The article presents the basic aspects of the activity of the institution established for the benefit of children from the moment of its foundation in 1927. There are noted landmarks in history and the priority scientific research works carried out in different periods of the institution development. Some results of the current history, improvement of its material resources are presented. There are described scientific achievements and the institution discoveries and their social value.

The aim: to present the current understanding of Japanese encephalitis as separate natural focal disease.

Method of investigation: search-analytical method.

Results. Japanese encephalitis is a classic natural focal disease of the vast area inSouth-East Asia. Its foci are active throughout the year, and are linked to the islands of the Sunda Islands andMalaysia. From here, the birds annually migrate through the Australasian seasonal flights route and bring the virus out, including new genotypes, to the north and north-easterly direction. In endemic countries, 85,996,0% of the patients are children and adolescents from 2 months up to 10-15 years of age. Mortality rate is 10-30%. Specific treatment is not available. Vaccination is effective. The population of the total area of Japanese encephalitis is vaccine-dependent. The natural focus in Primorsky Krai of theRussian Federationhas been self-eradicated.

Based on the annual UNAIDS reports the number of HIVinfected patients is continually growing since 1983. Antiretroviral Therapy (ART) allows to prolong life expectancy, but the problem of life quality and overall survival is still remaining. Nowadays, in the era of ART, one of the main cause of mortality in HIV-infected patients is malignancies. Lymphomas play one of the key roles in this group of diseases. The treatment of lymphomas includes combined regiments of chemotherapy with a curative potential. High dose chemotherapy with autologous hematopoietic stem cell transplant (auto-HSCT) is the main path of the treatment for relapsed / refractory lymphomas. In the last few years with a development of the genome editing technology auto-HSCT is becoming one of the most promising methods of HIV treatment. The case of “Berlin patient” when allogeneic HSCT from donor with mutation CCR5-delta32 lead to cure from HIV and proof of concept the efficacy of the gene therapy for HIV based on HSCT. Hematopoietic stem cell transplantation with edited autologous HSC (CCR5 knockout by site-specific genome editing tools with engineering nucleases) is a comprehensive treatment for this cohort of patients. On one hand, high dose chemotherapy with auto-HSCT cures the malignancy; on the other hand auto-HSCT works as a delivery method for the edited cells and creates an environment for the HIV eradication. This review is dedicated to HIV and oncology, methods of treatment of hematological malignancies and HIV-infection using genome editing technology based on HSCT.

Genetic characteristics of host organism may cause susceptibility to a variety of bacteria, viruses and fungi, as well as influence the course of infectious diseases. Multiple studies indicate the existence of alleles predisposing to infections. Furthermore, there are about 300 nosological entities of primary immunodeficiencies (PID), i.e., inherited defects of immunity. Timely diagnosis of such conditions is quite challenging; however, it is vital for improving quality of patient care. Modern methods of DNA analysis allow establishing genetic causes of vulnerability to certain infectious agents in many individuals

Aspergillus is very widely spread in nature. Daily people inhale to several thousand spores of micromycetes, however, an effective immune response prevents to development of the disease. In case of violation the mechanisms of innate and adaptive immune response as a result of genetic defects or iatrogenic immunosuppression Aspergillus spp. become pathogenic and can cause severe invasive infections in immunocompromised patients. Until now there are no reliable biomarkers for the risk prediction of invasive aspergillosis and monitoring the effectiveness of treatment of infectious process. In our review, we are considering the most important genetic and immunological factors affecting susceptibility to Aspergillus spp., The analysis of which can provide an individual approach to antifungal therapy / prevention in immunocompromised patients.

The destination of the study is to determine the effect of disorder of formation of the intestinal microbiota on the process of histamin release and development of allergic diseases in children. Materials and methods. 110 children are surveyed: 70 – with hereditary predisposition to allergic disorders (the basic group) and 40 without a genetic predisposition (the comparison group). Additionally 30 mothers was conducted microbiological. The release of histamine was determined from 807 intestinal culture of the qualitative methodology. The results of the study – in children with atopic dermatitis registered is first a proliferation of opportunistic bacteria of intestine. It was established that the manifestation of atopic dermatitis in the early stages contribute: pathological of pregnancy, disorder of the microbiota of the mother. This is the ground of congenital reduction of colonization resistance and of disorder of formation of the intestinal microbiota. First detected high intensity production of histamine from aerobic gram-negative bacteria of intestinal on the preclinical stage of atopic dermatitis. The intense of histamin release correlated with severity of disorder of the intestinal microbiota and with severity and stage of the disease. The summary: disorder of formation of the intestinal microbiota cause of the intense release of histamin and а manifestations of atopic dermatitis in the first year of life.

