For the first time in the domestic medical literature presents a deep review about epidemiological, clinical, and laboratory knowledge of Zika virus disease, based mainly on the publications of foreign authors and leading international organizations from 1947 to March 2016. Analyzed the essence of the problem, treatment of patients with Zika virus disease and infected pregnant women, indicated the unresolved question. For the first time were systematic sources of contemporary information about Zika virus disease for professionals and patients.

Generalized meningococcal infection belongs to the group of diseases with a high risk of initiation of life-threatening conditions and death outcomes. There was carried out a retrospective analysis of clinical and epidemiological features of generalized meningococcal infections in children and adolescents of Saint Petersburg in 1995–2014 on the basis of the analysis of 884 medical records of the patients hospitalized at Scientific Research Institute of Children’s Infections. With general prevalence of the children of the first years of life among the patients, there has been revealed the tendency to reduction in the portion of children of the first year of life from 41,4% in 1995 to 22,2% by 2014, and the increase in the number of patients of 1–3 years old from 19,3–30,5% in 1995–1996 to 46,4–46,4% in 2013–2014. Among the number of etiologically identified cases (59,4%) the majority of them has been caused by serogroup B meningococcus (58,5%), in 24,2% – by serogroup C meningococcus, in 11,2% – by serogroup A meningococcus, and in 6,1% – by rare (W135/Y) and unspecified strains N.meningitidis. Within the recent years there has been identified the tendency of rate growth concerning the diseases caused by serogroup C meningococci, remarkable for a severe course and high rate of death cases. Total death indicator for the investigated period has averaged 4,2%, with the variability from 0 to 12,5% for different years.

We have tested 253 strains (13 species) Candida spp. Determination of the minimum inhibitory concentration of amphotericin B was performed by 2 methods: epsilometric method (Etest®, BioMerieux, France) and on the instrument the Vitek2 (BioMerieux, France). In general, resistance was detected in 5 strains (2.1%) (C. parapsilosis – 4, C. tropicalis – 1). There were no resistance to amphotericin B among strains of C. albicans, C. glabrata and C.krusei. Coincidence evaluation results of the minimum inhibitory concentration of amphotericin B for categories sensitivity/resistance when tested strains 2 methods generally occurred in 98% of cases (248 of 253): 100% for the species C. albicans, C. glabrata and C.krusei, 92.2% for C. parapsilosis and 95% for C. tropicalis. The results of our study demonstrate a low degree of resistance of Candida spp. to amphotericin B, which allows the use of the drug in a

The objective was to develop mathematical and statistical models forecast the success of prevention of infectious genesis of complications in premature infants with very low birth weight during the inpatient nursing care when used in programs of the therapy probiotic form based on Enterococcus faecium L3. We proposed the mathematical discriminant model forecast the success of prevention of infectious complications based on observations of 55 premature infants with very low birth weight in the second stage of nursing in a specialized department of pathology of newborn hospital and analysis of outcomes for the formation of infectious complications
in 51 children. This model is based on the following six symptoms: 1) burdened obstetric and gynecological history mother; 2) the presence of chronic intoxication with the mother; 3) delivery is by caesarean section; 4) of the number of E. coli in the feces of children in real time polymerase chain reaction (relative to the norm values); 5) eosinophilia in the clinical analysis of blood; 6) use as a supplement to the diet of children probiotic liquid form on the basis of E. faecium L3. This model has a sufficiently high information capacity (80.4%) and statistically significant (p<0,01) for the prediction of the success of the prevention of infectious complications in premature infants with very low birth weight.

Purpose: modeling the risk of congenital infections (СI) based on a comprehensive assessment of the results of laboratory monitoring of pregnant women and infants. Materials and techniques: The study involved 92 pregnant women and 41 children born to them. A survey of pregnant women included the collection of standard anamnestic data and a set of laboratory diagnostic measures to identify markers of rubella, toxoplasmosis, herpes virus, cytomegalovirus, parvovirus B19V, chlamydia, mycoplasma, ureaplasma, assessment of the mucosa of the cervix in the first, second and third trimesters. Dynamic observation of children participating in the study included an assessment of somatic and neurological status, enzime-linked immunosorbent assay of blood serum for CI markers, molecular-genetic studies of blood. Results: using the methods of discriminant and regulate discriminant analysis, two groups of aggregated factors identified as having a significant impact on the development of CI, regardless of its etiology. The greatest weight for the prediction of congenital infections were immune status of pregnant towards herpes and the appearance of IgM antibodies to herpes simplex virus in the third study, laboratory markers of parvovirus infection. The predictive model created has accuracy of 92% and 94% (at three surveys) for prognosis of CI’s risks. It is shown that the predictive model based on the results of double and single survey is considerably less accurate – 85%. Conclusion: It is necessary for pregnants to be examined for CI’s markers in each trimester for effective prediction of probability of a CI. Reliable relationship with congenital infections was proved only to a combination of factors, combined into groups based on their statistical significance, confirming the need for an integrated dynamic examination of pregnant women. The high incidence of laboratory markers of parvovirus infection demonstrates the need for the inclusion of the infectious pathology in the list of pregnant mandatory screening. 

