Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-94-97
K. B. Vladimirov, S. I. Sokolov, G. Marfina
Herpes zoster is often associated with HIV infection. The article presents a clinical case of herpes zoster, complicated by the thoracic wall phlegmon in a 41-year-old male infected with HIV. Dissection and debridement of the phlegmon were performed. Antibacterial and pain relief therapy, start of antiretroviral therapy and treatment of the concomitant diseases were carried out. The residual thoracic wall skin and soft tissue defect on the site of the phlegmon was healed with surgery.Conclusions. Secondary manifestations of HIV infection present with the diversity of symptoms and severe clinical performance. Herpes zoster may be complicated with the purulent inflammation of surrounding tissue in the patients with HIV-infection. A multidisciplinary approach to the diagnosis and treatment of such patients is required.
{"title":"Herpes zoster, complicated with thoracic wall phlegmon in a patient with HIV-infection: a case report","authors":"K. B. Vladimirov, S. I. Sokolov, G. Marfina","doi":"10.22328/2077-9828-2023-15-4-94-97","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-94-97","url":null,"abstract":"Herpes zoster is often associated with HIV infection. The article presents a clinical case of herpes zoster, complicated by the thoracic wall phlegmon in a 41-year-old male infected with HIV. Dissection and debridement of the phlegmon were performed. Antibacterial and pain relief therapy, start of antiretroviral therapy and treatment of the concomitant diseases were carried out. The residual thoracic wall skin and soft tissue defect on the site of the phlegmon was healed with surgery.Conclusions. Secondary manifestations of HIV infection present with the diversity of symptoms and severe clinical performance. Herpes zoster may be complicated with the purulent inflammation of surrounding tissue in the patients with HIV-infection. A multidisciplinary approach to the diagnosis and treatment of such patients is required.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-47-52
O. N. Brazhenko, A. I. Loschakova
The autonomic nervous system (ANS) is an important part of the human nervous system responsible for regulating internal organs and maintaining the internal environment of the body. Adequate functioning of the ANS supports homeostasis is the internal stability of the body and regulates many functions in it, such as cardiac activity, breathing, etc. TB-related stress and inflammation affect have influence at the balance of sympathetic and parasympathetic activity. Affecting the work of the peripheral nervous system, it becomes possible to influence at the system of homeostasis of the body through its regulatory systems. Improving the diagnostics of autonomic dysfunction and identifying its dysfunction will provide an integrated individualized approach to treatment and will make a significant contribution to increasing the effectiveness of therapy for patients with tuberculosis.Aim. Diagnosis of the state of the autonomic nervous system by its main indicators using available informative methods for assessing its functional state in patients with respiratory tuberculosis, including in combination with HIV infection at the beginning of treatment and detecting the level of its damage for further correction with the prescription of pathogenetic therapy.Materials and methods. The functional state of the autonomic nervous system has been investigated in 260 people. In the study, 2 groups were formed: a control group (CG) of 70 healthy persons and a monitoring group (MG) of 190 newly diagnosed patients with tuberculosis. There are 3 subgroups in MG. The 1 subgroup included 65 patients with pulmonary tuberculosis, in whom the function of ANS was studied by conventional examination methods, and in 64 patients with tuberculosis 2 subgroups and 61 patients with tuberculosis in combination with HIV infection 3 subgroups using Varikard 2.51. Calculations were carried out in the program SPSS Statistics v. 23.Results and discussion. Comparison of the frequency of autonomic dysfunction in patients with MG, subgroup 1 with that in the CG according to questionnaires No. 1 (χ2=36.346; p<0.001) and No. 2 (χ2=50.885; p<0.001), HR per minute (χ2=31.989; p<0.001), Kerdo index (χ2=30.008; p<0.001), cold sample (χ2=36.549; p<0.001) revealed high reliability of differences and indicated the predominance of sympathicotension, which was determined 7 times more often in patients. At the beginning of treatment, in patients with concomitant HIV infection was detected a more pronounced dysfunction of ANS with a predominance of its sympathetic link, which was found 9.3 times more often than in healthy persons and 2.3 times more often than in patients without HIV infection. Comparing the frequency of PARS in the «normal zone» in the CG and in the 2 subgroup of MG (t1=5.01; p1<0,001; t2=3,69; p2>0.001), in CG and in MG subgroup 3 (t1=3.61; p1<0.001; t2=3.61; p2<0.001) high significant differences were identified, indicating a significant predominance of regulatory process disorders i
