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Current characteristics of the HIV/syphilis co-infection epidemic 艾滋病毒/梅毒合并感染流行的当前特征
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-15-25
M. A. Chirskaia, E. B. Yastrebova, T. V. Krasnoselskikh, M. I. Danilyuk
Syphilis, alongside with HIV infection, remains a pressing public health issue due to its widespread prevalence among high-risk groups: men who have sex with men (MSM), transgender women, and female sex workers (FSW). The MSM group shows a disproportionately high prevalence rate of HIV infection, with cases of syphilis/HIV co-infection also on the rise in this population. The increase in these co-infection cases deserves special attention. According to the literature, the rate of HIV infection among syphilis patients averages 15.7%. In addition, it varies significantly, going from 3% in the general population to 90% among MSM. Epidemiological surveillance data showed an increase in cases of HIV/syphilis co-infection in the MSM group, with the proportion of co-infection patients varying from 30 to 60% depending on the region. This syndemia can be explained by the fact that syphilis can contribute to HIV transmission and acquisition. The risk of HIV infection is 2 to 5 times higher among people with syphilis. At the same time, STDs are more and more difficult to control as the Internet and dating applications have made it easier to find potential sex partners. Given the high prevalence rate of syphilis among MSM, screening, diagnosis and treatment of STDs in this population should be a health care priority. Early detection and timely treatment of these socially significant diseases play an important role in epidemic prevention measures.
梅毒与艾滋病毒感染一起,仍然是一个紧迫的公共卫生问题,因为它在高危人群中广泛流行:男男性行为者(MSM)、变性妇女和女性性工作者(FSW)。男男性行为者群体显示出不成比例的高艾滋病毒感染率,该人群中梅毒/艾滋病毒合并感染的病例也在上升。这些合并感染病例的增加值得特别注意。根据文献,梅毒患者的HIV感染率平均为15.7%。此外,这一比例差别很大,从普通人群的3%到男同性恋者的90%不等。流行病学监测数据显示,男男性行为者群体中艾滋病毒/梅毒合并感染病例有所增加,合并感染患者的比例因地区而异,从30%到60%不等。这种综合征可以解释为梅毒可以促进艾滋病毒的传播和获得。梅毒患者感染艾滋病毒的风险是梅毒患者的2至5倍。与此同时,随着互联网和约会软件让人们更容易找到潜在的性伴侣,性病越来越难以控制。鉴于梅毒在男男性行为者中的高患病率,在这一人群中筛查、诊断和治疗性传播疾病应成为卫生保健的优先事项。及早发现和及时治疗这些具有重大社会意义的疾病,对防疫措施具有重要作用。
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引用次数: 0
The role of HIV-1 polymorphism in the pathogenesis of the disease HIV-1多态性在该病发病机制中的作用
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-26-37
A. I. Kuznetsova
High genetic variability is one of the defining HIV-1 properties. It contributes to the appearance of drug resistance and to the formation of various HIV variants. In the world, the different variants of HIV-1 are distributed unevenly. In Russia there are circulating unique virus variants which are characteristic for our country and some countries of the former USSR and which are difference from HIV-1 variants circulating in other countries of the world. For many years, the studies aimed on the analysis of the influence of various HIV-1 variants on pathogenesis have been conducted. Within the framework of these studies, the polymorphism mutations in different subtypes and recombinant forms have been detected. Currently the main objects of antiretroviral therapy are HIV-1 structural proteins, mainly enzyme proteins, thus polymorphic mutations in which could affect the degree of virus sensitivity to antiretroviral therapy. Non-structural HIV-1 proteins are involved in virus replication and virus protection from the host immune system, enter the bloodstream and tissues, causing the development of inflammation. The polymorphic mutations in non-structural proteins could affect the degree of HIV infection progression and the development of concomitant somatic diseases. Today, nonstructural proteins are considered as objects for the creation of therapeutic agents, thus the identification of polymorphic mutations in nonstructural proteins in different HIV-1 variants is a basis for such developments. Thus, the study of polymorphism of both structural and non-structural HIV-1 proteins is a promising area of research in the future.