Aim: evaluate the clinical manifestations, efficacy of microbiological
diagnosis and results of treatment of patients with tuberculosis (TB) in combination with HIV (TB/HIV), residing in the territory of the Saratov region.

Materials and methods: analyzed the medical records (hospital records, medical history, personal record cards TB/HIV), 130 patients coinfected with TB/HIV who were on treatment in TB facilities of Saratov region in 2014.

Results: it was found that the combination of TB and HIV infection was more common in men (71,5%) aged 30–39 years, mostly (75,4%) residents of large cities. TB in 64,6% of cases develop on the background of existing HIV infection with disease duration from 1 to 18 years. The dominant forms of TB were infiltrative – 50,8% and disseminated – 25,4% with high levels of multidrug resistance (MDR) – 25% and polyresistance – 17,3%. Efficiency a course of treatment of ТВ which was completed in 2014 year amounted to 41,5% and was higher in the group of patients in which treatment with anti-tuberculosis therapy is used antiretroviral therapy (ARVT) – 49,3% versus 30,9% without ARVT, p = 0,0416. It was found increase of CD4 cell counts after treatment in patients TB/HIV, which, together with anti-tuberculosis therapy received ARVT 301 ± 45 cells/microliter vs. 202,3 ± 32 cells/microliter in patients without ARVT, p=0,0416.

Conclusion: determined that TB in patients with HIV infection characterized by severe course of the process with low efficiency of treatment and high MDR, which requires the strengthening of measures to control the spread of TB in these patients. 

The Combined Socially Important Infections (CSII) in St. Petersburg are result of accumulation of chroniogenic potential of HIV infection, tuberculosis and chronic viral hepatitis B and C. The analysis of a lethality from the combined infection (CI) for the long-term period in dynamics by years, showed to age and sexual groups and other signs that it exceeds that from tuberculosis by 2,4 times, from chronic hepatitis by 7,5 times. High level of a lethality of persons of young age, sharp growth of tuberculosis of intra chest, intra belly lymph nodes, frequent generalization of process with involvement in process of a liver, a spleen, kidneys testifies to the leading role of HIV infection in failures of diseases. The system and algorithm of proofs about the reasons of lethal outcomes of SI have to be based on representative selections. For this purpose it is necessary to carry out registration of HIV infection not only in the AIDS centers, but also regional in the form of the uniform register SI (HIV+TB+HIC or HIB) for the purpose of complex impact on epidemic process.

Objective: To estimate the prevalence of genetic variants and features of the molecular epidemiology of HBV in Yakutia residents suffering from HBV.

Materials and methods: The study involved 35 patients with chronic hepatitis B from urban and rural areas of Yakutia while most of the group were representatives of the autochthonous population. In the present study we used genotyping by direct sequencing of the Pre-S1 / Pre-S2 / S region of HBV DNA.

Results: Based on the phylogenetic analysis of the isolates showed that among patients examined HBV identified only D genotype, which is the most common genotype of HBV in the Russian Federation. It is shown prevalence of HBV subtype D2 (85,8%) compared to the HBV subtype D3 (14,2%).

Conclusion: We identified clearly clustered group of HBV isolates and close ties within the group, which suggests the existence of at least four permanent sources of infection, acting for a few years and decades. The systematic application of complex molecular, virological, epidemiological methods and molecular phylogenetics could contribute to the current understanding of the epidemiology of HBV and improve the quality of the traditional methods of supervision in Russia.

HBsAg earlier was always considered as the required serological marker of the current HBV-infection, and the presence of НВsAb was considered as evidence of the previous infection with the elimination of virus and the recovery. Exceptions of this rule were discovered more than two decades ago, after which it appeared the concept «occult» hepatitis В.

