Pub Date : 2023-01-24DOI: 10.22328/2077-9828-2022-14-4-87-92
V. H. Fazylov, A. Oleynik, Chandrasekar G Revathy, Ah. M. Fayyadh, O. Abdullah
The article presents a series of clinical observations of confirmed cases of COVID-19 in hospitalized adult patients with HIV infection. The observed group of patients was characterized by a young age, a different spectrum of comorbid pathology, a moderate and comparable clinical and laboratory course, with the exception of a more prolonged clearance of SARS-CoV-2 compared with COVID-19 patients from the general population. Advanced stage of HIV infection with the development of secondary diseases (p=0.08), decrease in the relative number of CD4+T-lymphocytes less than 2% (p=0.03), and CD4+/CD8+ less than 0.05 (p=0.03), the presence of cytomegalovirus infection (p=0.004) distinguished HIV-SARS-CoV-2-coinfected patients with poor outcomes. The presence and similarity of the clinical and radiological course of COVID-19 and cytomegalovirus infection in patients with severe immunodeficiency was noted, which requires an extremely thorough differential diagnosis.
{"title":"COVID-19 in patients with HIV: case-series","authors":"V. H. Fazylov, A. Oleynik, Chandrasekar G Revathy, Ah. M. Fayyadh, O. Abdullah","doi":"10.22328/2077-9828-2022-14-4-87-92","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-4-87-92","url":null,"abstract":"The article presents a series of clinical observations of confirmed cases of COVID-19 in hospitalized adult patients with HIV infection. The observed group of patients was characterized by a young age, a different spectrum of comorbid pathology, a moderate and comparable clinical and laboratory course, with the exception of a more prolonged clearance of SARS-CoV-2 compared with COVID-19 patients from the general population. Advanced stage of HIV infection with the development of secondary diseases (p=0.08), decrease in the relative number of CD4+T-lymphocytes less than 2% (p=0.03), and CD4+/CD8+ less than 0.05 (p=0.03), the presence of cytomegalovirus infection (p=0.004) distinguished HIV-SARS-CoV-2-coinfected patients with poor outcomes. The presence and similarity of the clinical and radiological course of COVID-19 and cytomegalovirus infection in patients with severe immunodeficiency was noted, which requires an extremely thorough differential diagnosis.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43277040","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 : 2023-01-24DOI: 10.22328/2077-9828-2022-14-4-49-58
A. Kuznetsova, V. G. Bobkov, A. Lebedev, A. Tumanov, K. V. Kim, N. E. Chaikovskaia, A. G. Chudnovsky, A. N. Charushin, A. Pronin, Е. V. Drobyshevskaya, A. V. Shemshura, A. V. Turkin, Е. A. Ilyina, V. V. Shevchenko, T. V. Krylova, I. L. Kirillova, E. N. Begma, T. Bogatyreva, K. Prodanova, L. F. Sklyar, Е. V. Kazennova, M. Bobkova
Objective on creating a universal tool with Russian user interface (UI) to systematically collect and store epidemiological-demographic and clinical-laboratory data of patients with the possibility of their structured export for subsequent multifaceted analysis.Materials and methods. When creating an online tool, the solutions of European colleagues used to conduct a multicenter study of EuroSIDA, including a list, algorithms for collecting, storing and exchanging data, were used as a model.Research and discussion. A Russian UI online resource RuSIDA has been developed, hosted on the website http://hivgen.org/, designed to fulfill the tasks above. The tool requires authorized access and has been successfully tested on data collection from HIV-infected patients at several AIDS centers in the Russian Federation.Conclusion. The developed online resource RuSIDA can be used to maintain medical electronic records, intralaboratory databases, as well as to conduct epidemiological monitoring of various nosologies and multicenter scientific studies.