高遗传变异性是HIV-1的特征之一。它有助于耐药性的出现和各种HIV变体的形成。在世界范围内,HIV-1的不同变体分布不均匀。在俄罗斯,流行着独特的病毒变体,这是我国和前苏联一些国家的特点,与世界上其他国家流行的艾滋病毒-1变体不同。多年来,人们开展了旨在分析各种HIV-1变异对发病机制影响的研究。在这些研究的框架内,已经检测到不同亚型和重组形式的多态性突变。目前抗逆转录病毒治疗的主要对象是HIV-1结构蛋白,主要是酶蛋白,其多态性突变可能影响病毒对抗逆转录病毒治疗的敏感程度。非结构性HIV-1蛋白参与病毒复制和宿主免疫系统的病毒保护,进入血液和组织,引起炎症的发展。非结构蛋白的多态性突变可以影响HIV感染的进展程度和伴随躯体疾病的发生。今天,非结构蛋白被认为是创造治疗剂的对象,因此,在不同的HIV-1变异中鉴定非结构蛋白的多态性突变是这种发展的基础。因此,研究结构和非结构HIV-1蛋白的多态性是未来研究的一个有前途的领域。
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引用次数: 0
Chronology and problems of the evolution of HIV infection in the Vologda Region in the structure of the North-West of the Russian Federation 俄罗斯联邦西北部结构沃洛格达地区艾滋病毒感染演变的年表和问题
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-84-94
T. Yu. Kurganova, S. V. Ogurtsova, E. V. Boeva, M. A. Matveeva, T. N. Melnikova, N. A. Belyakov
Aim. To determine the general patterns and distinctive features of the formation of the HIV epidemic in chronology in various administrative territories of the Vologda Region. Materials and methods. The data of the epidemiological survey maps of HIV infection foci, reports «Causes of mortality of HIV-infected», statistical observations were analyzed: form No. 61 «Information on the contingent of HIV-infected patients», form No. 4 of the Federal State Statistical Observation, forms of the Vologda Regional Center for the Prevention and Control of AIDS and Infectious Diseases, materials of the North-Western District Center for the Prevention and Control of AIDS. Dynamic monitoring of the HIV epidemic in the Vologda Region (since 1995) and evaluation of the effectiveness of the national project to combat HIV infections were carried out. Results and discussion . On the territory of the Vologda Region, the trend of stability of the indicator of HIV infection remains. The prevalence of the population is increasing, accompanied by the identification of patients at late stages with the manifestation of secondary diseases. In the region, the HIV epidemic corresponds to the main trends of the epidemic process in the North-Western Federal District (NWFD) with some differences. The dominant transmission routes are parenteral (39.9% in 2021) and heterosexual. Over the past 5 years, there has been an upward trend in homosexual transmission of infection among men who have sex with a men (MSM), the share of which increased in 2021 by 2 times compared to 2017 and amounted to 3.1%. The detection rate in 2021, calculated for 100 thousand surveyed, in the Vologda Region was 111.3 (in the NWFD — 160.1). The highest detection rate of HIV infection was observed among MSM — 14.3% (in the NWFD — 4.1%), among injecting drug users (IDUs) — 1.0% (in the NWFD — 1.1%), among persons in prison — 1.8% (in the NWFD — 1.8%). One of the main causes of death in HIV-infected patients is the late detection of the disease and the initiation of antiretroviral therapy (ART). During the entire period of observation, the epidemic was most intense in Cherepovets and Vologda, since 2000 there has been a gradual spread of infection with involvement in the process in rural areas. Conclusion . The results obtained demonstrate the importance of implementing different models of the main stages of diagnosis, prevention and treatment of people in urban and rural areas, which is included in the developing concept of personalized HIV medicine. It is necessary to carry out additional measures for the active identification and registration of dispensary patients, the formation of adherence to dispensary monitoring and therapy, the timely appointment of ART, the introduction of new approaches to providing medical care to HIV-infected patients in the districts of the region.
