common adverse reactions were lopinavir/ritonavir-induced diarrhea and atazanavir/ritonavir-induced icteric coloration of the skin and sclerae. In most cases, these were mild and transient. Despite the fact that 65-80% of the patients included into the study were diagnosed as having chronic hepatitis C and before ART 25-29.4% of the patients were recorded to have elevated ALT levels, the use of ritonavir-boosted PIs was safe in the absolute number of patients. In 76-84%% of the patients, adherence to ART was greater than 95%; a half of the patients with incomplete therapy adherence were observed to have lower HIV RNA levels below the threshold of detection by a test system, which is likely to be caused by the improved pharmacokinetics of ritonavir-boosted PIs, with their use the treatment was effective even during incomplete adherence.
Epidemiology and Infectious Diseases. 2010;15(3):22-27
pages 22-27 views

The sociodemographic profile of patients suffering from HIV infection and Tuberculosis in Moscow

Lyubayeva Y.V., Kravchenko A.V., Yenikolopov S.N.


The paper analyzes the sociodemographic characteristics of a group of patients suffering with HIV and tuberculosis and shows how to increase the quality of care delivered to these patients. At present the concept of health and disease should be interpreted in the context of a biopsychosocial approach. It is wrong to consider disease apart from a human being having this disease. Of importance are both the objective evaluation of his/her condition and the subjective appraisal of life satisfaction, namely the quality of life. The main sociodemographic characteristics of a group of patients with HIV infection and tuberculosis are described. Knowledge about this contingent of patients makes it possible to give a better insight into their main needs, to assess possible behavioral risks, and to anticipate some problems during treatment.
Epidemiology and Infectious Diseases. 2010;15(3):27-31
pages 27-31 views

Efficiency of antiretroviral therapy for HIV infection

Moshkovich G.F., Minayeva S.V., Varlova L.V., Goryaeva M.P., Voronina I.D., Tikhonova Y.V.


The authors give the results of studying the efficiency of standard highly active antiretroviral therapy (HAART) regiments in patients with HIV infection. The findings suggest that longevity in HIV-infected patients receiving HAART is 2 times higher than in untreated patients. At the same time, the best treatment results were obtained at the beginning of HAART in patients with higher CD4+ lymphocyte levels and the choice of the first therapy regimen failed to affect therapeutic effectiveness. The change of the first treatment regimen was mainly associated with adverse reactions. Treatment was ineffective in only 1.4% of cases due to the developed resistance to antiviral agents.
Epidemiology and Infectious Diseases. 2010;15(3):31-35
pages 31-35 views

Comparative results of treatment for chronic hepatitis C in HIV-infected patients receiving and not receiving highly active antiretroviral therapy

Minayeva S.V., Moshkovich G.F., Goryaeva M.P., Varlova L.V., Voronina I.D.


The paper presents the comparative results of treatment for chronic hepatitis C in HIV-infected patients in two groups: those who receive and do not receive highly active antiretroviral therapy (HAART). The findings indicated that the efficiency of therapy for hepatitis was comparable in both groups: the proportions of patients with a steady-state virological response who received and did not receive HAART were 34.1 and 40.9%, respectively. Some adverse reactions significantly differed in their frequency in both groups. Nevertheless, their severity was that which did not require hepatitis therapy discontinuance.
Epidemiology and Infectious Diseases. 2010;15(3):35-38
pages 35-38 views

Heterogeneity of a cohort of persons living with HIV/AIDS of long-term infection from the values of virological and immunological monitoring of HIV infection

Kaminsky G.D., Serkov I.L., Zhukova Y.V., Drobyshevskaya Y.V., Orlova-Morozova Y.A., Pronin A.Y.


By analyzing a large cohort of HIV-infected persons in the Moscow Region, the authors studied the patients with a disease duration of more than 3000 days. Long-term nonprogressors and elite-controllers of HIV infection were identified and characterized. The increase in the total count of T lymphocytes (CD3+) and cytotoxic T lymphocytes (CD8+) may be considered to be factors that deter the progression of the disease.
Epidemiology and Infectious Diseases. 2010;15(3):38-42
pages 38-42 views

Choice of nucleoside inhibitors in antiretroviral therapy regimens for HIV-infected patients treated for chronic hepatitis C

Gankina N.Y., Kravchenko A.V., Kuimova U.A., Kanestri V.G.


The rates of development of virologic and biochemical responses and the incidence and degree of hematological disorders within the first 12 weeks of treatment for chronic hepatitis C (CHC) were determined in patients with HIV infection depending on the used agents from a group of nucleotide reverse transcriptase inhibitors as part of an antiretroviral therapy (ART) regimen. Seventy-eight patients with HIV infection and CHC who received ARVT for at least 3 months were followed up. According to the ARVT regimen, the patients were divided into 2 groups: 1) 46 took phosphaside incorporated into an ARVT regimen; 2) 32 received stavudine or abacavir. Among all the patients, rapid and complete early virologic responses (rEVR and cEVR) were obtained in 52 and 79% of cases, respectively. When phosphaside was used in the ART regimens, the rates of rEVR and cEVR development were significantly higher (95.8 and 53.3% of cases, respectively). The phosphaside-treated patients with hepatitis C virus (HCV) genotype 1 also had a high cEVR rate. The absolute majority of patients with HCV genotype 3 showed cEVR irrespective of the ART regimen. Following 12-week treatment for CHC, 83.3-95.5% had a reduction in alanine aminotransferase levels to the values observed in healthy individuals, which was also indicative of the efficiency of treatment. In the HIV infected patients treated for CHC, the use of phosphaside, stavudine, or abacavir was safe in terms of hematological complications. In the patients receiving phosphaside, the reduction in hemoglobin levels was more considerable. Evolving hematological disorders required no changes in the ART regimen or reductions in the dose of pegylated interferon or ribavirin.
Epidemiology and Infectious Diseases. 2010;15(3):42-46
pages 42-46 views