{"title":"Assessment of the state of autonomic dysfunction in patients with tuberculosis of the respiratory system and in combination with HIV infection in modern conditions","authors":"O. N. Brazhenko, A. I. Loschakova","doi":"10.22328/2077-9828-2023-15-4-47-52","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-47-52","url":null,"abstract":"The autonomic nervous system (ANS) is an important part of the human nervous system responsible for regulating internal organs and maintaining the internal environment of the body. Adequate functioning of the ANS supports homeostasis is the internal stability of the body and regulates many functions in it, such as cardiac activity, breathing, etc. TB-related stress and inflammation affect have influence at the balance of sympathetic and parasympathetic activity. Affecting the work of the peripheral nervous system, it becomes possible to influence at the system of homeostasis of the body through its regulatory systems. Improving the diagnostics of autonomic dysfunction and identifying its dysfunction will provide an integrated individualized approach to treatment and will make a significant contribution to increasing the effectiveness of therapy for patients with tuberculosis.Aim. Diagnosis of the state of the autonomic nervous system by its main indicators using available informative methods for assessing its functional state in patients with respiratory tuberculosis, including in combination with HIV infection at the beginning of treatment and detecting the level of its damage for further correction with the prescription of pathogenetic therapy.Materials and methods. The functional state of the autonomic nervous system has been investigated in 260 people. In the study, 2 groups were formed: a control group (CG) of 70 healthy persons and a monitoring group (MG) of 190 newly diagnosed patients with tuberculosis. There are 3 subgroups in MG. The 1 subgroup included 65 patients with pulmonary tuberculosis, in whom the function of ANS was studied by conventional examination methods, and in 64 patients with tuberculosis 2 subgroups and 61 patients with tuberculosis in combination with HIV infection 3 subgroups using Varikard 2.51. Calculations were carried out in the program SPSS Statistics v. 23.Results and discussion. Comparison of the frequency of autonomic dysfunction in patients with MG, subgroup 1 with that in the CG according to questionnaires No. 1 (χ2=36.346; p<0.001) and No. 2 (χ2=50.885; p<0.001), HR per minute (χ2=31.989; p<0.001), Kerdo index (χ2=30.008; p<0.001), cold sample (χ2=36.549; p<0.001) revealed high reliability of differences and indicated the predominance of sympathicotension, which was determined 7 times more often in patients. At the beginning of treatment, in patients with concomitant HIV infection was detected a more pronounced dysfunction of ANS with a predominance of its sympathetic link, which was found 9.3 times more often than in healthy persons and 2.3 times more often than in patients without HIV infection. Comparing the frequency of PARS in the «normal zone» in the CG and in the 2 subgroup of MG (t1=5.01; p1<0,001; t2=3,69; p2>0.001), in CG and in MG subgroup 3 (t1=3.61; p1<0.001; t2=3.61; p2<0.001) high significant differences were identified, indicating a significant predominance of regulatory process disorders i","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-63-72
N. B. Khalezova, Z. E. Kostyleva, M. Kissin, E. Boeva
The COVID-19 pandemic has exacerbated the increasing prevalence of non-psychotic mental disorders and the rise of antivaccination tendencies.The aim of the study was to describe the attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders, as well as in mentally healthy individuals.Materials and methods: a survey was conducted of 100 outpatient patients with psychiatric diagnoses of non-psychotic level: organic mental disorders (14), affective disorders (38), neurotic and stress-related disorders (48), as well as 30 people without mental disorders.Results and discussion. There was no association between the severity of COVID-19 and an adverse reaction to the vaccine. A high incidence of skepticism about vaccination against COVID-19 was noted in women, in the older age group, in people with higher education and highly qualified work, but poorly informed about immunoprophylaxis. Post-vaccination complications (fever, general weakness) after immunization against COVID-19 were more often detected in patients with affective disorders, however, this group of patients showed the most loyal attitude to vaccination. Patients with organic mental disorders shown the lowest degree of approval of vaccination against COVID-19, they cited fear of possible «side effects» and «lack of proven benefit» as the main reason for not being vaccinated.Conclusion. Vaccination of the population of all countries affected by COVID-19 has exacerbated such a phenomenon as doubt about the benefits of immunoprophylaxis. The results of the article can be extrapolated to the future development of new drugs in the field of immunoprophylaxis.