的目标。确定沃洛格达州各行政区域艾滋病毒流行形成的一般模式和年表特征。材料和方法。对艾滋病毒感染中心流行病学调查地图的数据、《艾滋病毒感染者死亡原因》报告、统计观察结果进行了分析:第61号表格《艾滋病毒感染者情况》、联邦国家统计观察表第4号表格、沃洛格达地区艾滋病和传染病预防和控制中心表格、西北地区艾滋病预防和控制中心材料。对沃洛格达地区的艾滋病毒流行情况进行了动态监测(自1995年以来),并对防治艾滋病毒感染国家项目的效果进行了评价。结果和讨论。在沃洛格达州境内,艾滋病毒感染指标保持稳定的趋势。人口的患病率正在增加,伴随着晚期患者的继发性疾病表现的识别。在该地区,艾滋病毒流行符合西北联邦区(NWFD)流行过程的主要趋势,但存在一些差异。主要的传播途径是肠外(2021年为39.9%)和异性恋。在过去5年中,男男性行为者(MSM)的同性恋传播感染呈上升趋势,2021年的比例比2017年增加了2倍,达到3.1%。2021年,Vologda地区的检出率为111.3 (NWFD地区为160.1),以10万名调查对象计算。艾滋病毒感染检出率最高的人群是男男性行为者(14.3%)(西北地区为4.1%),注射吸毒者(IDUs)为1.0%(西北地区为1.1%),服刑人员为1.8%(西北地区为1.8%)。艾滋病毒感染者死亡的主要原因之一是疾病的较晚发现和抗逆转录病毒治疗(ART)的开始。在整个观察期间,切列波韦茨和沃洛格达的疫情最为严重,自2000年以来,农村地区参与了这一进程,感染逐渐蔓延。结论。结果表明,实施城乡人群诊断、预防和治疗主要阶段不同模式的重要性,并将其纳入艾滋病毒个性化医学的发展理念。有必要采取其他措施,积极查明和登记药房病人,形成对药房监测和治疗的依从性,及时预约抗逆转录病毒治疗,采用新方法向该地区各区感染艾滋病毒的病人提供医疗服务。
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引用次数: 0
The structure of some blood-borne infections distribution among persons from penitentiary institutions the markers 某些血源性感染在监狱人员中的分布结构及标志物
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-95-104
E. V. Anufrieva, E. N. Serikova, Yu. V. Ostankova, A. N. Shchemelev, V. S. Davydenko, D. E. Reingardt, E. B. Zueva, A. A. Totolian
The aim of the study was to assess the occurrence of serological and molecular genetic markers of HIV infection, viral hepatitis B and C among persons in pre-trial detention. Materials and methods. The material of the study identified 138 samples of blood sequences obtained from men in the pretrial detention center in St. Petersburg. Patients were examined by ELISA for the presence of serological markers of HIV infection (Ag/Ab HIV), HBV (HBsAg, antiHBs IgG, anti-HBcore IgG) and HCV (anti-HCV IgG). Determination of HIV and HCV RNA, as well as HBV DNA by PCR with hybridization-fluorescence detection in «real time» mode. HBV DNA with a low viral form was detected using a technique developed at the Saint-Petersburg Pasteur Institute. Results and discussion . With the prevalence of the general prevalence of serological markers, markers of HIV infection were detected in 55 (39.86%) patients, HBV — in 73 (52.90%), HCV — in 83 (60.14%). the same markers of HIV infection and HBV were detected in 6 (4.35%) examined, HIV infection and HCV in 17 (12.32%), HBV and HCV in 22 (15.94%) persons, to all three infections in 26 (18.84%) cases. In 22 (15.94%) people did not notice any of the analyzed markers. HIV RNA was found in 23.19%, HCV RNA — in 46.38%, HBV DNA — in 10.14% of the examined. At the same time, HBV DNA with a low viral form (less than 50 IU/ml) was detected in 7.97% of cases, including 6.52% of seronegative samples. Simultaneously, HIV and HCV RNA were detected in 6.52%, HCV RNA and HBV DNA in 2.17% of patients. Molecular biological markers of all three indicators were found in 1.45% of patients. The examined group was ranked by age into the following subgroups: 21– 30 years old (12.32%), 31–40 years old (34.78%), 41–50 years old (37.68%) and older than 51 years old (15.22%). Certain differences in the prevalence and distribution of the analysis of serological and molecular biological markers between age markers, the highest frequency was found for groups of 31–40 and 41–50 years. Conclusion. The results obtained indicate a high prevalence of HIV infections and parenteral viral hepatitis B and C among persons convicted and awaiting a stage in a pre-trial detention center. Careful attention must be paid to their admission to penitentiary institutions, since many convicts are not aware of their morbidity and may become infected. Regular conclusions, concluded in dynamics, including laboratory diagnostics using highly sensitive molecular biological methods, upon admission to a penitentiary institution, and then annually and upon release, should be taken into account as measures to prevent infection with HIV, HBV, HCV.