{"title":"RuSIDA: the online resource for the collection, storage and analysis of epidemiologicel, demographic and clinical laboratory data of patients","authors":"A. Kuznetsova, V. G. Bobkov, A. Lebedev, A. Tumanov, K. V. Kim, N. E. Chaikovskaia, A. G. Chudnovsky, A. N. Charushin, A. Pronin, Е. V. Drobyshevskaya, A. V. Shemshura, A. V. Turkin, Е. A. Ilyina, V. V. Shevchenko, T. V. Krylova, I. L. Kirillova, E. N. Begma, T. Bogatyreva, K. Prodanova, L. F. Sklyar, Е. V. Kazennova, M. Bobkova","doi":"10.22328/2077-9828-2022-14-4-49-58","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-4-49-58","url":null,"abstract":"Objective on creating a universal tool with Russian user interface (UI) to systematically collect and store epidemiological-demographic and clinical-laboratory data of patients with the possibility of their structured export for subsequent multifaceted analysis.Materials and methods. When creating an online tool, the solutions of European colleagues used to conduct a multicenter study of EuroSIDA, including a list, algorithms for collecting, storing and exchanging data, were used as a model.Research and discussion. A Russian UI online resource RuSIDA has been developed, hosted on the website http://hivgen.org/, designed to fulfill the tasks above. The tool requires authorized access and has been successfully tested on data collection from HIV-infected patients at several AIDS centers in the Russian Federation.Conclusion. The developed online resource RuSIDA can be used to maintain medical electronic records, intralaboratory databases, as well as to conduct epidemiological monitoring of various nosologies and multicenter scientific studies.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48868491","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 : 2022-11-10DOI: 10.22328/2077-9828-2022-14-3-65-76
A. Bazhenova, K. Mironov, A. Kravchenko, V. Akimkin
Introduction. Identification of pharmacogenetic effects on antiretroviral therapy (ART) has become an important milestone to reach in the advancement of personalised treatment for HIV-positive patients. The therapy schemes are accompanied by multiple side effects. Therapy effectiveness and adverse reactions can be dictated by individual genetic predisposition factors, which should be taken into account for an optimal prescription. Some genetic markers (HLA-B*57:01 and UGT1A1*28), were already proven to improve discontinuation rates, and efforts are allocated to expand the range of clinically-relevant genetic tests.Objective. In this review, an updated summary of genetic polymorphisms and their effects defining patients’ tolerability to ART is presented. The aim of this research is to assess single nucleotide polymorphisms (SNPs) present in the genes that encode proteins involved in ART metabolism and transport. This review will be used to develop a PCR-based testing methodology for the detection and confirmation of risk alleles in the Caucasian population.Materials and methods. Data from 46 original research papers and reviews was analysed. Allele frequencies of the most relevant polymorphisms were checked against the data for European population.Results. As an outcome of this review, a few most promising SNPs were selected for future research. Firstly, ABCC4 rs1751034 and rs3742106 and ABCC10 rs9349256 and rs2125739 were associated with an increased risk of renal impairment, higher plasma concentration, and toxicity when treated with tenofovir. Parallel analysis of ABCC4 and ABCC10 SNP effects on renal impairment together with CYP24A1 rs2248359 that was recently reported as a potential renal toxicity marker might be more informative. Secondly, CYP2B6 rs3745274 that was associated with an increased efavirenz plasma concentration, and increased risk of liver and CNS toxicity should be evaluated. SNPs in CYP2B6, CYP2A6 (rs28399433), and CYP3A4 (rs4646437) should be evaluated in parallel since possession of all three variants might put patients at a much higher risk.Conclusion. Identified alleles could become new markers used in drug prescription protocols if significant effect in Caucasian population will be found. The most relevant SNPs should be tested in in supporting future studies to evaluate the significance for patients with HIV in Russia.