{"title":"Attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders","authors":"N. B. Khalezova, Z. E. Kostyleva, M. Kissin, E. Boeva","doi":"10.22328/2077-9828-2023-15-4-63-72","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-63-72","url":null,"abstract":"The COVID-19 pandemic has exacerbated the increasing prevalence of non-psychotic mental disorders and the rise of antivaccination tendencies.The aim of the study was to describe the attitude to vaccination against COVID-19 in patients with non-psychotic mental disorders, as well as in mentally healthy individuals.Materials and methods: a survey was conducted of 100 outpatient patients with psychiatric diagnoses of non-psychotic level: organic mental disorders (14), affective disorders (38), neurotic and stress-related disorders (48), as well as 30 people without mental disorders.Results and discussion. There was no association between the severity of COVID-19 and an adverse reaction to the vaccine. A high incidence of skepticism about vaccination against COVID-19 was noted in women, in the older age group, in people with higher education and highly qualified work, but poorly informed about immunoprophylaxis. Post-vaccination complications (fever, general weakness) after immunization against COVID-19 were more often detected in patients with affective disorders, however, this group of patients showed the most loyal attitude to vaccination. Patients with organic mental disorders shown the lowest degree of approval of vaccination against COVID-19, they cited fear of possible «side effects» and «lack of proven benefit» as the main reason for not being vaccinated.Conclusion. Vaccination of the population of all countries affected by COVID-19 has exacerbated such a phenomenon as doubt about the benefits of immunoprophylaxis. The results of the article can be extrapolated to the future development of new drugs in the field of immunoprophylaxis.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-53-62
N. Belyakov, V. Rassokhin, N. Totolyan, E. Boeva, A. S. Bobreshova, N. B. Khalezova, Y. Kushnir, A. O. Norka
Purpose of the study. To assess the nature of health complaints, frequency of occurrence, structure and characteristics of neurological, general somatic and mental disorders in people in the post-COVID period.Materials and methods. The main group (n=1000) was represented by people who had a new coronavirus infection, confirmed by polymerase chain reaction (PCR) SARS-CoV-2, from 18 to 60 years old. As part of the study, an extensive survey of the examined individuals was carried out, aimed at identifying the main psychoneurological and general somatic consequences that developed in the period from 4 weeks to 12 months after COVID-19.Results and discussion. The study included 289 men and 711 women (28.9% and 71.1%, respectively). The average age at the time of the examination was 40.2±11.8 years. More than half of the respondents were of working age, had a permanent job or were studying (72.3%), while 17.9% indicated a high level of physical activity before COVID-19. The majority of respondents suffered from mild COVID-19 (76.6%), in 23.4% of cases the disease was moderate. Among somatic (vegetative) disorders as a consequence of COVID-19, the most common complaints were hair loss (49.5%), fatigue in 77.5% of cases, regardless of workload and type of work, and fluctuations in blood pressure in 50.2% of patients. Women complained more intensely about hair loss (χ2=60.2608, df=9, p<.001), shortness of breath (χ2=17.5025, df=9, p=0.04), interruptions in heart function (χ2=22.7863, df=9, p=0.007).Among the respondents, the most common complaints were emotional disturbances, which determined the picture of anxiety and depressive disorders, as well as cognitive impairments in the form of memory loss (69.5%), concentration, difficulties with long-term attention maintenance (65,5%) and switching from one task to another (60%). With the age of the respondents, fatigue increased in intensity (R=0.2, p<0.05), insomnia (R=0.2, p<0.05), anxiety for health and for their close persons (R=0.2, p<0.05), neurological complaints (widespread muscle pain (R=0.3, p<0.05), pain in the spine (R=0.3, p<0.05), gait disturbances (R=0.2, p<0.05), as well as the intensity of general somatic complaints (urinary disorders (R=0.2, p<0.05), shortness of breath (R=0.2, p<0.05), pain and heaviness in the chest (R=0.2, p<0.05), irregular heartbeat (R=0.2, p<0.05), fluctuations in blood pressure (R=0.2, p<0.05). Clear gender differences in the intensity of post-COVID psychopathological manifestations were revealed. Women complained more strongly about post-COVID high fatigue (χ2=23.8901, df=9, p=0.004), general malaise (χ2=17.9304, df=9, p=0.04) and, accordingly, lower activity and inability to cope with household workload (χ2=22.3384, df=9, p=0.008) compared to men. Women had more severe dysmnestic disorders (χ2=23.0900, df=9, p=0.006) than men. Women were also characterized by having greater anxiety for close persons (χ2=20.5941, df=9, p=0.01) and insomnia (χ2=20.2633, df=9, p=0.02)
