The share of norovirus infection is 17–20% of all cases of acute gastroenteritis in the world. The dominant II genogroup of noroviruses is characterized by rapid variability. The new recombinant norovirus GII.P16-GII.2 caused a sharp increase in the incidence of gastroenteritis in Asian and European countries during the winter season 2016–2017. The epidemiological features of norovirus infection are long-term excretion of the pathogen from the body of patients and carriers of viruses, especially in persons with immunosuppression; the implementation of various transmission routes (food, water, contact, aerosol), high contagiosity, winter seasonality in the countries of the northern hemisphere. In recent years, two human systems for the cultivation of noroviruses in vitro have been created, a double tropism of noroviruses has been established for immune cells and epithelial cells of the intestine, and the life cycle of noroviruses has been studied. The microbiota and its members can be either protective or stimulating for norovirus infection. Lactobacillus may play a protective role against norovirus infection. The existence of chronic norovirus infection lasting from several months to several years is proved, especially in patients with immunodeficiency. Severe form of norovirus infection and deaths are more often recorded in young children, the elderly, patients with comorbidity and immunocompromised individuals. The clinical picture of norovirus gastroenteritis is similar in many respects to other viral gastroenteritis, which determines the need for laboratory verification of the diagnosis. The polymerase chain reaction method with reverse transcription is the most widely used in the world for diagnosing infection in patients and for detecting the virus in food and environmental objects. There are still no approved vaccines and antiviral drugs against this infection. Recommended therapeutic interventions include, along with rehydration with hypoosmolar solutions, the administration of specific probiotics such as Lactobacillus GG or Saccharomyces boulardii, diosmectit and racecadotril.

In our review we present update on modern state of knowledge on instrumental methods of heart function evaluation. This methods are valuable and reliable additional tool in diagnostic process in patients with infectious diseases of different origins. Electrocardiography and heart ultrasound allows to perform noninvasive and highly informative investigation of heart’s condition on all stages of the disease. We review both literature and our own data on these matters. Heart MRI may further improve that diagnostic process and add it with valuable insights into the heart function and anatomy during the infectious diseases. 

Aims. To establish the incidence of Helicobacter pylori infection and giardiasis in children of different age groups with abdominal pain and dyspeptic syndrome immunochromatographic method.

Materials and methods. The coprological material from 407 children of different age, aimed at examination by gastroenterologist and allergist, who have a history of abdominal pain and dyspeptic syndrome, was studied: 215 people were examined for Helicobacter infection, 192 people for giardiasis. The study was conducted by non-invasive methods with the help of immunochromatographic tests of ICT Helicontest (NOVAmed, Israel) and RIDA® QUICK Giardia (R-Biopharm AG, Germany). The examined groups were divided into five age subgroups, separated according to the conventional periodization of human ontogenesis.

Results. Invasion of Giardia detected in 27 (14,1%) of the 192 examined, the infection of Helicobacter pylori (H. pylori) was diagnosed in 65 (30, 2%) of the 215 patients of preschool and school age. It is shown that in early childhood and the second childhood (1–3 years and 10–12 years) recorded the maximum frequency of giardiasis (p<0,05), in the age dynamics of infection of H. pylori, no statistically significant differences were found, however, H. pylori infection is not diagnosed in children up to 3 years. The data obtained can be used in practice, doctors gastroenterologists, allergists and pediatricians for the diagnosis of H. pylori infection and Giardia lamblia.

Purpose: to analyze prevalence of alcohol abuse and influence of alcohol abuse on adherence to ARVT in HIV-positive patients.

Research materials: we performed an anonymous survey of 165 HIV-positive patients hospitalized in Clinical Infectious Diseases Hospital named after S.P. Botkin in 2017.

Results: more than a half of participants has hazardous alcohol use or alcohol dependence. HIV-positive patients with alcohol abuse have high level of alcohol anosognosia. According to our survey among hospitalised patients, who didn’t take ARVT, 57% wasn’t ready to start antiretroviral therapy. Among patients, who were on ARVT at the time of evaluation, 92% had history of at least one episode of treatment interruption. Most common reason for interruption of antiretroviral therapy was drug’s side effect (36,5%). Alcohol was mentioned as a cause of interruption by 7,7% of participants. Level of adherence was significantly different among patients with different alcohol consumption pattern. Adherence measured with different self-assessment tools was low among hospitalized HIV-positive patients.

Conclusion: Hazardous drinking and alcohol dependence is very common among hospitalized HIV-positive patients. Suggested adherence self-assessment tools should help doctors to detect patients with insufficient level of adherence to ARVT. 

