Convulsions in case of acute neuroinfections can both complicate the disease course and transfer to symptomatic epilepsy which is one of the most important medical and social problems. The review article presents the data on epidemiology of convulsive disorder and symptomatic epilepsy in case of neuroinfections in children. There are considered the current immune and biochemical aspects of epileptogenesis in case of infectious pathology. There is given the information on neurophysiological and radial features of symptomatic epilepsy developed in case of neuroinfections of different etiology. There is underlined the practical significance of timely complex etio-pathogenetic therapy for neuroinfections complicated by convulsion that allows to reduce the frequency of symptomatic epilepsy development. There are presented the data on the results of transcranial magnetic stimulation in case of refractory epilepsy.

Purpose of the study: To investigate the role and clinical inflammatory (IL-17A, IL-23, IL-33) and anti-inflammatory (IL-35) cytokines in patients with of form without erythema of Borrelia infection.

Materials and methods: We studied 30 patients with of form without erythema of Lyme borreliosis. The diagnosis was based on epidemiological, medical history, clinical and laboratory, serological data. The blood serum interleukins level was detected from patients at admission to the infectious hospital and on the 10th day of hospitalization, as well as from 30 healthy donors. Groups of investigated persons were matched by sex and age. Blood serum analysis was carried out in the laboratory of directed regulation inter microbe interactions in the exo- and endoecological systems in Kirov State Medical University. Statistical analysis was performed using StatSoft Statistica v 10.0.

 Results: Patients with form without erythema of Lyme borreliosis oft have lesions of the respiratory system (60,0%), nervous system (53,3%), cardiac disorders (40,0%), rarely – liver disease (26,7%), joints (10,0%). In blood serum of patients with form without erythema at admission and at hospital discharge concentrations of IL-17A, IL-23, IL-33 are authentically higher compared with healthy donors. The content of anti-inflammatory IL-35 in patients with a form without erythema during hospitalization and at discharge is authentically lower than in healthy donors.

Conclusion: Patients with form without erythema of Lyme borreliosis have early combined Th1-Th2 immune response (increased content of blood serum IL-23 and IL-33). Elevated concentrations of IL-17A and IL-33 serum in patients with form without erythema indicate the presence of autoimmune or allergic reactions. Patients with form without erythema have inflammatory processes limited moderately by inflammatory reactions on the part of Treg-system (lack of IL-35 production).

The aim was to study the causes of death in HIV patients in the Novokuznetsk tuberculosis dispensary in 2016 (population is 550 thousand people; about 2% of population are HIV-positive).

Materials and methods: Protocols of all autopsies of HIV-infected patients (n=221) performed in 2016 in the Novokuznetsk tuberculosis dispensary.

Results: The mean age of the deceased was 37Ѓ}6,9 years. HIV and tuberculosis (TB) co-infection was in 83,3% of patients (n=184), HIV/TB and other opportunistic or severe somatic diseases – in 10,4% (n=23), non-tuberculous opportunistic diseases – in 6,3% (n=14). The new tuberculosis cases were in 71,1% (n=147), relapses – in 7,2% (n=15), chronic tuberculosis cases – in 21,7% of patients (n=45). Disseminated form prevailed among the cases of respiratory tuberculosis; generalized tuberculosis (3 and more localizations) occurred in 87,0% (n=180), tuberculosis meningitis was found in 17,9% (n=37). Positive fluorescent sputum microscopy was in 72.5%, sputum cultures on Loewenstein-Jensen medium – in 78,3% with HIV/TB. Primary multidrug resistance was detected in 60,7% (including in 5,8% of them with primary extensively drug resistance). Severe opportunistic infections or malignancies were in 9,2% of HIV/TB (n=19) and in 78,7% of non-TB patients (n=11). Data on the CD4 level was known in 68,8% of cases (n=152): the median count was 75,5 cells/μl; 38,9% of new TB cases (n=46) were diagnosed with HIV in time of TB detecting. Antiretroviral therapy was performed only 13% of patients (n=29).

 Conclusion: There is a need for the optimization of HIV detecting approaches and early initiation of antiretroviral therapy before the appearance of incurable opportunistic diseases, as well as for comprehensive TB prevention.

The purpose of this study was to investigate the influence of the invasion process and different strategies of treatment on some biochemical blood indices of mice infested with Syphacia obvelata and Trichocephalus muris of gastrointestinal tract, in order to optimize etiotropic therapy and improve its efficiency.

