Vol 20, No 6 (2015)

The goal - to study the frequency of detection and levels of Shiga toxin in the feces ofpatients with HIV infection at the stage of secondary diseases in the presence of mono and mixed O-antigens of intestinal bacteria. Materials and methods In 2012-2014 there were examined 123 patients with 4A, 4B, 4C- HIV infection, without diarrhea. The average age ofpatients accounted for 36,8 ± 7,8 years. The control group was consisted of 40 blood donors. In paired stool samples by means of the reaction of coagglutination (RCA) on slides there were tested LPS/O-antigens as markers of causal pathogens of major intestinal infections, Shiga toxin antigen and levels of IgG-immune complexes (IgG-IC in RCA on the plates) in patients with mono and mixed O-antigen in feces. Results There were established the excess of detection rate and titers of antigen Shiga toxin in stool in patients with HIV in comparison with donors, an gain of these indices in mixed infection, and a downward trend of IgG-IC levels in the feces in all cases of HIV-infection if compared with blood donors (p ≤ 0.01). Conclusion Detection of mono- and mixed-O-antigens in the feces of patients with HIV infection, an gain in titers and the frequency of the detection of Shiga toxin antigen, declined IgG-IC levels in feces indicate to pronounced intestinal dysbiosis and disturbed production of specific antibodies in patients with HIV infection at the stage of secondary diseases.

Objective: Improvement of the diagnosis and prognosis of liver disease of viral etiology based on the analysis of clinical and epidemiological characteristics of the course and outcome of viral mixt-hepatitis. Materials and methods There are presented results of the retrospective study of 106 patients with chronic viral mixt-hepatitis (study group), which were under the medical observation for a period from two to five years between 2010 and 2014. The comparison group was consisted of 1,913 patients with chronic hepatitis C. Results and discussion The morbidity of chronic viral mixt-hepatitis in the majority of cases is registered among socially active groups of young and middle age persons, more common among males. Frequent risk factors are the artificial factor (55%), the intravenous drug usage (25%), tattooing (19%). Typical concomitant illnesses are diseases of the gastrointestinal tract and the endocrine system. Chronic viral mixt-hepatitis is mainly caused by a combination of HCV and HBV, and HCV + HBV + HDV also. HCV replication is noted in 64% of cases, the replication of HBV - in 58%, HDV replication - in 20%. Transformation into cirrhosis in patients with mixt-hepatitis C+B+D was recorded in 25% of cases, in mixt-hepatitis C+B cases - in 7.1%. In the group of C+B+D hepatitis patients, viral replication of HBV and HDV without HCV replication transformation into cirrhosis was seen in 36%. In the case of HDV replication alone, the rate of cirrhosis was 25%, while in cases with isolated HBV replication - 14%. In patients with mixt-infection C+B, the development of cirrhosis was registered within subgroup with simultaneous replication of HBV and HCV viruses in 9% cases. An isolated HCV replication, in general was less often, and led to the transformation into cirrhosis in 6% cases. Conclusions. Simultaneous replication of more than one type of hepatitis virus promotes transformation into cirrhosis, in greater extent, simultaneous replication of HBV + HDV, and monoreplication of HDV virus also. In order to prevent further progression of the pathological process it is recommended the well-timed causal treatment order with account for the predominant virus replication.

The purpose of the study To estimate the prevalence of markers of herpesvirus infections and pneumocystosis in patients of the hematological department. To identify whether the contamination of hematological patients with hepatitis B and C (HBV, HCV) affects on the activation of opportunistic infections (OIs). Materials and methods There were examined 94 patients of the hematological department, including 48 patients with markers of HBV infection and 46 cases without them. Obtained results Markers of acute OIs (simple herpes virus type 1- 6,4%, EBV - 14,9%, CMV - 6,4%, and Human Herpesvirus 6- 13,8% and 33,0% of pneumocystosis) in hematological patients were determined more frequently than in donors. Comparative analysis of the data revealed the excess of the proportion of cases with markers of acute HHV-6 infection in hematological HBV patients in comparison with a group of hematologic patients without markers of HBV infection (22,9% against 4,4%, p<0,05; χ2=6,8). Conclusion In the performed study there was shown the statistically significant effect of HBV and HCV in the activation of infection caused by HHV-6, whereas in relation to other herpes viruses (HSV, CMV, EBV), and pneumocystosis, this regularity has not been proved. At the same time in patients with hematological malignancies the proportion of the contamination with opportunistic infections was established to be higher than in donors. Opportunistic infections markers were detected almost at the same level in both groups of patients: patients with HBV, HCV markers, and cases without markers.

There are developed and tested by ourselves ELISA kits for serodiagnostics of most endemic to Russia arboviral infections and some imported tropical diseases. Their application allowed in 1999 to set the value WN virus in the etiology of outbreaks ofWN fever in the southern region of Russia, then in Voronezh and Tula regions. From 1999 to 2014, according to the data of Russian Service for Surveillance on Consumer Rights Protection and Human Wellbeing in the Russia there were diagnosed 2284 cases of WNfevers and 1725 cases of CCHF. In 2012-2014 specific IgG and neutralizing antibodies to the WN virus were detected in the population of the Southern and Black earth regions of Russia. Data of the examination of residents ’ sera from Tatarstan, Tver, Ryazan, Kaluga, Kursk and Vologda regions were proved to be negative. In 2000 there were revealedfirst cases of CCHF in the Volgograd region, Kalmykia and Dagestan also. The application of ELISA-IgM kits allowed to reveal cases of Sindbis, Batai, Tahyna, Inkoo, sandfly fevers, Uukuniemi and Bhanja. During the period of2009-2014 there were verified 190 imported cases of dengue fever, Chikungunya, WNfever, sandfly fevers, and Japanese encephalitis among persons returning from travel in tropical countries.