该研究的目的是评估审前拘留人员中艾滋病毒感染、病毒性乙型肝炎和丙型肝炎的血清学和分子遗传标记的发生情况。材料和方法。这项研究的材料鉴定了从圣彼得堡审前拘留中心的男性身上获得的138份血液序列样本。采用ELISA检测患者的HIV感染(Ag/Ab HIV)、HBV (HBsAg、抗hbs IgG、抗hbcore IgG)和HCV(抗HCV IgG)血清学标志物的存在。检测HIV和HCV RNA,以及HBV DNA的PCR与杂交荧光检测在“实时”模式。使用圣彼得堡巴斯德研究所开发的一种技术检测低病毒形式的HBV DNA。结果和讨论。随着血清学标志物的普遍流行,HIV感染标志物55例(39.86%),HBV - 73例(52.90%),HCV - 83例(60.14%)。检出HIV感染和HBV相同标志物者6例(4.35%),HIV感染和HCV相同标志物者17例(12.32%),HBV和HCV相同标志物者22例(15.94%),三者同时感染者26例(18.84%)。22人(15.94%)没有注意到任何分析标记。23.19%的人检出HIV RNA, 46.38%的人检出HCV RNA, 10.14%的人检出HBV DNA。同时,在7.97%的病例中检出低病毒型HBV DNA(小于50 IU/ml),其中血清阴性样本占6.52%。同时,6.52%的患者检出HIV和HCV RNA, 2.17%的患者检出HCV RNA和HBV DNA。在1.45%的患者中发现了所有三项指标的分子生物学标记物。按年龄分组分为21 ~ 30岁(12.32%)、31 ~ 40岁(34.78%)、41 ~ 50岁(37.68%)和51岁以上(15.22%)。血清学和分子生物学标记物的流行和分布在年龄标记物之间有一定的差异,31-40岁和41-50岁年龄组频率最高。结论。所获得的结果表明,在被定罪并在审前拘留中心等待阶段的人中,艾滋病毒感染和静脉注射乙型和丙型病毒性肝炎的流行率很高。必须仔细注意将他们送进监狱,因为许多囚犯不知道自己的病情,可能会受到感染。在进入监狱机构时,以及每年和释放时,应考虑以动态方式得出的定期结论,包括使用高度敏感的分子生物学方法进行实验室诊断,作为预防艾滋病毒、乙型肝炎病毒和丙型肝炎病毒感染的措施。
{"title":"The structure of some blood-borne infections distribution among persons from penitentiary institutions the markers","authors":"E. V. Anufrieva, E. N. Serikova, Yu. V. Ostankova, A. N. Shchemelev, V. S. Davydenko, D. E. Reingardt, E. B. Zueva, A. A. Totolian","doi":"10.22328/2077-9828-2023-15-3-95-104","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-3-95-104","url":null,"abstract":"The aim of the study was to assess the occurrence of serological and molecular genetic markers of HIV infection, viral hepatitis B and C among persons in pre-trial detention. Materials and methods. The material of the study identified 138 samples of blood sequences obtained from men in the pretrial detention center in St. Petersburg. Patients were examined by ELISA for the presence of serological markers of HIV infection (Ag/Ab HIV), HBV (HBsAg, antiHBs IgG, anti-HBcore IgG) and HCV (anti-HCV IgG). Determination of HIV and HCV RNA, as well as HBV DNA by PCR with hybridization-fluorescence detection in «real time» mode. HBV DNA with a low viral form was detected using a technique developed at the Saint-Petersburg Pasteur Institute. Results and discussion . With the prevalence of the general prevalence of serological markers, markers of HIV infection were detected in 55 (39.86%) patients, HBV — in 73 (52.90%), HCV — in 83 (60.14%). the same markers of HIV infection and HBV were detected in 6 (4.35%) examined, HIV infection and HCV in 17 (12.32%), HBV and HCV in 22 (15.94%) persons, to all three infections in 26 (18.84%) cases. In 22 (15.94%) people did not notice any of the analyzed markers. HIV RNA was found in 23.19%, HCV RNA — in 46.38%, HBV DNA — in 10.14% of the examined. At the same time, HBV DNA with a low viral form (less than 50 IU/ml) was detected in 7.97% of cases, including 6.52% of seronegative samples. Simultaneously, HIV and HCV RNA were detected in 6.52%, HCV RNA and HBV DNA in 2.17% of patients. Molecular biological markers of all three indicators were found in 1.45% of patients. The examined group was ranked by age into the following subgroups: 21– 30 years old (12.32%), 31–40 years old (34.78%), 41–50 years old (37.68%) and older than 51 years old (15.22%). Certain differences in the prevalence and distribution of the analysis of serological and molecular biological markers between age markers, the highest frequency was found for groups of 31–40 and 41–50 years. Conclusion. The results obtained indicate a high prevalence of HIV infections and parenteral viral hepatitis B and C among persons convicted and awaiting a stage in a pre-trial detention center. Careful attention must be paid to their admission to penitentiary institutions, since many convicts are not aware of their morbidity and may become infected. Regular conclusions, concluded in dynamics, including laboratory diagnostics using highly sensitive molecular biological methods, upon admission to a penitentiary institution, and then annually and upon release, should be taken into account as measures to prevent infection with HIV, HBV, HCV.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513569","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}
引用次数: 0
Genetic profile of HIV-1 in the Republic Sakha, Yakutia 雅库特萨哈共和国HIV-1基因图谱
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-73-83
V. O. Kotova, O. E. Trotsenko, L. A. Balakhontseva, E. A. Bazykina, L. S. Sokolova, V. N. Kulagina, R. N. Fedorova
Aim. To perform molecular-genetic analysis of HIV-1 variants circulation in the Republic Sakha (Yakutia) and analysis of drug resistance mutations. Materials and methods. 123 patients diagnosed with HIV infection were examined. Mutations of drug resistance were detected via sequencing of amplified fragments of pol gene that is coding protease and a part of reverse transcriptase of HIV-1 using «Amplisens® HIV-Resist-Seq» test-system. Phylogenetic analysis was performed with software MEGA version 7.0. Results and discussion . Sub-subtype A6 that is prevalent in the Russian Federation was revealed most frequently (78.0%) in the examined group. Subtype B was detected in four cases (3.3%). Isolated cases of infection due to subtypes C, G and subsubtype A7 were revealed. Recombinant forms of the virus were found in 16.2% of the patients (n=20). Drug resistance mutations were revealed in 65 patients (52.8%) that were undergoing antiretroviral therapy (ART) which dictates a necessity of changing ART drugs. Conclusion . The results of the research state changes in the genetic profile of HIV-1 variants that were circulating during the last years in the Republic Sakha (Yakutia).