Objective: To study the informative value of the detection of mycobacteria in blood with the cultural method in patients with suspected tuberculous sepsis and to determine the most significant clinical and laboratory criteria for testing. Materials and methods: The investigation to detect M.tuberculosis was fulfilled in 159 HIV-positive patients with suspected tuberculosis sepsis. Blood culture was completed with culture medium Myco/F Lytic Culture Vials and analyzer BACTEC 9050. Results: Mycobacteria were detected in blood of 19 patients (11,9% of all patients): in 18 patients the growth of М. tuberculosis complex was detected (25,3% of all patients with diagnosed tuberculosis) and in 1 patient it was Mycobacterium avium complex (0,6% of all patients). It was shown, that the probability of M.tuberculosis detection was especially associated with the severity of the disease, immunosupression (less than 100 cells/mkl), hemoglobin quantity less than 90 g/l (levels were determined through the seeking for the most significant cutoffs). It was not proofed, that meningoencephalitis develops more often in patients with proven bacteremia. There were no evident differences in detection frequency of mycobacteria in sputum between patients with tuberculous sepsis and without it.

The aim: to identify changes in mental status due to receive HAART and comprehensive assessment of the biological, behavioral and social factors in adherence to treatment in HIV-infected patients with endogenous mental disorders. Material: The study involved 53 patients with HIV infection and schizophrenia / affective spectrum comorbidity. Results: In the tolerability and adherence to ARV therapy affects not only the neurobiological vulnerability, but also a change in the mental state and condition of the patient social life. After the start of ART mental state of patients with endogenous mental disorders often deteriorates. Depending on their degree of penetration into the central nervous system were observed pronounced effect of ART on the structure of psychopathological symptoms and the course of mental illness in general.

The aim: of the prospective cohort study was a TB screening evaluation in HIV-infected current and released prisoners and homeless people in comparison to the local HIV-infected residents in the pilot territories. Methods: Prospective data collection of newly registered HIV and TB co-infected cases was provided inSt. Petersburg,VologdaandLeningradregions between 2008 and 2011. The patients’ social and demographic, clinical and epidemiological characteristics were analyzed and predictors of TB-attributable mortality were evaluated. Results: A total of 2888 patients were included in the analysis: 1570 local residents, 777 released prisoners, 404 prisoners and 137 homeless persons. There was no significant difference in age, but prisoners, released prisoners and homeless persons were more likely to be male, urban resident, unemployed and injection drug user, less likely to have microbiological confirmation, presented with a greater incidence of disseminated lung TB, lower CD4 cell count. Significant predictors of TB-attributable morality were current or prior incarceration, urban residence, unemployment, symptoms lasting over 1 year, extra-pulmonary TB at presentation and CD4 cell count less than 200 cell/mkl. Conclusions: Found TB cases in HIV-infected prisoners, released prisoners and homeless persons were at a significantly more advanced disease stage and presented with greater morbidity and mortality to compare to the local residents. Targeted early screening and on time started treatment interventions could improve TB outcomes in these highly vulnerable social groups.

Objectives: Evaluating the effectiveness of 2 therapeutic schemes for chronic hepatitis C (genotype 6) which combined sofosbuvir and ribavirin, one of them also included pegylated interferon. Materials and methods: The study included 110 patients with chronic hepatitis C (genotype 6), who have undergone antiviral therapy (HTP) in Hepatology Clinic inHo Chi Minh City,Vietnamfrom November 2015 to July 2016. 24 patients were treated by Pegylated interferon alfa-2a, ribavirin and sofosbuvir for 12 weeks, 86 patients – by sofosbuvir and ribavirin for 24 weeks. Non-interferon regimen was administered primarily to patients with contraindications to the use of interferon. To monitor the effectiveness of antiviral therapy, quantification of HCV RNA in serum was performed by PCR prior to treatment, at 4th, 12th or 24th week (depending on the observation group) from the starting of treatment and at 12th, 24th week after completion of treatment. Results: All patients, who were treated with pegylated interferon, ribavirin and sofosbuvir, completed the full course of treatment and 100% of them are registered with sustained virological response at 12th and 24th week after the end of antiviral therapy (SVR-12 and SVR-24, respectively). In the group of patients, who treated with ribavirin and sofosbuvir, 97,7% of patients completed full course of treatment (SVR-12 was registered in 93% of patients, and SVR-24 – in 91,9% of patients). Of 75 patients without a history of HCC, SVR24 was registered in 74 people (98,7%), of 11 patients with HCC – in 5 patients (45,5%). SVR-24 was registered in 98% of patients with cirrhosis (F4) without HCC. Conclusion: The results can serve as a justification for the use of these schemes of antiviral therapy for special groups of patients and/or conditions when it is impossible to follow the latest recommendations, which will help to expand the access of patients to effective antiviral therapy for chronic hepatitis C.