{"title":"Delayed mental, neurological and somatic disorders associated with COVID-19","authors":"N. Belyakov, V. Rassokhin, N. Totolyan, E. Boeva, A. S. Bobreshova, N. B. Khalezova, Y. Kushnir, A. O. Norka","doi":"10.22328/2077-9828-2023-15-4-53-62","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-53-62","url":null,"abstract":"Purpose of the study. To assess the nature of health complaints, frequency of occurrence, structure and characteristics of neurological, general somatic and mental disorders in people in the post-COVID period.Materials and methods. The main group (n=1000) was represented by people who had a new coronavirus infection, confirmed by polymerase chain reaction (PCR) SARS-CoV-2, from 18 to 60 years old. As part of the study, an extensive survey of the examined individuals was carried out, aimed at identifying the main psychoneurological and general somatic consequences that developed in the period from 4 weeks to 12 months after COVID-19.Results and discussion. The study included 289 men and 711 women (28.9% and 71.1%, respectively). The average age at the time of the examination was 40.2±11.8 years. More than half of the respondents were of working age, had a permanent job or were studying (72.3%), while 17.9% indicated a high level of physical activity before COVID-19. The majority of respondents suffered from mild COVID-19 (76.6%), in 23.4% of cases the disease was moderate. Among somatic (vegetative) disorders as a consequence of COVID-19, the most common complaints were hair loss (49.5%), fatigue in 77.5% of cases, regardless of workload and type of work, and fluctuations in blood pressure in 50.2% of patients. Women complained more intensely about hair loss (χ2=60.2608, df=9, p<.001), shortness of breath (χ2=17.5025, df=9, p=0.04), interruptions in heart function (χ2=22.7863, df=9, p=0.007).Among the respondents, the most common complaints were emotional disturbances, which determined the picture of anxiety and depressive disorders, as well as cognitive impairments in the form of memory loss (69.5%), concentration, difficulties with long-term attention maintenance (65,5%) and switching from one task to another (60%). With the age of the respondents, fatigue increased in intensity (R=0.2, p<0.05), insomnia (R=0.2, p<0.05), anxiety for health and for their close persons (R=0.2, p<0.05), neurological complaints (widespread muscle pain (R=0.3, p<0.05), pain in the spine (R=0.3, p<0.05), gait disturbances (R=0.2, p<0.05), as well as the intensity of general somatic complaints (urinary disorders (R=0.2, p<0.05), shortness of breath (R=0.2, p<0.05), pain and heaviness in the chest (R=0.2, p<0.05), irregular heartbeat (R=0.2, p<0.05), fluctuations in blood pressure (R=0.2, p<0.05). Clear gender differences in the intensity of post-COVID psychopathological manifestations were revealed. Women complained more strongly about post-COVID high fatigue (χ2=23.8901, df=9, p=0.004), general malaise (χ2=17.9304, df=9, p=0.04) and, accordingly, lower activity and inability to cope with household workload (χ2=22.3384, df=9, p=0.008) compared to men. Women had more severe dysmnestic disorders (χ2=23.0900, df=9, p=0.006) than men. Women were also characterized by having greater anxiety for close persons (χ2=20.5941, df=9, p=0.01) and insomnia (χ2=20.2633, df=9, p=0.02)","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139617027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-105-111
V. S. Borovitsky, M. V. Sinitsyn
Objective. To identify a mathematical pattern for the subsequent calculation of the prognosis of the outcome of a tuberculosis patient with HIV infection upon admission to the hospital of the Federal Penitentiary Service.Materials and methods. The object of the study was 363 patients with tuberculosis and HIV infection who were admitted for treatment at the hospital of the Federal Penitentiary Service. Discriminant analysis was used to evaluate the features most associated with the discrimination of observations, a priori divided into groups, and reclassify them. As a result, new discriminant axes were obtained, in the space of which the compared groups have the maximum difference.Results and discussion. Formulas were obtained for predicting the outcome of a tuberculosis patient with HIV infection upon admission to a medical institution of the Federal Penitentiary Service: favorable outcome =–91.2138+4.2971×(body mass index)+0.4426×(«experience» of smoking, years)+0.5143×(hemoglobin level, g/l)+0.6158×(stab neutrophils, %)+ 0.4913×(leukocyte T-cell index);unfavorable outcome =–81.8053+3.9467×(body mass index)+0.4071×(«experience» of smoking, years)+0.4724×(hemoglobin level, g/l)+0.6861×(stab neutrophils, %)+0.6630×(leukocyte T-cell index); progression or chronicity =–91.9349+4.2025×(body mass index)+0.5119×(smoking experience, years)+0.5103×(hemoglobin level, g/l)+0.5901×(stab neutrophils, %)+0.5×(leukocyte T-cell index).Conclusion. Simple formulas have been obtained that can be successfully used to calculate the prognosis of the course of the disease upon admission to a hospital in a patient with tuberculosis with concomitant HIV infection.