During the dynamic observation, clinical and laboratory results of 194 patients with infectious mononucleosis of Eрstein-Barr etiology of different age groups were summarized. In the comparative aspect, the identity of the symptoms is revealed. Along with this, the dependence of some clinical and laboratory parameters on the age of patients was found. Patients with preschool and school age often registered febrile fever, decreased appetite, raids on tonsils, the first appeared «snoring in a dream», hepatosplenomegaly. For teenagers and adults, icterus, a pronounced mononuclear response and cytolysis syndrome are more common. 

The aim of the study was to determine the serum level of homocysteine in children with neuroinfections.

Mаterials and methods: A blood serum assay of 60 children with viral and bacterial neuroinfections was performed using the enzyme immunoassay to evaluate homocysteinemia as a marker of endothelial dysfunction.

Results: In interpreting the results, the average level of hyperhomocysteinemia in patients with bacterial and viral neuroinfections was established. The highest homocysteine levels in serum were observed in bacterial neuroinfections, especially in the presence of signs of meningoencephalitis and pneumococcal etiology of the disease. Dependence of changes in the level of homocysteinemia from the sex of sick children was not revealed.

Conclusion: Neuroinfections in children, regardless of the cause, are accompanied by hyperhomocysteinemia, indicating the presence of endothelial activation in this pathology, more pronounced in the case of a bacterial etiology of the infectious process and the combined lesion of the soft dura mater and the brain substance. 

Chronic immune activation is one of the main causes of HIV disease progression. Bacterial components passed to the bloodstream from the gut as a result of microbial translocation, are known to induce immune activation. Component of Gram-negative bacteria’s cell walls, the lipopolysaccharide (LPS), is considered to be the major marker of microbial translocation. Through the activation of myeloid cells (predominantly monocytes) LPS causes the secretion of soluble CD14, thus making it a marker of LPS bioactivity. Besides sCD14 was shown to correlate with immune status in HIVinfected patients and to be an independent predictor of disease progression.

Hypothesis: opiates increase microbial translocation from the gut in HIV-infected patients that is manifested by a higher concentration of sCD14 in plasma.

Aim: to estimate the influence of opiate use on the level of sCD14 in plasma of HIV-infected patients.

Materials and methods. Longitudinal study of 351 HIV positive individuals. Concentration of sCD14, was evaluated at 3 time points: baseline, after 12 and 24 months. Following groups were studied: 1) current opiate users – opiate use within past 30 days; 2) opiate users, who denied consumption of opiates within past 30 days; 3) people claiming to never have used opiates.

Results. In dynamic assessment sCD14 mean was significantly higher in current opiate users (2222,46±39,02 ng/ml) against patients who denied opiates within past 30 days (1930±597 ng/ml) and those, claiming to never have used opiates (1915±577 ng/ml) (p<0,001).

Conclusion. Opiate use in the course of HIV disease leads to increase in LPS induced monocyte activation which therefore signifies more intensive microbial translocation.

Objective: to evaluate the significance of respiratory syncytial viral infection in lower respiratory tract infections in hospitalized children 1 year of life and its features.

Materials and methods: the research was carried out from march 2015 till october 2016. We enrolled all children under 1 year with acute lower respiratory tract infections. A real-time PCR method was used to detect viruses in nasopharyngeal swabs. The levels of CRP and procalcitonin were estimated.

Results: We enrolled in our research 356 children with acute lower respiratory tract infections. RS-virus was detected in 129 patients (36,2%). Single viral infection was detected in 79.9% of cases. The median age of the patients was 4 (1; 7) months. 14,7% of children with RS-infection had burdened premorbid background, 16.7% of children were premature. Severe forms of RS-infection have been detected in 26.4% children. These were the children of the first months of life, the median age was 2 (1; 4) months. RS-infection proceeded mostly in the form of bronchiolitis (62%). WBC count in pneumonia and bronchiolitis associated with RSV significantly differed (10,6 against 9,2×109 /l, p 0,028). The level of CRB was 1,8 (0,5; 6,8) mg/l, procalcitonin 0,075 (0,059; 0,104) ng/ml, there was no difference in bronchiolitis and pneumonia.

Conclusions: Respiratory syncytial virus infection is the leading cause of lower respiratory tract infections in hospitalized children 1 year of life. There was no increase of CRP and procalcitonin. The risk factor of severe RS- infection is early age (less than 6 months). 

The objective of the study was to describe patients with HIV infection, who were diagnosed in 2016 in St Petersburg AIDS Center, including provided antiretroviral therapy (ART).

A retrospective review of 521 patients’ case histories was performed. The case history selection was done by random sampling, in which the only criterion was the year of HIVinfection registration.

The majority of patient were young people (middle age -), socially adapted, with higher or secondary special education (%),acquired HIV by sexual rout (%). 44% of patients had a CD4-lymphocyte count less than 350 cells / mm3, indicating a late detection of HIV and advanced stage of the disease at the moment of HIV registration. 25% of patients with a CD4 counts more than 350 cells / mm3 also had clinical symptoms of HIV-infection and needed ART.