的目标。在萨哈共和国(雅库特)进行HIV-1变异循环的分子遗传学分析和耐药性突变分析。材料和方法。对123例诊断为HIV感染的患者进行了检查。使用«Amplisens®hiv - resistance - seq»测试系统,通过对编码蛋白酶和部分HIV-1逆转录酶的pol基因扩增片段进行测序,检测耐药突变。采用MEGA 7.0软件进行系统发育分析。结果和讨论。俄罗斯联邦流行的A6亚型在检查组中最常见(78.0%)。B亚型4例(3.3%)。C、G、A7亚型感染病例均有分离。在16.2%的患者(n=20)中发现病毒的重组形式。在接受抗逆转录病毒治疗(ART)的患者中,有65例(52.8%)发现耐药突变,这表明有必要更换抗逆转录病毒药物。结论。研究结果表明,过去几年在萨哈共和国(雅库特)流行的HIV-1变异基因谱发生了变化。
{"title":"Genetic profile of HIV-1 in the Republic Sakha, Yakutia","authors":"V. O. Kotova, O. E. Trotsenko, L. A. Balakhontseva, E. A. Bazykina, L. S. Sokolova, V. N. Kulagina, R. N. Fedorova","doi":"10.22328/2077-9828-2023-15-3-73-83","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-3-73-83","url":null,"abstract":"Aim. To perform molecular-genetic analysis of HIV-1 variants circulation in the Republic Sakha (Yakutia) and analysis of drug resistance mutations. Materials and methods. 123 patients diagnosed with HIV infection were examined. Mutations of drug resistance were detected via sequencing of amplified fragments of pol gene that is coding protease and a part of reverse transcriptase of HIV-1 using «Amplisens® HIV-Resist-Seq» test-system. Phylogenetic analysis was performed with software MEGA version 7.0. Results and discussion . Sub-subtype A6 that is prevalent in the Russian Federation was revealed most frequently (78.0%) in the examined group. Subtype B was detected in four cases (3.3%). Isolated cases of infection due to subtypes C, G and subsubtype A7 were revealed. Recombinant forms of the virus were found in 16.2% of the patients (n=20). Drug resistance mutations were revealed in 65 patients (52.8%) that were undergoing antiretroviral therapy (ART) which dictates a necessity of changing ART drugs. Conclusion . The results of the research state changes in the genetic profile of HIV-1 variants that were circulating during the last years in the Republic Sakha (Yakutia).","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513714","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}
引用次数: 0
15<sup>th</sup> anniversary of the journal «HIV Infection and Immunosuppressive Disorders» 15 & lt; sup&gt; th&lt / sup&gt;《艾滋病毒感染和免疫抑制疾病》杂志周年纪念
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-7-14
N. A. Belyakov, V. V. Rassokhin, E. V. Boeva
.
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引用次数: 0
Medicak techniligies assesment in COVID-19 COVID-19医疗技术评估
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-105-115
A. S. Kolbin, Yu. M. Gomon
According to official information about the coronavirus, as of May 2023, about 400 thousand people died from COVID-19 in Russia, 6.9 million people in the world. Social, as well as medical and economic aspects are associated with the COVID-19 pandemic. The main global financial resources were allocated to the provision of vaccines ($13.8 billion, 40.4%); reorganization of health systems ($4.1 billion); COVID-19 drug therapy ($3.4 billion). The costs of research, development and study of vaccines and medicines accounted for only 0.6% of total costs ($166 million). The article presents a clinical and pharmacological analysis of various medicines recommended for the treatment of infection. In these conditions, the reliability and effectiveness of national health technology assessment systems has become particularly relevant.