Materials and methods. In the experiment were used albino mice, divided into the following groups: intact animals (control group); animals infected with Syphacia obvelata; animals infected with Trichocephalus muris; infected animals, who received a single dose of albendazole (7 mg/kg); infected animals, who received a single dose of albendazole (7 mg/kg) and gamavit dose intramuscularly (0.3 cm3/kg) simultaneously. Blood for the studies was taken from the animals at 1, 3, 7, 10, 14, 17, 21 days after the infection and after drug administration. From biochemical parameters were determined activities of next enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GTP) and alkaline phosphatase (AP) – with kinetic method IFCC.

Results. Infecting animals with helminthes caused a noticeable increase in AP and gamma-GTP levels and cytolytic activity of enzymes: ALT and AST compared with intact group. The above-mentioned complex of metabolic changes clearly reveals a disturbance in hepatocyte metabolism that leads to the decrease in detoxifying function of the liver. This can be apparently explained with toxic effects of helminthes waste products. Albendazole mono-therapy in the therapeutic dose (7 mg/kg) of mice infected with both Syphacia and Trichocephalus caused an even greater increase in ALT and AST levels and also increased serum levels of alkaline phosphatase and γ-GTP, compared with the control and infected animals, that clearly shows an additional toxic effect from the antihelmintic drug. The use of albendazole in combination with a complex antioxidant “Gamavit” in animals infected with both Syphacia and Trichocephalus caused a gradual decrease in serum concentrations of alkaline phosphatase and γ-GTP, and a reduction in ALT and AST levels almost to control values. As a result of this treatment were normalized processes of protein synthesis, antitoxic liver function returned to normal levels and were decreased levels of endogenous intoxication.

Conclusion. Thereby, in consideration of this dynamics of blood beochimical parameters in we can conclude that the animal invasion provokes hepatotoxic effect in the host organism, which is further enhanced with the albendazole etiotropic mono-therapy. At the same time integrated antihelminthic therapy with simultaneous application of antioxidant drug “Gamavit” and albendazole stimulates cell energy metabolism, detoxification and hepatoprotective effect. Consequently, the use of complex antihelminthic therapy in combination with antidote therapy in pathologies of parasitic origin is highly relevant and appropriate.

Objective: Evaluation of CVD and their risk factors in Russian 40+ HIV-infected patients is a key objective of the study.

 Materials and Methods: A retrospective analysis of 1872 medical records of 40+ HIV-infected patients from 12 regions of Russia on HAART was performed, including assessment of CVD presence, their risk factors and 10-years CVD risk based on SCORE. All patients received ARV treatment; the average duration of admission was 5 years (1–2 years – 43%, 3–5 years – 29%, over 5 years – 28%).

Results: High incidence of CVD was observed: hypertension – 48%, including cerebrovascular disease – 2%; CAD – 9%, including myocardial infarction – 6%. Analysis of cardiovascular risk factors showed that 19% were overweight, lipid metabolism disorders were detected in 30% of patients, diabetes in 5%. 51% of patients smoked, systematic intake of alcohol in 61% of patients. 69% of patients had a risk of fatal CVD within 10 years based on SCORE, 16% of patients had a high/very high risk. Analysis of metabolic parameters showed that 99,4% of patients needed lifestyle improvement measures, 85% needed lipid lowering medication. One third of patients were constantly taking cardiovascular medications.

 Conclusions: CVD and metabolic disorders are more common for 40+ HIV-infected patients than for general population. ART assessment in 40+ patients additionally to viral load and CD4 level, should include analysis of cardiovascular risk factors and comorbidities. In elder patients ART regimen choice is particularly important, considering the risks of development and/or progression of CVD and risk of drugdrug interactions development.

Aims: determine the structure of IFNL3/IFNL4 interferon genes’ polymorphism in healthy people and in HCV patients and the frequency of spontaneous viral clearance in ethnic groups of Caucasians and Mongolians, living in the Asian part of Russia (Irkutsk Region) and in Mongolia.

Materials and methods: population genetic studies were conducted at 669 patients with hepatitis C, including 567 representatives Caucasian and 102 Mongoloid races. The control group consisted of 1520 healthy individuals, blood donors (800 Caucasians and 720 Mongoloids).