{"title":"Pharmacogenetic effects of single nucleotide polymorphisms commonly associated with antiretroviral therapy metabolism","authors":"A. Bazhenova, K. Mironov, A. Kravchenko, V. Akimkin","doi":"10.22328/2077-9828-2022-14-3-65-76","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-65-76","url":null,"abstract":"Introduction. Identification of pharmacogenetic effects on antiretroviral therapy (ART) has become an important milestone to reach in the advancement of personalised treatment for HIV-positive patients. The therapy schemes are accompanied by multiple side effects. Therapy effectiveness and adverse reactions can be dictated by individual genetic predisposition factors, which should be taken into account for an optimal prescription. Some genetic markers (HLA-B*57:01 and UGT1A1*28), were already proven to improve discontinuation rates, and efforts are allocated to expand the range of clinically-relevant genetic tests.Objective. In this review, an updated summary of genetic polymorphisms and their effects defining patients’ tolerability to ART is presented. The aim of this research is to assess single nucleotide polymorphisms (SNPs) present in the genes that encode proteins involved in ART metabolism and transport. This review will be used to develop a PCR-based testing methodology for the detection and confirmation of risk alleles in the Caucasian population.Materials and methods. Data from 46 original research papers and reviews was analysed. Allele frequencies of the most relevant polymorphisms were checked against the data for European population.Results. As an outcome of this review, a few most promising SNPs were selected for future research. Firstly, ABCC4 rs1751034 and rs3742106 and ABCC10 rs9349256 and rs2125739 were associated with an increased risk of renal impairment, higher plasma concentration, and toxicity when treated with tenofovir. Parallel analysis of ABCC4 and ABCC10 SNP effects on renal impairment together with CYP24A1 rs2248359 that was recently reported as a potential renal toxicity marker might be more informative. Secondly, CYP2B6 rs3745274 that was associated with an increased efavirenz plasma concentration, and increased risk of liver and CNS toxicity should be evaluated. SNPs in CYP2B6, CYP2A6 (rs28399433), and CYP3A4 (rs4646437) should be evaluated in parallel since possession of all three variants might put patients at a much higher risk.Conclusion. Identified alleles could become new markers used in drug prescription protocols if significant effect in Caucasian population will be found. The most relevant SNPs should be tested in in supporting future studies to evaluate the significance for patients with HIV in Russia.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44399749","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 : 2022-11-10DOI: 10.22328/2077-9828-2022-14-3-94-99
V. S. Borovitsky
Objective. To detect patient’s complaints on admission to the hospital, statistically important with adverse outcome in tuberculosis with HIV infection, most sensitivity and specificity.Materials and methods. 363 patients were examined with tuberculosis and HIV infection. The first group included 59 (16,3%) patients with adverse disease outcome, the second group contained 304 patients (83,7%) with favorable outcome. Methods: clinical, laboratory, microbiological, statistical: analysis of pairwise contingency tables by Pearson’s criterion, Mann-Whitney test on quantitative characteristics, logistic regression.Results and discussion. The highest odds ratio of sensitivity and specificity among HIV and tuberculosis patient’s complaints, highly probable on risk of adverse outcome (р<0,0001), has fever — 26,8, 93,2% and 66,1%, loose stools — 25,4, 40,7% and 97,4%, weight loss — 18,8, 72,9% and 87,5%, loss of appetite — 17,0, 69,5% and 88,2%, shortness of breath — 15,6, 79,7% and 79,9%, weakness — 8,7, 91,5% and 44,7%, headache — 7,4, 49,2% and 88,5% accordingly. Thus, in the absence of other complaints the risk of adverse outcome in a patient with HIV and tuberculosis, compared to a patient with no such complaints increases for fever 26,8 times, for loose stools — 25,4 times, for weight loss — 18,8 times, for loss of appetite — 17,0 times, for shortness of breath —15,6 times, for weakness — 8,7 times, for headache — 7,4 times.