根据有关冠状病毒的官方信息,截至2023年5月,俄罗斯约有40万人死于COVID-19,全球有690万人。社会、医疗和经济方面都与COVID-19大流行有关。全球主要财政资源用于提供疫苗(138亿美元,占40.4%);改组卫生系统(41亿美元);COVID-19药物治疗(34亿美元)。疫苗和药物的研究、开发和研究费用仅占总费用(1.66亿美元)的0.6%。本文介绍了临床和药理学分析的各种药物推荐治疗感染。在这种情况下,国家卫生技术评估系统的可靠性和有效性变得尤为重要。
{"title":"Medicak techniligies assesment in COVID-19","authors":"A. S. Kolbin, Yu. M. Gomon","doi":"10.22328/2077-9828-2023-15-3-105-115","DOIUrl":"https://doi.org/10.22328/2077-9828-2023-15-3-105-115","url":null,"abstract":"According to official information about the coronavirus, as of May 2023, about 400 thousand people died from COVID-19 in Russia, 6.9 million people in the world. Social, as well as medical and economic aspects are associated with the COVID-19 pandemic. The main global financial resources were allocated to the provision of vaccines ($13.8 billion, 40.4%); reorganization of health systems ($4.1 billion); COVID-19 drug therapy ($3.4 billion). The costs of research, development and study of vaccines and medicines accounted for only 0.6% of total costs ($166 million). The article presents a clinical and pharmacological analysis of various medicines recommended for the treatment of infection. In these conditions, the reliability and effectiveness of national health technology assessment systems has become particularly relevant.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513568","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}
引用次数: 0
HIV diagnosis in Russia: evaluation of effectiveness and prospects 俄罗斯艾滋病毒诊断:有效性评价和前景
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-50-60
E. B. Tsybikova, M. Yu. Kotlovskiy, S. O. Fadeeva, P. A. Fadeev
Aim . To study the effectiveness of measures aimed at timely diagnosis of HIV infection in Russia and the subjects of the Russian Federation for the period from 2016 to 2022. Materials and methods . Information from Rosstat forms No. 4 and No. 61 for 2016–2022 and data on the population of Russia. To search for correlations between the indicators characterizing the number of persons covered by the survey and the number of identified patients with HIV infection, data from 85 subjects of Russia for 2016–2021 were used. Statistical analysis was carried out using the Statistica 10.0 program. To work with data from 85 subjects of Russia for the period from 2016 to 2021, the Jupiter Notebook interactive computing environment (6.5.2) was used. The Pandas software library (1.5.3) was used for data processing and analysis, compilation and work with a structured dataset. The statistical function module Scipy (1.9.3) was used to find correlation coefficients by the Pearson, Spearman and t-Kendall method. Scikit-learn (1.0.2) and Statsmodels (0.13.5) software libraries were used to build a trend line and find linear regression coefficients. Results and discussion . In Russia in 2016–2022, there was an annual increase in the proportion of the population covered by a survey aimed at timely diagnosis of HIV infection among the population. However, this did not lead to an increase in the number of identified patients with HIV infection, the proportion of which decreased and in 2022 reached 0.11% among the total number of examined persons (in 2016 — 0.23%). The current situation was caused by a decrease in the incidence of HIV infection in 2017–2022 by 1.5 times — from 52.8 to 34.7 per 100,000 population. As a result, in order to identify one patient with HIV infection, an increasing number of healthy individuals had to be examined, which led to an increase in the economic costs for diagnosing HIV infection in one patient. Among the examined persons there was an extremely low proportion of persons from key risk groups, which averaged 2.3% in 2018–2022, and the proportion of identified patients among them in 2022, on the contrary, reached 24.1% of their total number. As a result, it became necessary to make changes to the existing strategy aimed at expanding the coverage of the Russian population with a survey for the diagnosis of HIV infection. The results of the study showed that the increase in the coverage of the population by the survey was justified only in those 15 subjects of the Russian Federation in which coverage was low and did not correspond to the growth rate of the number of identified patients with HIV infection, which increased the risk of late detection of patients with HIV infection, when they independently applied to medical organizations with clinical manifestations of the disease. In the same 8 subjects of the Russian Federation, in which the survey coverage was excessive and did not lead to a proportional increase in the number of identified