Results: it was found that in Caucasians patients with chronic hepatitis C were significantly less common CC genotype rs12979860, TT genotype rs8099917 and TT/TT genotype rs368234815, than in the general population. However, in patients with chronic hepatitis C, the representatives of the Mongoloid race, compared with healthy individuals, significant differences were found only in relation to the TT genotype rs8099917 IFNL3 gene. Spontaneous clearance of the virus was significantly more common in the Mongoloid race than in Caucasians.

Conclusions: the spontaneous viral clearance after clinical evidence or latent suffering hepatitis C was significantly more common in the Mongoloid race than in Caucasians that genetically determined high rate of prevalence in the population of the Mongols CC genotype rs12979860, TT genotype rs8099917 and TT/TT genotype rs368234815 polymorphisms of interferon type III genes.

The objective of the research was to study clinical and epidemiological features and outcomes of generalized forms of meningococcal infection in children from Krasnoyarsk and Krasnoyarsk Territory during the period from 2012 to 2016.

Materials and methods. A retrospective analysis of 57 medical records of hospital patients with generalized forms of meningococcal infection was carried out in the infectious and resuscitative departments of the Krasnoyarsk Clinical Hospital No. 1 from 2012 to 2016, including 12 protocols of pathologoanatomical studies of the deceased patients and 45 medical cards of ambulatory patients – convalescents of the disease from 2012 to 2016.

Results. The epidemic situation for meningococcal infection in Krasnoyarsk Territory from 2012 to 2016 is characterized by signs of inter-epidemic period. Children of the first 3 years of life are in the group of high risk for the development of GFMI, which accounts for 74% of the total number of cases of children aged 14. There are signs of meningococcal infection «aging» – in the age structure the number of children in the first year of life decreased, while the proportion of children aged 4–7 and 7–14 increased compared to previous decades. There is a tendency to a decrease in the proportion of the combined forms with an increase in the frequency of «pure» meningococcemia. In recent years there has been an «atypical» course of generalized forms of the disease, when classical hemorrhagic necrotic rashes appear only on the 3rd – 4th day of the disease. In convalescents who underwent a combined form of MI and «pure» meningitis severe residual effects leading patients to disability are possible to develop.

Conclusion. The use of polyvalent conjugated vaccines in potential risk groups will allow us to reduce the morbidity and mortality from generalized forms of meningococcal infection, including younger children.

In 20 patients, treated with regime of ART including phosphazid at a dose of 800 mg/day, his daily dose was reduced to 400 mg. In 19 of 20 patients the phosphazod’ dose reduction was due to the development of adverse events related to therapy. After changing the phosphazid’ daily dose the patients seen during the 1 year. Lowering the phosphazid’ dose did not lead to virological failure of the regime of ART and/ or progression of HIV-infection. On the background of lower doses in almost all patients observed a significant improvement in health- the reduction of weakness, disappearance of nausea and headaches. The analysis of laboratory data through 48 weeks after the change daily dose of the phosphazid also showed improvement in these indicators.

Purpose: The article contains results of the comparative analysis of dynamics of immunological parameters in the clinical period at children with an infectious mononucleosis of moderate severity during the acute period at treatment by the drugs “Anaferon kids “ and “Viferon” and further, in a catamnesis, within 6 years. The materials and methods: In group of research was 187 children. Three groups were created: the I group (n=75) – the patients receiving during the acute period «Anaferon kids» and pathogenetic therapy, the II group (n=72) – «Viferon» and pathogenetic therapy, the III group (n=40) – only with pathogenetic therapy. Results: Against the background of therapy with «Anaferon kids» and «Viferon» normalization of clinical symptoms and laboratory indicators came quicker in comparison with group of the children receiving only symptomatic therapy. At observation in a catamnesis, at all children the high rate of recurrent respiratory diseases was noted by viral infections. Changes in immunologic indicators became perceptible in all three groups throughout the entire period of observation.

Aim: To characterize the modern trends of the hepatitis A clinic in adults with markers of the hepatitis B virus.

 Materials and methods: The study included 124 patients with hepatitis A, were hospitalized in Clinical Infectious Diseases Hospital named after S.P. Botkin in the period from 2012 to 2015. Diagnosis of hepatitis A and chronic hepatitis B was established on the basis of clinical and epidemiological criteria, confirmed by the results of a laboratory study. Two groups of patients were identified: 1 group – patients with hepatitis A as a monoinfection (n=85), 2 group – patients who had hepatitis A on a background of chronic hepatitis B (n=39).