Evaluation of the effectiveness and safety of chemoprophylaxis for vertical HIV transmission, by using the regimens of monotherapy and highly active antiretroviral therapy

Konnov D.S., Goliusova M.D., Konnov V.V., Kozyrina N.V., Ladnaya N.N., Yurin O.G.


The study including 69 pregnant women diagnosed as having HIV infection who received chemoprophylaxis for vertical HIV infection evaluated the effectiveness and safety of the regimens of monotherapy and highly active antiretroviral therapy (HAART) used during pregnancy. There was a significant reduction in the levels of HIV RNA and an increase in the CD4 lymphocyte count in the patients receiving both chemoprophylaxis regimens. The efficiency of HAART regimens to prevent vertical HIV transmission was significantly higher than that of monoprophylaxis. The use of antiretroviral drugs was safe as monotherapy and in the HAART regimens during pregnancy.
Epidemiology and Infectious Diseases. 2010;15(3):46-51
pages 46-51 views

Health workers' readiness to form adherence to the regular medical check-up system in HIV-infected patients

Belyaeva V.V., Kravchenko A.V.


The investigation was undertaken to specify the readiness of physicians taking part in the treatment of HIV infection for the use current technologies to form adherence to regular medical check-up in this disease. The investigation was performed using an anonymous questionnaire and a focused interview in a group of 190 physicians of various specialties who were involved in the delivery of specialized medical care in HIV infection. The analysis showed the readiness of the physicians taking part in the treatment of HIV infection for the use current complex and interdisciplinary technologies to form adherence to regular check-up in this disease. The problems of attracting and holding HIV-infected patients in the regular medical check-up regimen are realized as urgent by health workers; the solution of the problems is embodied in their practical activity.
Epidemiology and Infectious Diseases. 2010;15(3):51-53
pages 51-53 views

A case of lactic acidosis developing during antiretroviral therapy in a patient with HIV infection

Konnov D.S., Yurin O.G.


The paper describes a clinical case of development of lactic acidosis, a specific delayed complication, in a HIV-infected patient who received antiretroviral therapy (ART) for 1.5 years and was adherent to ART. During the latter, the patient achieved stable clinical, immunological, and virologic effects. However, 1.5 years later, the patient was found to have blood biochemical changes as blood accumulation and elevated levels of lactate; clinical signs of lactic acidosis appeared. His therapy regimen with zidovudine and didanosine was changed to abacavir and lamivudine and pathogenetic therapy was performed, which relieved lactic acidosis. Long-term adverse reactions of the used drugs, which endanger the long-range goals of ART (the quality of life and its duration in patients), play an important role in patients adherent to ART despite the clinical, immunological, and virologic successes of treatment.
Epidemiology and Infectious Diseases. 2010;15(3):54-56
pages 54-56 views

Clinicomorphological observation of cytomegalovirus ventriculoencephalitis in HIV infection

Shakhgildyan V.I., Tishkevich O.A., Parkhomenko Y.G., Tsvetkova O.O., Zyuzya Y.R., Belyaeva V.V., Safonova A.P., Fligil D.M.


A central nervous system (CNS) lesion in a HIV-infected patient presents particular difficulty in an infectiologist's work. No pathognomonic symptoms, a need for expensive instrumental and laboratory studies to interpret the nature of neurologic disease frequently lead to its late diagnosis, the inefficiency of etiotropic therapy, and severe consequences of organic brain lesion. A CNS lesion occurred in 16.3% of 957 patients with Stage 4B HIV infection (AIDS) treated at Moscow Infectious Diseases Hospital Two. Cytomegalovirus encephalitis accounts for 4-12% of cases of infectious CNS lesion in HIV infection and 15-18% of the cases with manifest cytomegalovirus (CMV) infection. CMV encephalitis develops in not only HIV-infected patients, but also in neonates and babies of the first months of life, less frequently in organ recipients; the pattern and pathogenesis of disease, its clinical features and early diagnosis remain inadequately studied. The paper describes a clinical case of CMV ventriculoencephalitis with the morphological characteristics of brain lesion in an adult patient with HIV infection.
Epidemiology and Infectious Diseases. 2010;15(3):56-59
pages 56-59 views

Factors influencing the course of infection

Pokrovskaya A.V.


The author reviews the data available in the literature on the factors influencing the survival of HIV-infected patients, in addition to highly active antiretroviral therapy. The determinants of the rate of disease development are described. These may be used to develop recommendations for the patients.
Epidemiology and Infectious Diseases. 2010;15(3):60-64
pages 60-64 views

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