目的确定一种数学模式，用于随后计算联邦监狱管理局医院收治的感染艾滋病毒的结核病患者的预后结果。研究对象是在联邦监狱管理局医院接受治疗的 363 名结核病和艾滋病毒感染患者。使用判别分析来评估与观察结果的判别最相关的特征，先验地将观察结果分为几组，并对其进行重新分类。结果和讨论。联邦监狱管理局医疗机构对感染艾滋病毒的肺结核病人的预后预测公式为：良好预后 =-91.2138+4.2971× （体重指数）+0.4426×（吸烟 "经历"，年）+0.5143×（血红蛋白水平，克/升）+0.6158×（稳定中性粒细胞，%）+0.4913×（白细胞 T 细胞指数）；不良预后 =-81.8053+3.9467×（体重指数）+0.4071×（吸烟 "经历"，年）+0.4724×（血红蛋白水平，克/升）+0.6861×（稳定中性粒细胞，%）+0.6630×（白细胞T细胞指数）；进展或慢性化=-91.9349+4.2025×（体重指数）+0.5119×（吸烟经历，年）+0.5103×（血红蛋白水平，克/升）+0.5901×（稳定中性粒细胞，%）+0.5×（白细胞T细胞指数）。我们获得了一些简单的公式，可成功用于计算合并艾滋病毒感染的肺结核患者入院后的病程预后。
{"title":"Mathematical prognosis of the outcome of the disease of a patient with tuberculosis with HIV infection upon admission to the hospital of the Federal Penitentiary Service","authors":"V. S. Borovitsky, M. V. Sinitsyn","doi":"10.22328/2077-9828-2023-15-4-105-111","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-105-111","url":null,"abstract":"Objective. To identify a mathematical pattern for the subsequent calculation of the prognosis of the outcome of a tuberculosis patient with HIV infection upon admission to the hospital of the Federal Penitentiary Service.Materials and methods. The object of the study was 363 patients with tuberculosis and HIV infection who were admitted for treatment at the hospital of the Federal Penitentiary Service. Discriminant analysis was used to evaluate the features most associated with the discrimination of observations, a priori divided into groups, and reclassify them. As a result, new discriminant axes were obtained, in the space of which the compared groups have the maximum difference.Results and discussion. Formulas were obtained for predicting the outcome of a tuberculosis patient with HIV infection upon admission to a medical institution of the Federal Penitentiary Service: favorable outcome =–91.2138+4.2971×(body mass index)+0.4426×(«experience» of smoking, years)+0.5143×(hemoglobin level, g/l)+0.6158×(stab neutrophils, %)+ 0.4913×(leukocyte T-cell index);unfavorable outcome =–81.8053+3.9467×(body mass index)+0.4071×(«experience» of smoking, years)+0.4724×(hemoglobin level, g/l)+0.6861×(stab neutrophils, %)+0.6630×(leukocyte T-cell index); progression or chronicity =–91.9349+4.2025×(body mass index)+0.5119×(smoking experience, years)+0.5103×(hemoglobin level, g/l)+0.5901×(stab neutrophils, %)+0.5×(leukocyte T-cell index).Conclusion. Simple formulas have been obtained that can be successfully used to calculate the prognosis of the course of the disease upon admission to a hospital in a patient with tuberculosis with concomitant HIV infection.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-98-104
M. Gubkina, Y. Khokhlova, N. Yukhimenko, I. Petrakova, S. Sterlikova
The article represents a clinical observation of the development of disseminated TB in a 12-year-old child with HIV infection, a high CD4 lymphocyte count (1315 cells/μl), and undetectable viral load (<20 copies per ml of blood). Perinatal transmission occurred, HIV infection was diagnosed immediately after birth, ART was administered from the first days of life. The girl has lived in a foster family since the age of 12 months. Poor adherence to treatment resulted in raised viral load. At the same time, the girl got ill with severe measles. ART was corrected with a rapid positive immunological and virological effect. One year later, TB manifested under the guise of acute bronchopulmonary disease. The examination revealed traces of infancy intrathoracic lymph node TB in the form of small calcinates. The patient had not been previously examined for TB infection and never received preventive TB treatment. The development of acute progressive TB in the child with HIV infection and satisfactory immunological and virological indicators was caused by: lack of due interdisciplinary (pediatricians, infectiologists, phthisiologists) and interdepartmental (medical services, children’s services) interactions; poor adherence to treatment; past measles.