Aim: to characterize clinical course of chronic HBV-infection HBsAg-negative (occult) depending on HBsAb levels in serum.

Materials and methods: were examined 198 patients with HBsAg-negative chronic HBV-infection, with the confirmation mono-infection in the absence of factors of liver injury noninfectious etiology.

Results: most of the patient was in 45–74 years old. In 53 patients (27,8%) were identified HBcAb and HBsAb titer greater than 10 IU/l: positive HBcAb and HBsAb titre from 10 to 100 IU/l in 21,2% of cases; positive HBcAb and HBsAb titer more than 100 IU/l – 5,5%. DNA HBV was determined in 7,1% of cases. Cirrhotic stage of disease diagnosed in 30,2% of patients with low levels of HBsAb and 13,2% of patients with a high level of HBsAb. Evaluation of the degree of liver cirrhosis were revealed a class C in 86,9% of cases. Patients with decompensated cirrhosis are twice as likely HBsAb in low titre than high.

Conclusion: chronic HBV-infection with the serological profile of «past infection» independently of the level HBsAb can estimate as disease with the latent flow and may progression of pathologic process up to cirrhosis of the liver. These patients are subject to regular medical check once a year in a day hospital of a specialized center.

Aim: to study gene enzyme polymorphism of xenobiotic detoxification in patients suffered from HFRS influenced by disease severity

Proceedings : Molecular genetic checkup has been done in 292 patients suffered from HFRS and 426 seronegative donors.DNA samples isolated from lymphocytes of peripheral gene enzyme were used for molecular genetic checkup. Phenic-chloroform extraction method was applied to isolate DNA. The given DNA was used for polymerase chain reaction of DNA synthesis. Polymorphous CYP1A1 and GSTP1 gene locus analysis was performed on an automatic basis by polymerase chain reaction of DNA synthesis in a thermal cycle «Terzik» produced «DNK–techologiya» ( Moscow city) with the use of locus specific and oligonucleotide primers.

Outcomings: Glutathion-S-transferase class π with A313G locus of AG heterozygous genotype is typical for people of Bashkortostan due to underlying risk for HFRS. A combination of genotypes in the form of cytochrome P-450A1 with polymorphous locus A2455G and glutathione-S-transferase class π with A313G locus of AG can be found only in case of severe form of HFRS.

The protease inhibitors (PI) actively using for the treatment of chronic hepatitis C (CHC).

The aim of this analysis was to evaluate the cost-effectiveness of narlaprevir and simeprevir in the CHC (genotype 1) therapy in treatment-naïve patients and relapses.

Material and methods. Analysis of the cost-effectiveness of simeprevir and narlaprevir was conducted from the perspective of the health care system and base on QUEST-1, QUEST-2, ASPIRE and PIONEER clinical trials. The relative risk of achieving SVR 24 compared to the peg-INF + RBV therapy was used in the model. Treatment discontinuation in patients receiving narlaprevir assumed in the absence of a SVR after 12 weeks and in patients receiving simeprevir in the SVR absence after 4 weeks. The cost of narlaprevir was calculate based on estimated registration price in case of EDL (essential pharmaceutical list approved by MOH) inclusion, including VAT (10%) and 10% as trade margin. Costs of other antiviral products were in line with the results of 2015 average auctions prices.

Results. In the base case costs on antiviral products with narlaprevir as first-line therapy are lower compared with simeprevir by 12,2% (950,6 and 1083,0 thousand RUR, respectively), and the cost per patient with SVR 24 by 7,8%. In patients group after relapse costs on antiviral products with narlaprevir as first-line therapy will decrease compared with simeprevir by 4,3% (971,3 and 1014,7 thousand RUR, respectively), and the cost per patient with SVR 24 by 25,0%. The sensitivity analysis demonstrated a high reliability of obtained results. Thus, assuming equal clinical effectiveness of narlaprevir and simeprevir, costs of treatment naive patients will be 10.6% lower for narlaprevir group compared to simeprevir group (953,0 and 1066,0 thousand rur, respectively), and by 12,9% for the treatment of relapses (957,9 and 1100,0 thousand RUR, respectively).

Conclusions. With comparable clinical efficacy and tolerability of narlaprevir and simeprevir both in treatmentnaïve patients and patients with relapse after therapy, which included PEGylated interferon and ribavirin, narlaprevir reduces the burden on the budget. Due to substantial variability of PI prices, it is advisable to take into account local pricing at regional programs implementation.