Results: An analysis of the age structure revealed that patients of the second group were older than the first. The analysis of gender structure established the same ratio of women and men (51,0% and 49,0%, respectively, p> 0,05) in the first group, in the second group the prevalence of women was found (64,0% and 36,0% respectively; p=0,001). General weakness, decreased appetite, and fever were more common for patients in the second group. Skin pruritus was more often in the first group. A comparative analysis of the two variants of hepatitis A showed that monoinfection of hepatitis A often occurs in mild form (47,0% and 18,0%, respectively, p=0,001). The severe form of the disease developed more often in patients of the second group (28,0% and 13,0%, respectively, p=0,02). Duration of hospitalization of patients and duration of icteric period was longer for hepatitis A on a background of chronic hepatitis B, regardless of the degree of severity.

Conclusion: Modern hepatitis A in a third of cases is combined with chronic hepatitis B in people older than 40 years, and characterized by a higher frequency of severe icteric forms with severe cytolytic syndrome and requires a long hospitalization, which is accompanied by significant economic damage.

Objectives: To identify homologous segments of human hemostatic and viral proteins and to assess the role of human hemostatic proteins in viral replication.

Materials and Methods: The following viruses were chosen for comparison: influenza B (B/Astrakhan/2/2017), coronaviruses (Hcov229E and SARS-Co), type 1 adenovirus (adenoid 71), measles (ICHINOSE-BA) and rubella (Therien). The primary structures of viral proteins and 41 human hemostatic proteins were obtained from open–access www.ncbi.nlm.nih. gov and www.nextprot.org databases, respectively. Sequence homology was determined by comparing 12-amino-acid segments. Those sequences identical in ≥ 8 positions were considered homologous.

Results: The analysis shows that viral proteins contain segments which mimic a number of human hemostatic proteins. Most of these segments, except those of adenovirus proteins, are homologous with coagulation factors. The increase in viral virulence, as in case of SARS-Co, correlates with an increased number of segments homologous with hemostatic proteins.

Conclusion: Hemostasis plays an important role in viral replication and pathogenesis. The conclusion is consistent with the literature data about the relationship of hemostasis and inflammatory response to viral infections.

The objective. To conduct a comparative assessment of circulation different genotypes of group A rotaviruses on the territory of the Orenburg region during several epidemic seasons.

Materials and methods. The article presents the findings of genotyping faeces of 182 patients with rotavirus infection. The patient’s age was below 5 years. The methods of ELISA, PCR were used.

Results. 10 genotypes of group A rotaviruses circulated during 3 epidemic seasons in the Orenburg region, the dominant genotypes were G4[P]8, G3[P]8, G2[P]4. The greatest variety of the circulating genotypes of group A rotaviruses were noted among children aged below two years. Genotype G4[P]8 was presented as the most frequently occurring in all age categories. 20 (11%) of the samples with the simultaneous combination of different genotypes of rotaviruses (Mixt) form were revealed.

Conclusion. The dominant genotype variants were singled out and their regional variety were shown in the different epidemic seasons. The characteristic of rotavirus genotype among children in various age was defined. The activity of the circulation of rotaviruses in the region was evaluated.

Aim: Characteristics of the peculiarities and the etiological factor of enterovirus infection on some territories of Russia in 2016.

Materials and methods: We investigated 2138 samples from the patients with enterovirus infection. The isolation and identification of enteroviruses were conducted by the virological method and by partial sequencing of the genome region VP1. Phylogenic trees were constructed according to the method of Bayesian Monte Carlo Markov Chain.

Results: Epidemic peaks of enterovirus infection were fixed on some territories of Russia. In Saratov region the morbidity index of enterovirus infection in 2016 was twice as high as the median morbidity index over previous years. The morbidity level of enterovirus meningitis – 3, 21 for 100000 of the population (77% from all the cases of enterovirus infection) was higher than on the other territories. In Kostroma region the morbidity index of enterovirus infection in 2016 was 11 times higher than the index of the previous year. On both territories the rise of morbidity depends on the active circulation of enterovirus ЕСНО30. Enteroviruses ECHO30 from Saratov region belonged to two phylogenic groups of genotype h. To one of them belonged viruses ECHO30 from Kostroma region. In Murmansk and Leningrad regions in 2016 most cases of enterovirus infection were represented by hand, foot and mouth disease (HFMD). The grouped foci of infection were registered in some preschool institutions. The etiological factor of this clinical form was Coxsackieviruses A6 belonging to different genetic variants.