的目标。研究2016年至2022年期间俄罗斯和俄罗斯联邦受试者及时诊断艾滋病毒感染措施的有效性。材料和方法。来自俄罗斯统计局2016-2022年第4号和第61号表格以及俄罗斯人口数据的信息。为了寻找表征调查所涵盖人数的指标与确定的艾滋病毒感染患者人数之间的相关性,使用了2016-2021年俄罗斯85名受试者的数据。采用Statistica 10.0软件进行统计分析。为了处理2016 - 2021年俄罗斯85名受试者的数据,使用了Jupiter Notebook交互式计算环境(6.5.2)。Pandas软件库(1.5.3)用于数据处理和分析,编译和使用结构化数据集。采用统计函数模块Scipy(1.9.3),采用Pearson、Spearman和t-Kendall方法求相关系数。使用Scikit-learn(1.0.2)和statmodels(0.13.5)两个软件库建立趋势线,求线性回归系数。结果和讨论。在俄罗斯,2016-2022年期间,一项旨在及时诊断人口中艾滋病毒感染的调查所涵盖的人口比例每年都在增加。然而,这并没有导致确诊的HIV感染患者数量的增加,这一比例有所下降,到2022年达到了总检查人数的0.11%(2016年- 0.23%)。目前的情况是由于2017-2022年艾滋病毒感染率下降了1.5倍,从每10万人52.8人降至34.7人。因此,为了确定一名感染艾滋病毒的患者,必须对越来越多的健康个体进行检查,这导致在一名患者中诊断艾滋病毒感染的经济成本增加。在被检查的人群中,来自关键危险人群的比例极低,2018-2022年平均为2.3%,而在2022年被发现的患者比例却达到了24.1%。因此,有必要对现有战略进行修改,以便通过艾滋病毒感染诊断调查扩大俄罗斯人口的覆盖范围。研究结果表明,只有在俄罗斯联邦覆盖率较低的15个调查对象中,调查才有理由增加人口覆盖率,这些调查对象的覆盖率不符合已确定的艾滋病毒感染患者人数的增长率,这增加了艾滋病毒感染患者在独立应用于有该疾病临床表现的医疗机构时被发现较晚的风险。在俄罗斯联邦同样的8个调查对象中,调查覆盖率过高,没有导致确定的艾滋病毒感染患者人数按比例增加,因此有必要优化开展年度调查的组织方法,并加强旨在首先吸引关键高危群体的人自愿进行艾滋病毒感染筛查以及与他们直接接触的人的措施。结论。近年来,在俄罗斯,为及时诊断艾滋病毒感染而接受检查的人口比例逐年增加,但并没有导致确诊的艾滋病毒感染患者比例增加,特别是在俄罗斯联邦艾滋病毒感染率较低、每10万人中不超过20人的受试者中。在俄罗斯联邦的这些问题中,增加人口的调查范围在经济上是无利可图的,因为执行调查的费用成倍增加。只有在俄罗斯联邦艾滋病毒感染率仍然很高的地区,即每10万人中超过50人的地区,才有理由扩大人口调查的覆盖面。
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引用次数: 0
Genetic diversity of HIV-1 at the current stage of the epidemic in the Russian Federation: an increase in the prevalence of recombinant forms 艾滋病毒-1在俄罗斯联邦流行病的当前阶段的遗传多样性:重组形式的流行率增加
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-61-72
A. A. Antonova, A. I. Kuznetsova, E. N. Ozhmegova, A. V. Lebedev, E. V. Kazennova, K. V. Kim, A. S. Tumanov, L. N. Glinkina, M. R. Bobkova
The aim of the study: assessment of genetic diversity and prevalence of recombinant forms of HIV-1 at the current stage of the epidemic in the Russian Federation. Materials and methods . The study used collections of blood and its components obtained from 3178 HIV-infected patients of federal and regional «Centers for the Prevention and Control of AIDS» in the period from 2011 to 2020. Next, the extraction of proviral DNA or HIV-1 viral RNA was carried out, followed by amplification of the pol gene region and sequencing of the ampli fication products. Then, the obtained nucleotide sequences were analyzed to determine their subtype and the prevalence of recombinant forms of the virus was estimated. Results and discussion . It was found that sub-subtype A6 remains the dominant (82.9%) genetic variant of HIV-1 at the current stage of the epidemic in the Russian Federation. The second most common was subtype B — 7.14%. The share of each of the recombinant forms of HIV-1 — CRF02_AG and CRF03_AB accounted for about 1% of all analyzed samples, CRF63_02A6 — about 3.59%. In addition to circulating recombinant forms of HIV-1, 87 unique recombinants (2.74%) were identified. A significant (p<0.001) increase in the frequency of occurrence of HIV-1 recombinant forms of over time was revealed. The largest proportion of recombinant forms of HIV-1 was detected in the Siberian (35.83%) and Northwestern (15.98%) federal districts, the smallest — in the Volga (1.99%) and Ural (2.36%) federal districts. Conclusion. The results obtained indicate the growing genetic diversity of HIV-1 in the Russian Federation, along with the spread of HIV infection beyond vulnerable groups, as well as an increase in the frequency of occurrence of recombinant forms of HIV-1 over time and their involvement in the epidemic process.
