Vol 14, No 1 (2024)

Objective. Epidemiological characteristics of herpes zoster (HZ) in the Russian Federation for justification of measures to improve epidemiological surveillance and prevention.

Materials and methods. Data from statistical observation form No. 2 and the «Department for Registration and Record of Infectious Disease (DRRID)» AIS system of the Center for Hygiene and Epidemiology in Moscow on the incidence of herpes zoster in the Russian Federation in 2019–2022 were studied. A correlation analysis between the incidence in the constituent entities of the Federation and the number of newly diagnosed cases of the disease caused by HIV was carried out, and the economic damage from HZ was assessed.

Results. Up to 19.5 thousand cases of the disease were registered annually in the Russian Federation. Average Russian incidence rates in 2019–2022. were 30–50 times lower than those of most foreign countries. The burden of disease varies among the constituent entities. In the age structure of the cases, more than 90% were adults. Cases of the disease are diagnosed in children, including those under the age of 1 year.

Conclusion. HZ is a significant problem for healthcare and the economy of the Russian Federation. In the absence of vaccine prophylaxis, the high incidence of HZ increases the risk of chickenpox infection.

Objective. Analysis of the epidemiological anamnesis of patients according to the Federal «Register of Patients with Viral Hepatitis» of the Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being.

Materials and methods. Information on 54,998 patients with various forms of hepatitis B was assessed, taking into account life history and information on parenteral interventions for 6 months. before the onset of the disease.

Results. Most often, patients indicated medical manipulations in medical institutions (811.7‰) and manipulations outside them (453.9‰) over 6 months. before the onset of the disease. As the most likely variant of infection, patients noted sexual contact (65.8‰), medical procedures in a hospital setting (63.0‰), manipulations in outpatient clinics (59.3‰) and intravenous drug use (33.2‰).

Conclusion. The «Register» is an important tool for tracking monitoring parameters of the epidemiological surveillance system, as well as assessing the effectiveness of preventive measures. It is a source of information that ensures scientifically based adoption of organizational and management decisions in the field of prevention of viral hepatitis.

Objective. Evaluation of the relationship between the formation of antigen (AG) – specific T-cell and humoral immunity and its cytokine regulation in the dynamics of pertussis in children.

Materials and methods. 100 children with pertussis were examined at 2–5 weeks of disease and during the period of convalescence. The balance of IFN-γ and IL-4 cytokines in the blood was compared with the dynamics of the specific immune response to B. pertussis antigens. The humoral response was assessed by enzyme immunoassay using Ridascreen test systems, and the T-cell response was assessed by the proliferation of lymphocytes isolated from the blood of patients after incubation on plates from the same test systems.

Results. In 69–92% of unvaccinated children, antigen-specific T-cells are detected from the 2nd to 12th week from the onset of the disease with a temporary sharp decrease in indicators at the 5–6th week. In vaccinated children with pertussis, the immune response develops as a secondary one, but memory T cells are found in no more than 67% of patients.

Conclusion. The nature of cytokine regulation of antibody formation in the dynamics of pertussis is reflected in the process of formation of memory T-cells and depends on the vaccine history.

Objective. Optimization of diagnosis and treatment of hemostasis disorders in the post-COVID period.

Materials and methods. The study included 100 patients aged 50.5 ± 0.84 years discharged from a COVID hospital 9 months ago. The state of the hemostatic system was assessed after 6 and 9 months after discharge using coagulogram and thrombodynamics test. Depending on the results of the thrombodynamics test in the post-COVID period, patients were divided into 3 groups (A, B, C). Patients in group A (n = 35), with severe hypercoagulation, received rivaroxaban 10 mg per day or apixaban 5 mg per day, patients in group B (n = 45) with moderate hypercoagulation – sulodexide 250 LU 2 times a day, patients of group C (n = 20), with minor changes in hemostasis, did not receive medications. The control group, examined at outpatient settings, included 20 apparently healthy individuals who had not had coronavirus infection (clinically and serologically) and had not been vaccinated against COVID-19. Statistical analysis of the results was carried out in the Statistica version 10 program (StatSoft Inc., USA), using multivariate ANOVA, Kruskal–Wallis test and Spearman correlation analysis.

Results. A hypercoagulable state in the post-COVID period was recorded in 86% of patients. After 3 months in group A, the number of patients with severe hypercoagulation decreased by 2.08 times (from 73 to 35%). Sulodexide was effective in situations with moderate hypercoagulation; in group B, after taking the drug, normocoagulation was observed in 16% of cases.

Conclusion. The data obtained indicate a long-term (more than 9 months) and persistent impairment of hemostasis in the post-COVID period and allows to determine tactics for diagnosing and correcting the prothrombotic state.

