Vol 24, No 4 (2019)

Herpes zoster is a viral disease that occurs as a result of reactivation of Varicella zoster virus and is characterized by damage to the skin, nervous tissue. This disease develops as a secondary endogenous infection in individuals who have previously had chickenpox. Potential risk factors for herpes zoster are old age, the presence in patients of cancer and / or hematological diseases, diabetes, HIV infection, drug immunosuppression. Changes in socio-economic conditions are accompanied by pathomorphosis of diseases. This fully applies to the infection caused by Varicella zoster virus. Diagnosis of herpes zoster in the prodromal period is difficult, since there are no characteristic bubble rashes. Late diagnosis leads to delayed medical care. The clinical differences of herpes zoster in 78 patients of different age categories were studied: up to 60 years, and after 60 years. The terms of diagnosis, duration of prehospital and hospital stages, clinical symptoms, presence of concomitant pathology and complications were studied. It was shown that the diagnosis of herpes zoster at the prehospital stage was established only in half of the patients, which led to late hospitalization and may have contributed to the development of complications. Among the features of the clinical course, a lower incidence of concomitant pathology and adequate immunoreactivity were noted in persons under the age of 60 years, compared with patients over the age of 60 years. It is assumed that the reactivation of Varicella zoster virus, which is associated in the elderly with immunosuppression against the background of combined chronic somatic pathology, in young people may be due to other reasons, among which may be, including the features of the pathogen.

Tuberculosis remains the leading cause of death in HIV patients. The purpose of our study is to assess risk factors of the fatal outcome development in HIV infection patients with tuberculosis using mathematical methods. A retrospective analysis of lethal cases was performed using statistical methods and multivariate models of the mortality probability in 113 HIV infection patients at the stage of secondary diseases with respiratory damage were calculated. While calculating the prognosis coefficients of the lethal outcome was established the higher the fibrinogen level at the moment of hospitalization is the better the patients’ prognosis, and the high level of other indicators increases the probability of the lethal outcome.

The study is based on a socio-hygienic assessment of the contribution of inapparent infections to anti-influenza immunization of risk groups. We use data on preventive vaccination against influenza and morbidity rate among vaccinated and unvaccinated in the period of 2010-2011 in the Sverdlovsk region. Based on information about the frequency of registration of inapparent and clinically apparent forms of infection, groups with the largest and the least contribution of the inapparent component were identified. The proportions of the vaccine and inapparent component in the total increase of herd immunity were calculated. The results of the analysis indicate the need for the usage of differentiated approach to the study of inapparent immunization, suggesting a purposive expansion of immunological studies of inapparent forms of infection. The study points that the optimal combination of naturally occurring asymptomatic immunization with vaccination can become an effective strategy for maintaining health.