{"title":"Complaints of a patient — as predictors of adverse outcomes in tuberculosis with HIV infection","authors":"V. S. Borovitsky","doi":"10.22328/2077-9828-2022-14-3-94-99","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-94-99","url":null,"abstract":"Objective. To detect patient’s complaints on admission to the hospital, statistically important with adverse outcome in tuberculosis with HIV infection, most sensitivity and specificity.Materials and methods. 363 patients were examined with tuberculosis and HIV infection. The first group included 59 (16,3%) patients with adverse disease outcome, the second group contained 304 patients (83,7%) with favorable outcome. Methods: clinical, laboratory, microbiological, statistical: analysis of pairwise contingency tables by Pearson’s criterion, Mann-Whitney test on quantitative characteristics, logistic regression.Results and discussion. The highest odds ratio of sensitivity and specificity among HIV and tuberculosis patient’s complaints, highly probable on risk of adverse outcome (р<0,0001), has fever — 26,8, 93,2% and 66,1%, loose stools — 25,4, 40,7% and 97,4%, weight loss — 18,8, 72,9% and 87,5%, loss of appetite — 17,0, 69,5% and 88,2%, shortness of breath — 15,6, 79,7% and 79,9%, weakness — 8,7, 91,5% and 44,7%, headache — 7,4, 49,2% and 88,5% accordingly. Thus, in the absence of other complaints the risk of adverse outcome in a patient with HIV and tuberculosis, compared to a patient with no such complaints increases for fever 26,8 times, for loose stools — 25,4 times, for weight loss — 18,8 times, for loss of appetite — 17,0 times, for shortness of breath —15,6 times, for weakness — 8,7 times, for headache — 7,4 times.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46383910","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 : 2022-11-10DOI: 10.22328/2077-9828-2022-14-3-77-85
Z. Zagdyn, O. B. Nechaeva, S. Sterlikov, T. P. Vasilyeva, O. Alexandrova
Introduction. One of the main factors affecting TB burden is HIV progression and, in turn, PLWH predominantly die of TB.The study purpose was to identify high risk regions of HIV, HIV/TB coinfection in NWFD of Russia between years of 2007 to 2018.Materials and methods. K-means method was applied to identify HIV, HIV/TB incidence, prevalence and mortality rates, as well as share of heterosexual HIV transmission route clusters in 10 regions of NWFD. The need data were extracted from relevant forms of federal statistical observation between 2007 to 2018. NAO was excluded from cluster analysis due to absence of HIV/TB coinfection cases in study period. For holistic understanding of HIV/TB coinfection trends, TB incidence, prevalence and mortality rates were estimated too without including them in cluster analysis.Results. Along with significant reduce in TB cases there was increase in HIV case data in most regions, especially in Arkhangelsk oblast where HIV incidence raised by 617.8% in period analyzed. Meanwhile Kaliningrad oblast became the only region where HIV incidence (–21.5%) and mortality (–65.6%), also HIV/TB incidence (–55.0%) is failed in 2007–2018. Heterosexual HIV transmission risk was high in almost all regions, especially in NAO (100.0%), Pskov (89.2%), Novgorod (78.8%) oblasts. K-means method detected the highest HIV spread in Arkhangelsk oblast (first cluster), lowest — in Kaliningrad, Leningrad, Murmansk oblasts and St. Petersburg (third cluster). Other regions with intermediate HIV case data formed second cluster. HIV/TB coinfection most rapidly spreads in Arkhangelsk, Pskov and Novgorod oblasts (first cluster), most slowly — in Kaliningrad, Leningrad oblasts and in St. Petersburg (third cluster). In other regions, spread of HIV/TB coinfection has average rate, forming second intermediate cluster.Conclusion. Along with significant improvement in TB epidemic, spread of HIV and HIV/TB coinfection in regions of NWFD considered as uneven. In regions with high concentration of HIV cases, HIV and HIV/TB coinfection rates are slowed down. Conversely, highest rates of HIV cases, as well as of HIV/TB coinfection case data, are observed in regions with low HIV accumulation, indicating the need to strengthen TB measures in PLWH in regions with a low spread of HIV.
