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Vol 26, No 3 (2021)

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Influence of immunity intensity to opportunistic infections on in vitro fertilization efficiency

Avdeeva M.G., Krutova V.A., Konchakova A.A., Dudnikova A.V., Prosolupova N.S., Konchakova E.A., Omelchak A.S.


BACKGROUND: The number of infertile couples and women seeking in vitro fertilization is on the rise worldwide. At the same time, the probability of pregnancy after one in vitro fertilization attempt is 25–40%. Among the various causes of in vitro fertilization failure, the impact of opportunistic infections remains underestimated.

AIMS: retrospective assessment of the dependence of the number of successful in vitro fertilization attempts on the intensity of immunity to opportunistic infections.

MATERIALS AND METHODS: On the basis of the Clinic of the Kuban State Medical University, from January 2020 to March 2021, 865 women aged 26 to 48 years with infertility, included in the assisted reproductive technology program, were observed. Before the in vitro fertilization procedure, all patients were examined by enzyme immunoassay (ELISA) and polymerase chain reaction for the presence of herpesvirus infections (herpes infection, cytomegalovirus infection) and toxoplasmosis. The study included 79 people with unexplained infertility with a history of one to four in vitro fertilization cycles and positive antibody titers [IgG (+), IgM (–)] to herpes simplex virus, cytomegalovirus, and toxoplasmosis. During the study, groups were formed depending on the presence of opportunistic infections and the number of unsuccessful in vitro fertilization attempts.

RESULTS: During the study, a dependense was established between the number of in vitro fertilization attempts and the level of the initial (before pregnancy) IgG to toxoplasma. A negative prognosis for the effectiveness of in vitro fertilization is most likely in the presence of high titers of IgG to toxoplasma (370.0±57.0 U/ml). In the case of herpes infection, there was a tendency to increase the number of necessary in vitro fertilization attempts to 3–4 in the group with higher herpes simplex virus IgG levels. The baseline IgG cytomegalovirus level was not directly related to the effectiveness of the in vitro fertilization procedure.

CONCLUSION: The study demonstrates the importance of determining the intensity of immunity to toxoplasma and herpes infection in preparation for in vitro fertilization, especially if there is a history of unsuccessful in vitro fertilization attempts or spontaneous abortion.

Epidemiology and Infectious Diseases. 2021;26(3):92-103
pages 92-103 views

Monitoring of adverse events after immunization against a new coronavirus infection among young people

Gabbasova N.V., Mamchik N.P., Yatsenko L.A., Mazina O.L., Knyazeva V.A.


BACKGROUND: To increase public confidence in vaccine prevention and to actually assess the safety of vaccines against COVID-19, it is necessary to study the frequency and structure of adverse events after immunization in the post-registration period of vaccine use.

AIM: To assess the frequency and structure of adverse events after immunization against COVID-19 among young people during the period of post-registration use of vaccines.

MATERIALS AND METHODS: A single center cross-sectional study was conducted based on a questioning of 333 respondents aged 18–25 years (76.88% female, 23.12% male). The questionnaire included 2 groups of questions: general and special (nature of post-vaccination reactions, history of COVID-19 disease before and after vaccination). Statistical processing of the results was carried out using standard Microsoft Office Excel 2016 software packages.

RESULTS: The most common complaints after vaccination were soreness at the injection site (57.66%), weakness (54.65%) and body aches (24.92%). There were local and general/combined (weak, moderate, strong) reactions, they were observed in 30.93% of respondents after 1 dose and 45.35% after 2 doses. In the structure of reactions after the first immunization, general weak reactions (15.32%, p=0.001) were significantly more common than others, after the second — local ones (21.92%, p <0.0001). A strong correlation was established between responses to the 1st and 2nd doses of the vaccine (r=0.94, p <0.0001). When studying the frequency and structure of post-vaccination reactions in sex groups and in those who had COVID-19 before vaccination and those who did not, no significant differences were found.

CONCLUSIONS: The study found that among young people, the majority did not have objective reactions after immunization against a new coronavirus infection. General weak and local reactions were more common among the objective post-vaccination reactions.