{"title":"The causes of TB development in a child with HIV infection","authors":"M. Gubkina, Y. Khokhlova, N. Yukhimenko, I. Petrakova, S. Sterlikova","doi":"10.22328/2077-9828-2023-15-4-98-104","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-98-104","url":null,"abstract":"The article represents a clinical observation of the development of disseminated TB in a 12-year-old child with HIV infection, a high CD4 lymphocyte count (1315 cells/μl), and undetectable viral load (<20 copies per ml of blood). Perinatal transmission occurred, HIV infection was diagnosed immediately after birth, ART was administered from the first days of life. The girl has lived in a foster family since the age of 12 months. Poor adherence to treatment resulted in raised viral load. At the same time, the girl got ill with severe measles. ART was corrected with a rapid positive immunological and virological effect. One year later, TB manifested under the guise of acute bronchopulmonary disease. The examination revealed traces of infancy intrathoracic lymph node TB in the form of small calcinates. The patient had not been previously examined for TB infection and never received preventive TB treatment. The development of acute progressive TB in the child with HIV infection and satisfactory immunological and virological indicators was caused by: lack of due interdisciplinary (pediatricians, infectiologists, phthisiologists) and interdepartmental (medical services, children’s services) interactions; poor adherence to treatment; past measles.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.22328/2077-9828-2023-15-4-86-93
D. E. Reingardt, Y. Ostankova, L. V. Lyalina, E. V. Anufrieva, A. V. Semenov, A. A. Totolian
The aim of the study was to identify the prevalence of drug resistance mutations in the hepatitis C virus among patients with relapse of the disease on therapy with direct antiviral drugs.Materials and methods. The study material included 31 blood plasma samples from patients with chronic hepatitis C with relapse of the disease on therapy with direct antiviral drugs. Samples were screened for the presence of HCV RNA. In case of detection of HCV RNA, amplification was carried out using a set of primers jointly flanking the NS3, NS5A, NS5B genes. After sequencing the nucleotide sequences of these genes, the subtype of the virus was determined and drug resistance mutations were identified.Results and discussion. The age of the patients ranged from 33 to 62 and averaged 45.8±8.38 years. The number of men in the group prevailed compared to women — 21 (67%) and 10 (33%), respectively. Viral load determination results ranged from 3.1×103 to 4.2×107 IU/ml. The distribution of genotypes was as follows: 1a — 26% (n=8), 1b — 29% (n=9), 3a — 45% (n=14). The nucleotide sequence of the NS3, NS5A, NS5B regions was determined in all samples. Mutations associated with drug resistance were detected in 87% (n=27). In all identified cases, the mutations resulted in viral resistance to at least one drug included in the patient’s current treatment regimen. In one patient, amino acid substitutions were found in three regions at once, which led to the emergence of resistance to two drugs in the regimen.Conclusion. Conducting a preliminary examination of patients to identify mutations of drug resistance to direct antiviral drugs can affect the effectiveness of the planned treatment and the choice of the optimal regimen.