{"title":"HIV and HIV/TB coinfection: cluster distribution of regions in the Northwestern Federal District of Russia","authors":"Z. Zagdyn, O. B. Nechaeva, S. Sterlikov, T. P. Vasilyeva, O. Alexandrova","doi":"10.22328/2077-9828-2022-14-3-77-85","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-77-85","url":null,"abstract":"Introduction. One of the main factors affecting TB burden is HIV progression and, in turn, PLWH predominantly die of TB.The study purpose was to identify high risk regions of HIV, HIV/TB coinfection in NWFD of Russia between years of 2007 to 2018.Materials and methods. K-means method was applied to identify HIV, HIV/TB incidence, prevalence and mortality rates, as well as share of heterosexual HIV transmission route clusters in 10 regions of NWFD. The need data were extracted from relevant forms of federal statistical observation between 2007 to 2018. NAO was excluded from cluster analysis due to absence of HIV/TB coinfection cases in study period. For holistic understanding of HIV/TB coinfection trends, TB incidence, prevalence and mortality rates were estimated too without including them in cluster analysis.Results. Along with significant reduce in TB cases there was increase in HIV case data in most regions, especially in Arkhangelsk oblast where HIV incidence raised by 617.8% in period analyzed. Meanwhile Kaliningrad oblast became the only region where HIV incidence (–21.5%) and mortality (–65.6%), also HIV/TB incidence (–55.0%) is failed in 2007–2018. Heterosexual HIV transmission risk was high in almost all regions, especially in NAO (100.0%), Pskov (89.2%), Novgorod (78.8%) oblasts. K-means method detected the highest HIV spread in Arkhangelsk oblast (first cluster), lowest — in Kaliningrad, Leningrad, Murmansk oblasts and St. Petersburg (third cluster). Other regions with intermediate HIV case data formed second cluster. HIV/TB coinfection most rapidly spreads in Arkhangelsk, Pskov and Novgorod oblasts (first cluster), most slowly — in Kaliningrad, Leningrad oblasts and in St. Petersburg (third cluster). In other regions, spread of HIV/TB coinfection has average rate, forming second intermediate cluster.Conclusion. Along with significant improvement in TB epidemic, spread of HIV and HIV/TB coinfection in regions of NWFD considered as uneven. In regions with high concentration of HIV cases, HIV and HIV/TB coinfection rates are slowed down. Conversely, highest rates of HIV cases, as well as of HIV/TB coinfection case data, are observed in regions with low HIV accumulation, indicating the need to strengthen TB measures in PLWH in regions with a low spread of HIV. ","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42692669","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 : 2022-11-10DOI: 10.22328/2077-9828-2022-14-3-59-64
D. Baryshnikova, A. Mordyk, L. Puzyreva
Objective. To identify risk factors of adverse outcome in patients with HIV infection and cytopenia.Materials and methods. The analyzed group included 30 patients with HIV and two-line cytopenia and pancytopenia. The patients were on inpatient treatment in the Budget Healthcare Institution «CTBD №4», BHCI «Regional Clinical Hospital», Omsk. Results and discussion. Hematopoiesis was found in 14 patients (46,66%), while dyseritropoiesis was noted in 4 patients (13,33%), dysgranulocytopoiesis in 3 patients (10%), cellular rejuvenation of granulocyte series in 2 patients (6,67%), mononuclear cells (involutive forms of megakaryocytes) in 5 patients (13,33%). As HIV progresses the patients experience increasing number and severity of hematological abnormalities in hemograms and myelograms. Early correction of hematopoietic disorders allows to improve the quality of these patients’ life. Myelodysplasia emergence in myelogram in patients with or without ARV therapy statistically differed only in a megakaryocytic germ. The death risk scale of patients with HIV and cytopenia is developed, on the basis of clinical data, obtained results of bone marrow research, based on regression equations.