Epidemiology and Infectious Diseases. 2021;26(3):104-112
pages 104-112 views


Practical aspects of human immunodeficiency virus multiresistance in modern clinical practice

Nabiullina D.R., Mazus A.I., Litvinova N.G., Khamatova A.A., Nagibina M.V., Chebotareva T.A., Bessarab T.P., Ivannikov E.V., Smirnov N.A., Mashael V.S., Vlatshkaya Y.F.


The article presents an analysis of a special clinical case: a male patient with perinatal HIV infection and the development of HIV multi-resistance to antiretroviral drugs. Multiple corrections of treatment regimens were carried out based on the results of determining HIV resistance to the antiretroviral drugs used. The treatment regimen included antiretroviral drugs with fundamentally new mechanisms of action for HIV, not registered in the Russian Federation. However, to date, in the patient with more than twenty years of experience in antiretroviral therapy, it has not been possible to achieve immunological and virological efficacy of treatment. There continues to be a persistent decrease in the indicators of the immune status and an increase in the viral load of HIV in the blood, the appearance of clinical symptoms of opportunistic diseases indicating the progression of HIV infection and an unfavorable vital prognosis, despite the use of various combinations of antiretroviral drugs. This observation demonstrates the difficulties in choosing an effective antiretroviral therapy, taking into account the established sensitivity of HIV to antiretroviral drugs and the possibility of their progredient administration. It is certainly necessary to analyze all ART regimens with the results of HIV resistance to antiretroviral drugs using to improve the effectiveness of therapy is in each case.

Epidemiology and Infectious Diseases. 2021;26(3):113-126
pages 113-126 views

Difficulties in diagnosing the severe coronavirus disease COVID-19 with a negative PCR test result

Kharisova S.R., Mukhametshina E.I., Abdulkhakov S.R., Gaifullina R.F.


The clinical case in this article describes the topic of current interest concerning the diagnostic methods for coronavirus disease (COVID-19). The diagnostic process was hindered by nonspecific initial symptoms and twice negative results of the PCR test. For the next several days, the worsening in dynamics was observed in terms of symptoms and laboratory test results, specific to acute kidney injury, hypercoagulability syndrome and multiple organ failure. Ongoing monitoring of lungs via computed tomography revealed the typical for COVID-19 image of lungs (including ground-glass opacity and pulmonary consolidation). With suspected coronavirus disease the patient’s sample was transferred to the University research laboratory for a serologic test to detect IgG antibodies. The positive result of the test confirmed that the patient had COVID-19. The prescribed anticoagulants and glucocorticosteroids improved the condition. The described clinical case acknowledges the complexity of the PCR test, therefore full investigation and other tests are recommended in the case of suspected coronavirus disease.

Epidemiology and Infectious Diseases. 2021;26(3):127-134
pages 127-134 views

Cardiovascular pathology in HIV infection

Tuaeva R.G., Loseva O.K., Nagibina M.V., Bessarab T.P.


Currently, there are indications of an increase in the incidence of cardiovascular pathology in patients with HIV infection in comparison with population data and a higher mortality rate from cardiovascular diseases. The problem of detecting the pathology of the cardiovascular system in patients infected with the human immunodeficiency virus (HIV) is relevant due to the increase in the number of HIV-positive individuals and the established effect of HIV infection on the circulatory organs. In order to identify cardiovascular pathology, two patients with stages III and IV of HIV infection were extensively examined. The examination was carried out using electrocardiography, echocardiography and ultrasound dopplerography. Both clinical cases are presented below, in which pronounced cardiovascular pathology was detected in both cases. As factors influencing the development of pathology of the cardiovascular system, based on the presented clinical examples, drug addiction (long-term intravenous use of surfactants) and pathologies of other internal organs in the development of HIV-mediated opportunistic diseases are considered. Analysis of the course of the disease showed that the lesion can develop in various stages of HIV infection, more often infectious endocarditis is the main diagnosis in patients in stage 3 of HIV infection (the first clinical example), and dilated cardiomyopathy — in the late stages of HIV infection and is considered as a concomitant pathology due to lung and kidney damage (the second clinical example).

Epidemiology and Infectious Diseases. 2021;26(3):135-140
pages 135-140 views

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