Vol 18, No 6 (2013)

The purpose of research - based on analysis of the clinical-epidemiologic data, the level of viral load and the prevalence of HCV genotypes to determine current consistencies and epidemiological trends of the development of HCV-infection in the area of the Krasnodar Territory. Patients and methods. Population incidence of hepatitis C in the Krasnodar Territory was studied for the period from 2004 to 2011. Clinical manifestations of the disease we evaluated on the base of a retrospective analysis of 1913 hospital records of patients with chronic hepatitis C. There were investigated the results of 19,338 qualitative PCR studies of RNA-HCV, 2041 studies for genotyping and 363 results of quantitative evaluation of RNA-HCV Results. In the Krasnodar Territory there is revealed circulation of 1a, 1b, 2, 3a HCV genotypes. In a population of genotypes 1b (48 %) and 3a (38 %) prevail. In recent years there has been visible trend to displacement of genotype 1b by the increase the incidence of genotype 3 a in a set of areas. Social Portrait of the patient with hepatitis C: a man aged 28 to 48, a city resident, a salary earner or unemployed. There were established gender peculiarities: males are more often infected with hepatitis C genotype 3a, females - genotype 1b. In most cases (65%) viremia is characterized by moderate viral load. In the studied population there is revealed the relationship between the activity of the process and infection with certain genotype. Moderate grade of hepatitis activity is significantly more frequently recorded in the disease caused by 1c and 3 a virus subtypes. Minimal activity of hepatitis is not typical for the process caused by genotype 2 and in genotype 3 a occurs much less frequently than in cases caused by genotype 1b. Conclusion. Epidemiological analysis of the incidence of hepatitis C should take into account trends in the spread of various genotypes of the virus. Hepatitis C virus genotype should be taken into account as in the forecast of the disease and in determination of the indications for antiviral therapy. The main socio-age group actively involved in the epidemic process and need for causal treatment, are young persons of working age.

The etiological structure of chronic viral hepatitides with the outcome in hepatocellular carcinoma (HCC) was studied among deceased patients for the periods of 1986-1998 and 2002-2012 in total and in comparison. HCC developed as the outcome of CHB in 45.0% of patients, CHC - in 20.7 % , CHB+C - 18,6%, CVHN- in 12.9%, CHB + D - 1.4%, CHB+C+D - also in 1.4% of patients. When comparing the data for 1986-1998 (13 years), and 2002-2012 (11 years) there was noticed an increase in the number of deaths from HCC (2-fold), there was significantly increased the incidence of HCC, associated with CHC (from 2.0% to 30.8 %), nonverified chronic hepatitis as a cause of HCC occurred 6.5 times less often (28.6 % - 4.4%), the number of cases of HCC, caused by CHB, became lower (49.0 % - 42.9 %), CHB+C - almost unchanged (20.4% - 17.6 % ). A presumptive middle time of the development of HCC since infection with hepatitis viruses is 27,6 ± 9,8 years. In assessing the cofactors ofprogression of HCC there was found that alcohol abuse occurred in 38.5 % ofpatients, diabetes - in 18,7%, HIV- infection -in 3.3%.

Infections of the respiratory tract (acute respiratory infection (ARI), acute bronchitis, pneumonia, etc.), skin and subcutaneous tissue (pyodermas) are the most urgent for the conscripts in training units of the Armed Forces of the Russian Federation. The most common complication of ARI is community acquired pneumonia, severe course of which leads to an unfavorable outcome. In the first period of military service in a number of military units up to the one-third of the military personnel gets pyoderma. Factors of military service and a significant reduction in body immunoresistance of recruits contribute to the high incidence. The use of herbal drug preparation "Karmolis drop" with a prophylactic purpose permits to significantly reduce the incidence of ARI in military units - in 2,0-3,3 times. Also, there was noticed a decrease in the incidence of pneumonias - 2.33.0 times, tonsillitides - in 3,2-6,8 times, pyodermas - in 1,8-2,9 times. The use of the drug "Karmolis drop" has a pronounced non-specific protective effect and resistance to diseases of the respiratory system and pyoderma due to the increase of general non-specific resistance of the organism, allows to prevent substantial economic damage. The preparation can be recommended for the prevention of ARI and pyodermas in groups of troops prior to their seasonal breaks.

To date, C. difficile is considered as an etiological factor in pseudomembranous colitis and antibiotic-associated diarrhea as well as the main cause of nosocomial diarrhea spread mainly in economically developed countries. The complexity of laboratory and experimental studies of infection is what the microbe cannot be genetically manipulated. At the same time, the most of hospital and municipal laboratories have no the possibility to carry out research on detection C. difficile toxins, that limits the resource of real estimation of the spread of the disease in the Russian Federation.

In the article there is presented the life and the creative work way of a prominent national epidemiologist, a microbiologist and immunologist, a talented organizer of medical science, USSR State Prize winner, Nikolay Akimovich Gayskiy.