{"title":"Distribution of hepatitis С virus drug resistance mutations among patients with recurrence of the disease during therapy with direct antiviral drugs","authors":"D. E. Reingardt, Y. Ostankova, L. V. Lyalina, E. V. Anufrieva, A. V. Semenov, A. A. Totolian","doi":"10.22328/2077-9828-2023-15-4-86-93","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-86-93","url":null,"abstract":"The aim of the study was to identify the prevalence of drug resistance mutations in the hepatitis C virus among patients with relapse of the disease on therapy with direct antiviral drugs.Materials and methods. The study material included 31 blood plasma samples from patients with chronic hepatitis C with relapse of the disease on therapy with direct antiviral drugs. Samples were screened for the presence of HCV RNA. In case of detection of HCV RNA, amplification was carried out using a set of primers jointly flanking the NS3, NS5A, NS5B genes. After sequencing the nucleotide sequences of these genes, the subtype of the virus was determined and drug resistance mutations were identified.Results and discussion. The age of the patients ranged from 33 to 62 and averaged 45.8±8.38 years. The number of men in the group prevailed compared to women — 21 (67%) and 10 (33%), respectively. Viral load determination results ranged from 3.1×103 to 4.2×107 IU/ml. The distribution of genotypes was as follows: 1a — 26% (n=8), 1b — 29% (n=9), 3a — 45% (n=14). The nucleotide sequence of the NS3, NS5A, NS5B regions was determined in all samples. Mutations associated with drug resistance were detected in 87% (n=27). In all identified cases, the mutations resulted in viral resistance to at least one drug included in the patient’s current treatment regimen. In one patient, amino acid substitutions were found in three regions at once, which led to the emergence of resistance to two drugs in the regimen.Conclusion. Conducting a preliminary examination of patients to identify mutations of drug resistance to direct antiviral drugs can affect the effectiveness of the planned treatment and the choice of the optimal regimen.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139616508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.22328/2077-9828-2023-15-4-25-35
A. A. Khryanin, E. V. Pushkarev, V. K. Bocharova
In this analytical review, the authors present current views on the relationship between the persistence of HIV infection and the gut microbiome in people living with HIV (PLHIV). The study of this issue remains highly relevant for various reasons, because HIV-associated dysbiosis may underlie chronic diseases that persist and progress throughout the entire period of HIV infection, despite the control of viral load achieved with antiretroviral therapy (ART). The identification of close pathogenetic links between intestinal bacteria and HIV-associated diseases contributes to the development of new treatments aimed at changing the intestinal microbiome. It has been demonstrated that the gut microbiome has the potential to influence HIV disease at every stage of the viral life cycle, from infection through AIDS, opening the door for therapeutic interventions targeting the gut microbiome at each of these stages. Modern therapeutic strategies, including ART and agents aimed to normalizing the gut microbiome and reducing systemic chronic inflammation, may influence the existence of the HIV reservoir and thereby provide a cure for HIV infection.
{"title":"HIV infection and the gut microbiome","authors":"A. A. Khryanin, E. V. Pushkarev, V. K. Bocharova","doi":"10.22328/2077-9828-2023-15-4-25-35","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-25-35","url":null,"abstract":"In this analytical review, the authors present current views on the relationship between the persistence of HIV infection and the gut microbiome in people living with HIV (PLHIV). The study of this issue remains highly relevant for various reasons, because HIV-associated dysbiosis may underlie chronic diseases that persist and progress throughout the entire period of HIV infection, despite the control of viral load achieved with antiretroviral therapy (ART). The identification of close pathogenetic links between intestinal bacteria and HIV-associated diseases contributes to the development of new treatments aimed at changing the intestinal microbiome. It has been demonstrated that the gut microbiome has the potential to influence HIV disease at every stage of the viral life cycle, from infection through AIDS, opening the door for therapeutic interventions targeting the gut microbiome at each of these stages. Modern therapeutic strategies, including ART and agents aimed to normalizing the gut microbiome and reducing systemic chronic inflammation, may influence the existence of the HIV reservoir and thereby provide a cure for HIV infection.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139618505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.22328/2077-9828-2023-15-4-36-46
A. V. Samarina, M. Yarmolinskaya, A. V. Koloshkina
In 2021 in Russia, the proportion of women among HIV-infected patients was 54.6%. In recent years, there has been an increase in the number of female patients of older reproductive age and those in peri- and postmenopause among women living with HIV. Data on the age of onset of menopause and its course in this group of women are contradictory, and clinical recommendations on the features of dispensary observation, the choice of antiretroviral therapy, and the treatment of climacteric syndrome in this group of patients are absent, despite its high frequency and greater intensity of manifestations compared to population indicators. The insufficient amount of research on this topic, low awareness of doctors about the possibilities of prescribing menopausal hormone therapy to HIV-positive patients, and drug interactions between MHT and antiretroviral drugs limit the provision of effective medical care, worsen the quality of life of HIV-positive women, and represent a problem that requires a solution. This article offers a review of modern studies aimed at studying the peculiarities of menopause in women with HIV, the age of its onset, and data on the prescription of MHT. Literature search was conducted on PubMed, and the review includes articles published from 2016 to 2023.