Purpose: analysis of epidemiological, clinical and laboratory features of imported malaria in the North-Western Federal district (NWFD) in 2012–2016. Research materials: the study included 84 patients treated for malaria in the hospitals of the NWFD. Results: 84 cases of malaria were registered in the NWFD from 2012 to 2016, which constituted 18,9% of all cases registered inRussian Federation(n=445):St. Petersburg(n=60),Arkhangelsk(n=10),Murmansk(n=5),Leningradregion (n=4),Vologdaregion (n=2) and 1 case in Komi,NovgorodandKaliningradregion. Patients with malaria had a history of a recent visit to: Asian countries (37%, n=31), West Africa (35%, n=30), North Africa (11%, n=7),South Africa(8%, n=7), East and Central Africa (3% correspondingly),Dominican Republic,CubaandSouth America(1% correspondingly). Pl. vivax was most common cause of malaria in patients visited Asia (87%), while recent travel to West Africa predispose patients to malaria caused by Pl. vivax in 37%, Pl. falciparum in 57% and Pl. оvale in 6% of all cases. All patients arrived from the North, South, Central Africa andDominican Republichad malaria caused by Pl. falciparum. Conclusion: in NWFD in 2012-2016 in the process of providing care to patients with malaria the following trends were marked: late referral of patients for medical care, careless collection of epidemiological data and travel history, late diagnosis of the disease, insufficient supply of antimalarial drugs and severe malaria in patients with comorbidity. Lack of adequate therapy with modern drugs has led to the lethal cases in patients with tropical malaria and the occurrence of late relapses of tertian malaria.

The incidence of chronic hepatitis C inRussiais extremely high, that requires an increase the access to effective treatment regimens.

The aim of the study is to assess the cost of HCV therapy (genotype 1) of naïve patients without cirrhosis with second wave protease inhibitors narlaprevir and simeprevir in combination with peg-INF + RBV.

Materials and methods. Analysis of the cost-effectiveness is conducted from the perspective of the health care system. The assessment took into account only the cost of antiviral drugs. In the base case, costs were calculated based on the median price including VAT and the weighted average trade margin of theRussian Federationon given population. The cost of narlaprevir was calculated on the basis of estimated registration price including VAT and average trade margin on given population (price of registration – 98 000 RUB per pack 100 mg № 56). The sensitivity analysis evaluated the option of modifying the registered price of simeprevir and the estimated rates of narlaprevir registered price on 25%, and took into consideration the auction prices in 2016.

Results. In the base case costs on narlaprevir therapy 29,9% less compared with simeprevir (due to therapy with simeprevir failure after 4 weeks if lack of response). In the calculation of the full course of therapy, the savings increases to 38,4%. Analysis on prices of auctions also demonstrates the economic benefits of narlaprevir: estimated savings will account for 26,7% and 35,7% with and without allowance for failures with simeprevir in the absence of response after 4 weeks, respectively. Subgroup analysis shows that with any degree of fibrosis, narlaprevir allows reducing costs compared to simeprevir. Even in case of increasing the narlaprevir registration price and lower the simeprevir registration price compared to the baseline (in both cases – 25%) cost of therapy with narlaprevir will be 1,8% lower compared with simeprevir. Thus, the sensitivity analysis demonstrated a high reliability of the obtained results in the baseline.

Conclusions. Narlaprevir in combination with peg-INF + RBV will significantly decrease the cost of treatment of naïve patients with HCV genotype 1 infection without cirrhosis compared with the combination of simeprevir and therefore increase the availability of therapy. 

The analysis of organizational technologies of medical rehabilitation of children, who have undergone neuroinfections and children with organic damage of the nervous system is carried out. A comprehensive approach is recommended for the implementation of rehabilitation measures. It is included in the early recovery period of the course of neuroinfections, in accordance with the profile and severity of the infectious process, according to the individual rehabilitation program, to minimize the negative consequences of infections on the central nervous system in children. The role of a multidisciplinary team in the formation of a rehabilitation program based on an objective assessment of the rehabilitation potential is demonstrated. An algorithm aimed at providing rehabilitation measures for children with neuroinfections.