41% of patients with HIV had different concomitant noncommunicable diseases, of which one third (29%) received therapy for these diseases. This situation dictates the need for careful choice of ART regimens taking into account the clinical features of patients, concomitant therapy and drugdrug interactions. 

Purpose of the study: to assess the state of nonspecific immunity in women with relapsing herpetic infection, planning pregnancy, period of gestation, from infants and children in the first six months of life, depending on the method of prophylaxis of relapses of infection and intrauterine infection.

Patients and methods: under observation were 342 pregnant women with relapsing herpetic infection and their children. Testing for the presence of HSV infection was performed using methods of PCR and ELISA. Women and their children were studied: interferon status, indicators of phenotyping of lymphocytes, the levels of tumor necrosis factor, growth factor of the placenta, placental alkaline phosphatase, placental alpha-1 microglobulin, interleukin 10, immunoglobulin classes A, M, G; for the assessment of fetoplacental complex was used ultrasonic methods. The health status of infants and children in the first six months of life was estimated taking into account the diagnosis of intrauterine infection with herpes simplex virus and realization of somatic pathology.

Results of the study: validated method of prevention of intrauterine infection of the fetus with the use of the drug Alloferon on degustatsionnom stage and human recombinant interferon Alfa-2b in the antenatal period. A proven Association between the efficiency of consequent preventive therapy and frequency of complications of gestation, intrauterine infection with herpes simplex virus, the state of nonspecific immunity in pregnant women, newborns and children in the first six months of life.

Conclusion: for recurrent herpes infection during pregnancy, an imbalance in the system of nonspecific immunity, development planetarnoi failure lead to tensions antiinfectious immunity in the neonatal period in children with intrauterine infection, and in uninfected children. Newborn children with the implementation of the herpes infection observed inhibition of nonspecific immunity. Milestone method of prevention of intrauterine infection of the fetus with the use of drugs Alloferon and human recombinant interferon Alfa-2b meets the modern requirements of perinatal pharmacology, accessible and safe.

To reveal factors associated with negative attitude to vaccination against viral hepatitis B we performed two crosssectional studies including 1243 adults aged 18–39 years, recruited by a public opinion agency applying a quota sampling method to achieve a data set with similar age- and sex-distribution as the population in Arkhangelsk, and 2896 parents, visiting child’s health-care facilities of Arkhangelsk region.

Binary logistic regression was used to analyze factors associated with negative attitude to vaccination.

Among 1243 adult respondents 3,5% expressed a negative attitude to vaccination against viral hepatitis B. According to serological testing 15,9% of participants who demonstrated negative attitude to vaccination had serological markers of viral hepatitis B infection (HBsAg, antiHBc-antibodies, sometimes in combination with antiHBs-antibodies). Respondents younger than 30 years and people who had standard risk factors of infection (injecting drug use, blood transfusion, surgery, induced abortions, tattoo, 5 and more sexual partners in a year), more often demonstrated positive attitude to vaccination against viral hepatitis B in comparison with others.

Among 2896 parents 1,6% expressed a negative attitude to vaccination of their children against viral hepatitis B. Factors associated with negative attitude to vaccination were age younger than 25 years, high education, concerns and misinformation about vaccines, distrust in physicians.

Thus, young adult people, who had standard risk factors of infection, had positive attitude to vaccination against viral hepatitis B. Young parents underestimated the risk of infection in children and importance of timely vaccination. The major reasons for negative public attitude to vaccination against viral hepatitis B were lack of information about vaccination and, as a consequence, unawareness of the need of immunization.

Antiretroviral therapy is one of the most effective strategies for preventing tuberculosis among people living with HIV. It significantly reduces the risk of tuberculosis, regardless of immunosuppression level, results of tuberculin tests and prevalence of drug-resistant tuberculosis in the region. The results of the retrospective cohort study conducted at the Pskov Regional AIDS Center from 2007–2016 convincingly confirmed the importance of the ART in preventing the TB development in patients with HIV. Of the 814 subjects included in the study, 590 – received ART, 305 – did not receive it. In compared groups TB was more likely developed in patients without antiretroviral therapy, RR 0,37 (95% CI 0,20–0,49), they were more likely to die of tuberculosis, RR 0,20 (95% CI 0,065-0,4), and among them more likely occurred other opportunistic diseases, RR 0,53 (95% CI 0,35–0,75). Among those receiving ARVT, tuberculosis and other opportunistic diseases developed more often in individuals with CD4 350 cells/ml, there were no lethal outcomes of tuberculosis, RR 0.23 (95% CI 0.0-2.0). 