{"title":"Features of menopausal period in HIV-positive women","authors":"A. V. Samarina, M. Yarmolinskaya, A. V. Koloshkina","doi":"10.22328/2077-9828-2023-15-4-36-46","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-36-46","url":null,"abstract":"In 2021 in Russia, the proportion of women among HIV-infected patients was 54.6%. In recent years, there has been an increase in the number of female patients of older reproductive age and those in peri- and postmenopause among women living with HIV. Data on the age of onset of menopause and its course in this group of women are contradictory, and clinical recommendations on the features of dispensary observation, the choice of antiretroviral therapy, and the treatment of climacteric syndrome in this group of patients are absent, despite its high frequency and greater intensity of manifestations compared to population indicators. The insufficient amount of research on this topic, low awareness of doctors about the possibilities of prescribing menopausal hormone therapy to HIV-positive patients, and drug interactions between MHT and antiretroviral drugs limit the provision of effective medical care, worsen the quality of life of HIV-positive women, and represent a problem that requires a solution. This article offers a review of modern studies aimed at studying the peculiarities of menopause in women with HIV, the age of its onset, and data on the prescription of MHT. Literature search was conducted on PubMed, and the review includes articles published from 2016 to 2023.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139620371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.22328/2077-9828-2023-15-4-7-24
E. Boeva, V. Rassokhin, N. Belyakov, A. S. Simbirtsev
This publication reflects modern ideas about the main aspects of etiology, pathogenesis and the latest achievements of clinical practice in the field of the most common primary and secondary immunodeficiency. The features of laboratory diagnostics of congenital immunodeficiency, risk factors and early clinical guidelines that allow the patient to suspect an immunosuppressive state are considered. Special attention is paid to the problem of secondary immunodeficiency, their prevalence and polyetiology. When covering immunopathogenesis, infection caused by the human immunodeficiency virus (HIV), attention is paid to the multimorbidity of clinical manifestations of HIV-associated immunosuppression and concomitant diseases, the importance of timely administration of antiretroviral therapy (ART) and its role in the development of immune reconstitution syndrome (IRS). The criteria for the diagnosis of SVI based on their own experience and the opinion of foreign colleagues, the tactics of patient management are presented in detail.
本出版物反映了有关最常见的原发性和继发性免疫缺陷病的病因、发病机制和临床实践最新成果等主要方面的现代观点。其中考虑了先天性免疫缺陷的实验室诊断特点、风险因素和早期临床指南，使病人能够怀疑自己处于免疫抑制状态。特别关注继发性免疫缺陷的问题、其发病率和多病因。在介绍由人类免疫缺陷病毒（HIV）引起的免疫发病机制和感染时，关注了与 HIV 相关的免疫抑制临床表现和伴随疾病的多重性、及时进行抗逆转录病毒疗法（ART）的重要性及其在免疫重建综合征（IRS）发展中的作用。根据自己的经验和国外同行的意见，详细介绍了 SVI 的诊断标准和患者管理策略。
{"title":"The nature and origin of immunosuppressive disorders","authors":"E. Boeva, V. Rassokhin, N. Belyakov, A. S. Simbirtsev","doi":"10.22328/2077-9828-2023-15-4-7-24","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-4-7-24","url":null,"abstract":"This publication reflects modern ideas about the main aspects of etiology, pathogenesis and the latest achievements of clinical practice in the field of the most common primary and secondary immunodeficiency. The features of laboratory diagnostics of congenital immunodeficiency, risk factors and early clinical guidelines that allow the patient to suspect an immunosuppressive state are considered. Special attention is paid to the problem of secondary immunodeficiency, their prevalence and polyetiology. When covering immunopathogenesis, infection caused by the human immunodeficiency virus (HIV), attention is paid to the multimorbidity of clinical manifestations of HIV-associated immunosuppression and concomitant diseases, the importance of timely administration of antiretroviral therapy (ART) and its role in the development of immune reconstitution syndrome (IRS). The criteria for the diagnosis of SVI based on their own experience and the opinion of foreign colleagues, the tactics of patient management are presented in detail.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139619731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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