Conclusion: Epidemic peaks of enterovirus infection with the prevalence of different clinical forms of the disease were provoked by different etiological factors. On territories where enterovirus meningitis prevailed strains of enterovirus ECHO30 belonging to different variants of genotype h were detected. In patients with clinical picture of HFMD from territories where this form was leading the etiological factor of infection was Coxsackievirus A6 of different genetic variants.

The purpose of the study is the morbidity analysis of HIV infection and procuring of antiretroviral medicines in the Arab countries on the example of the Lebanese Republic.

Materials and methods: The research was carried out for the period from 2010 to 2016. The objects were the State Register of Medicines, statistical reporting materials of the Center for AIDS Prevention and Control of the Lebanese Republic.

Results. The article analyzes the dynamics of the morbidity of citizens of the Lebanese Republic with HIV infection. The following is shown: the growth rate of the number of newly detected cases of HIV infection relative to the previous period; the number of cases identified by age group, sex, type of sexual orientation, method of infection. The characteristic of the system of procuring HIV-positive citizens with antiretroviral medicines is given. The holders of marketing authorization of these drugs in Russia are indicated. The possibilities of conducting the most cost-effective antiretroviral therapy are shown.

 Conclusion. There are opportunities in the Lebanese Republic for effective antiretroviral therapy. The availability of HIV treatment is provided through the use of predominantly generic versions of medicines, which reduces the number of new HIV infections and deaths from HIV / AIDS.

The review presents the data of Russian and foreign authors about the widespread and often under-diagnosed, as well as rare clinical forms of complications of VZV infection. Provides data on the frequency and structure of complications. There are groups risk of complications during varicella. Given the information first presented in the literature information classification of complications of chickenpox. The data on significant reduction in the frequency of complications, morbidity, mortality, economic losses in countries that have implemented mass immunization against varicella.

Abstract

Purpose: the evaluation of systemic immunobiochemical mechanisms of chronic opisthorchiasis, significant pathogenic criteria for the disease activity degree. Subjects and methods: We studied 312 chronic opisthorchiasis patients with the laboratory-confirmed diagnosis. The functional status of humoral immunity was assessed in 312 patients before the course of treatment and during the residual period of the invasion (2 weeks, 3 and 6 months after the course of treatment) together with the dynamics of specific markers (IgM and IgG antibodies and antigen Op. felineus CICs). According to the course of opisthorchiasis and the treatment provided the levels of autoantibodies to native and denatured DNA antigens were assessed in 94 patients.

Results: All patients showed high levels of immune complexes which were circulating in blood during the whole period of the disease, including immune complexes specific to antigen Op. felineus (61.3% of all seropositive results). We revealed a significantly high level of autoantibodies to native and denatured DNA antigens and their destruction was observed for a longer period of time compared to the designated period of follow-up monitoring (during 6 months). The destruction took place irrespective of the course of opisthorchiasis – nonmanifest or manifest. The results show a significant negative correlation between the level of autoantibodies to native and denatured DNA antigens and the amount of immune complexes (r =- 0.48, r = – 0.73).

Conclusion: Humoral immune response components are only disease markers during the course of opisthorchiasis and long period of circulation of specific and nonspecific immune complexes and they cause Op.felineus persistence in a host organism. The destruction revealed according to the levels of K nDNA and K dDNA during the whole period of followup monitoring may be one of the symptoms of post-opisthorchiasis even in the case of effective dehelmintization and it may work as an objective criterion for the disease activity degree. The correlation between the levels of autoantibodies to DNA and CICs show that immune mechanisms contribute to the process of the destruction.

Pseudomonas aeruginosa is an extremely dangerous cause of sepsis in patients with antitumor chemotherapyassociated neutropenia. Sometimes, the source of infection may be localized lesions of the skin (e.g. folliculitis) or its derivatives, which are not of particular concern in the absence of neutropenia. The appearance of Ecthyma gangrenosum in a patient with neutropenia, even in the absence of any signs or symptoms of sepsis, requires emergency care and the appointment of antibiotics with high antipseudomonal activity. We are report the case of the complications of chemotherapy with the sequential development of Ecthyma gangrenosum and Pseudomonas aeruginosa septicemia in a patient with concomitant skin infection (folliculitis).