The purpose of the study. To evaluate immunogenicity of influenza vaccination in HIV-infected adults initially seronegative to influenza virus.

Materials and methods. There were 175 HIV-infected persons and 50 healthy volunteers vaccinated against influenza in Republican center of AIDS (Ufa) in 2016-November. Titers of antibodies to influenza virus (A [H1N1], A [H3N2] and B) were detected in standard hemagglutination-inhibition reaction: before (day 0) and after (on 21th and 150th days) vaccination. Post-vaccination trends of antibodies to influenza virus were analyzed in 12 HIV-infected patients (7%) and 13 subjects from control group (26%) with the titer of antibodies lower than protective level (1/40) according to the criteria of immunogenicity for influenza vaccines for all subtypes of its antigens.

Results. The shares of initially seronegative were 2–7% for HIV-infected and 12–24% Saint-Petersburg for healthy persons. Seroconversion coefficient varied from 1,6 to 2,3; seroconversion rate varied from 0 to 25%; seroprotection rate – from 67% for А (H1N1) to 100% for А (H3N2) and В. The titer of antibodies detected on day 21 didn’t decrease up to day 150 in all vaccinated persons.

The analysis of the titer in HIV-infected adults with the different levels of CD4-cells demonstrated achievement of minimal protective level (1/40) in the majority of cases, and at least fourfold increase of the titer was determined when CD4-cells level was 350 cells/μl.

Conclusion. Single immunization of HIV-infected adults with standard vaccine for seasonal prevention of influenza is insufficient for creation of adequate immune response. A small sample of the study does not allow extrapolating the results of studies to large cohorts of patients with HIV infection. Further research is required to develop recommendations for vaccine prevention of influenza in patients with HIV infection.

Objective: analysis of the incidence of SARS, influenza and determining the etiological structure of influenza in the Republic of Sakha (Yakutia), and in particular, in the Arctic zone of the Republic.

Materials and methods: we used data from the official statistics of the national center for CPS, as well as summary data of the Federal center of Rospotrebnadzor. We analyzed the results of epidemiological survey (form 357/u) and laboratory tests. In the first season of the surveyed 1,140, in the II epidsezona – 3317 in the season – 3270. To determine circulating RNA of influenza virus of birds studied 1375 samples of wild and 958 samples in poultry.

Results: the average incidence of Ari in the Republic of Sakha (Yakutia) for the period 2007–2016 significantly above the average for the same period the incidence in the Russian Federation. The incidence of SARS in some Arctic regions is considerably higher than the Russian and of the national average. The evolution over the last ten years the number of cases of influenza in the Republic varied greatly. In the Arctic regions of the Republic of the diagnosis of «influenza» over the entire period of observation were recorded in isolated cases. Was highly pathogenic strain of avian influenza A/wigeon/Sakha/1/2014 (H5N8).

Conclusion: it is necessary to develop a network of interdistrict laboratories for the laboratory diagnosis of infectious diseases, equipping with modern equipment, developing a logistic scheme for the delivery of material for research with respect for transportation conditions, and training. 

On the example of clinical observation of severe respiratory syncytial virus (RSV) infection, which occurred with the development of a specific pneumonia complicated by acute respiratory distress-syndrome and disseminated intravascular coagulation syndrome, which caused a lethal outcome in the non-term (33-34 weeks gestation) child of two months of life, the clinical and pathomorphological features of the disease are shown. Immunomorphologic study after death allowed to demonstrate the most important stages of respiratory syncytial viral infection pathogenesis and to specify reasons of long-term airway obstruction, caused by complicated respiratory syncytial viral infection. It was indicated, that bronchial obstruction may be caused by qualitative changes of epithelial lumen of different bronchi, such as direct cytophatic effect of respiratory virus or reactive changes of lumen in the form of basal squamous cell differentiation of epithelial lumen and poor regeneration of respiratory epithelium in the later stages of the disease. 

The article describes the clinical cases of anti-N-methylD-aspartate receptor encephalitis of two patients. An analysis of the dynamics of neurologic symptoms, the results of neurovisualization and neurophysiological examinations was carried out. It was shown that in patients with AntiN-methyl-D-aspartate receptor encephalitis, neurological symptoms are similar in their manifestations with symptoms of virus encephalitis. At the same time, the mechanism of development and etiology of this form of autoimmune pathology is not understood. Also, no pathognomonic changes were detected for MRI of the brain, PET, EEG for Anti-N-methylD-aspartate receptor encephalitis. The authors conclude that the diversity of neurological symptoms in patients with antiN-methyl-D-aspartate receptor encephalitis may be due not only to dysfunction of brain structures due to disruption of NMDA receptor activity, but also to a reversible disruption of functional interrelationships between different parts of the brain.