Objective. Determination of criteria for epidemic well-being and precursors of epidemic ill-being to improve the system of comprehensive monitoring of tularemia infection in the Donetsk People’s Republic (DPR).

Materials and methods. Data on the incidence of tularemia (T) from statistical reports of the Donetsk Regional Sanitary and Epidemiological Station for 1991–2014, the Republican Center for Sanitary and Epidemiological Surveillance of the State Sanitary and Epidemiological Service of the Ministry of Health of the DPR (2015–2022), industry reports on the results of epizootic monitoring for tularemia were used. Zoological-parasitological, bacteriological and serological research methods were used to characterize the epizootic situation in the outbreaks.

Results. The identified features of the tularemia epidemic process on the territory of the Donetsk region were used to substantiate the system of diagnostic and prognostic criteria for the epidemic process and the main provisions for optimizing the surveillance of this infection.

Conclusion. New approaches to the structure of the information subsystem for epidemiological surveillance of tularemia and specific measures for infection monitoring, based on the specifics and principles of a systematic approach to the tularemia epidemic process have been proposed.

The etiological agent of cervical cancer (CC) is human papillomavirus (HPV). However, not all HPV-infected women develop CC, which suggests a genetic predisposition.

Objective. Comparison and selection of the most optimal machine learning method for predicting the development of cervical cancer in HPV-infected women using data on genetic predisposition.

Materials and methods. DNA samples from 127 women with CC and 120 women without intraepithelial lesions were studied. The following single nucleotide polymorphisms were taken for analysis: rs55986091 (HLA-DQB1), rs2516448 (MICA) and rs9271898 (HLA-DQA1). To predict cervical cancer, the following methods were used: logistic regression, random forests, Gradient Boosting Machine (GBM), XGBoost and neural network.

Results. Predictors associated with the risk of developing CC included the presence of HPV types 16, 18 or 45 and 3 polymorphic variants: rs55986091, rs2516448 or rs9271898. When comparing machine learning methods, more accurate prediction results were shown for neural network and XGBoost.

Conclusion. Genetic predisposition and calculation models based on machine learning can be used to calculate individual risk of cervical cancer, identify risk groups and adjust the period between screenings.

A clinical observation of a case of typhoid fever in a child 1 year 7 months old admitted to an Infectious Diseases Hospital in Novokuznetsk in 2022 is presented. The disease proceeded in a typical moderate form with a favorable outcome. The diagnosis was confirmed by Salmonella typhi blood culture and serological tests. A local source of infection has been identified.

The review is based on literature data and analysis of previous studies. The current indications for vaccination in HIV-infected adults, the effectiveness and safety of modern vaccines are reviewed and systematized, and strategies aimed at improving vaccination results are discussed.

Objective. Evaluation of the effectiveness and safety of treatment of children with chronic hepatitis C (CHC) with the direct-acting antiviral drug Maviret in real clinical practice.

Materials and methods. The study included 38 children with CHC aged 12 to 17 years (mean age 14.7 ± 1.9 years). The patients were followed-up in the Children’s Infectious Diseases Department of the N.A. Semashko City Clinical Hospital. Of these, 13 had previously received antiviral therapy (AVT) (interferon alfa-2b + rebetol or peginterferon alfa-2b + rebetol), the remaining 25 children did not receive AVT. All 38 patients were prescribed Maviret (treatment was carried out at the Samara Regional Clinical Center for the Prevention and Control of AIDS). The duration of follow-up of patients after the end of combination therapy according to the interferon alfa-2b + rebetol regimen was 7–14 years (mean 6.4 ± 3.9 years), and immediately before the prescription of a direct-acting antiviral drug was 3–15 years (7. 6 ± 4.1 years). General and biochemical blood tests were performed, and the HCV RNA level was determined by PCR (sensitivity – 10–15 IU/ml).

Results. The dynamics of clinical, biochemical and virological parameters in children with CHC after IFN therapy, before and after the end of treatment with Maviret were considered. The duration of therapy was 8 weeks in 37 patients, and in one child with HCV genotype 3–16 weeks, since a virological response was not obtained to the previously administered combination therapy. At the end of the course of therapy, the children’s biochemical parameters normalized and a virological response was obtained after 12 weeks after completion of treatment, a sustained virological response was observed in 100% of patients. During the treatment of children with CHC with a direct-acting antiviral drug, no serious adverse events were registered.

Conclusion. Therapy with a direct-acting antiviral drug in children with CHC has shown high efficiency and safety.

The article presents a number of empirically obtained medical and social rules aimed at preserving the health and life of people, which were clothed in religious dogmas in the past for the purpose of mandatory performance.