这项研究的目的是:评估俄罗斯联邦目前艾滋病毒1型重组形式的遗传多样性和流行情况。材料和方法。该研究使用了2011年至2020年期间从联邦和地区“艾滋病预防和控制中心”收集的3178名艾滋病毒感染者的血液及其成分。然后提取原病毒DNA或HIV-1病毒RNA,扩增pol基因区域,对扩增产物进行测序。然后,对获得的核苷酸序列进行分析以确定其亚型,并估计病毒重组形式的流行率。结果和讨论。结果发现,在俄罗斯联邦艾滋病毒-1流行的当前阶段,A6亚型仍然是主要的遗传变异(82.9%)。第二常见的是B亚型- 7.14%。每种重组形式的HIV-1 - CRF02_AG和CRF03_AB各占所有分析样本的1%左右,CRF63_02A6 -约占3.59%。除了循环的HIV-1重组形式外,还鉴定出87个独特的重组形式(2.74%)。随着时间的推移,HIV-1重组形式的发生频率显著增加(p<0.001)。重组型HIV-1在西伯利亚(35.83%)和西北(15.98%)联邦区检测到的比例最大,在伏尔加河(1.99%)和乌拉尔(2.36%)联邦区检测到的比例最小。结论。所获得的结果表明,俄罗斯联邦境内艾滋病毒-1的遗传多样性日益增加,艾滋病毒感染向弱势群体以外蔓延,随着时间的推移,重组形式的艾滋病毒-1的发生频率有所增加,它们参与了流行病进程。
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引用次数: 0
Genetic, virological, infectious, and pharmacological risk factors for CD4<sup>+</sup> T-cell regeneration failure in HIV-infected subjects receiving ART cd4的遗传、病毒学、感染性和药理学危险因素接受抗逆转录病毒治疗的hiv感染者的t细胞再生失败
Q4 Medicine Pub Date : 2023-10-21 DOI: 10.22328/2077-9828-2023-15-3-38-49
E. V. Saidakova
In 10 to 40% of HIV-infected patients being adherent to highly active antiretroviral therapy (HAART), viral load suppression is not accompanied by a significant increase in the number of CD4 + T-lymphocytes. This phenomenon, known as immunological non-response to treatment, is associated with a high risk of developing AIDS-associated and non-AIDS-associated diseases, as well as premature death. The bases of immunological non-response to HAART are poorly understood, while information on the risk factors for its development is scattered. The aim of the present review is to organize data on non-immune-system risk factors for the development of immunological nonresponse to HAART. Materials and methods . Electronic searching using PubMed, Science Direct, and Scopus were conducted. Results and discussion. The database search delivered information on genetic, virological, infectious, and pharmacological risk factors for the development of immunological non-response to HAART. Each factor contribution might be substantially different. Still, none of them can be considered a trigger mechanism for this phenomenon. Conclusion. Immunological non-response to HAART is a polyetiological condition. Apparently, this phenomenon is based on normally imperceptible immune system features or defects, which manifest during the CD4 + T-cell regeneration.
在10%至40%坚持高效抗逆转录病毒治疗(HAART)的hiv感染患者中,病毒载量抑制并不伴随着CD4 + t淋巴细胞数量的显著增加。这种现象被称为对治疗的免疫无反应,与发生艾滋病相关和非艾滋病相关疾病以及过早死亡的高风险有关。对HAART免疫无反应的基础知之甚少,而其发展的危险因素的信息是分散的。本综述的目的是组织对HAART免疫无反应发展的非免疫系统危险因素的数据。材料和方法。使用PubMed、Science Direct和Scopus进行电子检索。结果和讨论。数据库搜索提供了基因、病毒学、感染性和药理学风险因素对HAART免疫无反应发展的信息。每个因素的贡献可能有很大的不同。尽管如此,它们都不能被认为是这种现象的触发机制。结论。对HAART的免疫无反应是一种多方面的情况。显然,这种现象是基于通常难以察觉的免疫系统特征或缺陷,这些特征或缺陷在CD4 + t细胞再生过程中表现出来。
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引用次数: 0
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HIV Infection and Immunosuppressive Disorders
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