{"title":"Analysis of myelogram data in patients with HIV infection and hematopoiesis oppression","authors":"D. Baryshnikova, A. Mordyk, L. Puzyreva","doi":"10.22328/2077-9828-2022-14-3-59-64","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-59-64","url":null,"abstract":"Objective. To identify risk factors of adverse outcome in patients with HIV infection and cytopenia.Materials and methods. The analyzed group included 30 patients with HIV and two-line cytopenia and pancytopenia. The patients were on inpatient treatment in the Budget Healthcare Institution «CTBD №4», BHCI «Regional Clinical Hospital», Omsk. Results and discussion. Hematopoiesis was found in 14 patients (46,66%), while dyseritropoiesis was noted in 4 patients (13,33%), dysgranulocytopoiesis in 3 patients (10%), cellular rejuvenation of granulocyte series in 2 patients (6,67%), mononuclear cells (involutive forms of megakaryocytes) in 5 patients (13,33%). As HIV progresses the patients experience increasing number and severity of hematological abnormalities in hemograms and myelograms. Early correction of hematopoietic disorders allows to improve the quality of these patients’ life. Myelodysplasia emergence in myelogram in patients with or without ARV therapy statistically differed only in a megakaryocytic germ. The death risk scale of patients with HIV and cytopenia is developed, on the basis of clinical data, obtained results of bone marrow research, based on regression equations.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41980466","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 : 2022-11-10DOI: 10.22328/2077-9828-2022-14-3-100-109
D. Sulima, S. Suleymanova, A. A. Yakovlev, V. N. Koryagin, V. Rassokhin
Objective. Description of clinical forms of chronic HCV infection in the observed patients, clarifications of options and causes of virological failures of primary interferon-free therapy (DAAT/1) and the results of repeated interferon-free treatment (DAAT/2).Materials and methods. 8 patients with chronic RNA HCV viremia (subtypes 1b+/–1a and 3а/3ab) were prospectively observed who suffered a virological failure of primary interferon-free therapy with original inhibitors in the form of relapse of RNA HCV viremia and aviremic low-level replication RNA HCV in PBMCs (peripheral mononuclears), but then achieved HCV eradication with a repeated course of interferon-free therapy.Results. Two variants of virological failures of primary interferon-free therapy were noted — relapse of RNA HCV viremia and aviremic low-level replication of RNA HCV in PBMCs. A number of unfavorable prognosis signs (individual clinical and laboratory syndromes and laboratory parameters) were revealed, which were observed in most patients who did not achieve HCV eradication using primary interferon-free therapy with antiviral drugs: HCV-associated syndromes of low-grade systemic inflammation (LGSI), benign lymphoproliferation and autoantibody production, a high level viral load of HCV RNA viral load in blood plasma, HBV-coinfection without HBsAg and cirrhosis of the liver in the outcome of chronic hepatitis C. The target result of repeated interferon-free therapy, confirmed by the sustainable virological response after 12 weeks after the end of the treatment (SVR12), was achieved in all «losers» of primary interferon-free therapy.Conclusion. The unfavorable prognostic signs identified in the majority of «losers» of primary interferon-free therapy in the form of individual clinical and laboratory syndromes and laboratory parameters may be associated with potential virological inefficiency of therapy. Based on logistic regression analysis, the value of each of the identified features for predicting different outcomes of primary interferon-free therapy in a large group of patients with HCV is shown. Pangenotypic combinations of GLE/PIB+SOF+/–RBV and VEL/SOF+RBV inhibitors have shown their high antiviral efficacy in the treatment of relapse of RNA HCV viremia and aviremic low-level replication of RNA HCV in peripheral mononuclears for all the patients for whom primary interferon-free therapy was unsuccessful.
{"title":"Virological failures of primary interferon-free therapy in patients with chronic HCV RNA viremia and successful repeated interferon-free therapy","authors":"D. Sulima, S. Suleymanova, A. A. Yakovlev, V. N. Koryagin, V. Rassokhin","doi":"10.22328/2077-9828-2022-14-3-100-109","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-100-109","url":null,"abstract":"Objective. Description of clinical forms of chronic HCV infection in the observed patients, clarifications of options and causes of virological failures of primary interferon-free therapy (DAAT/1) and the results of repeated interferon-free treatment (DAAT/2).Materials and methods. 8 patients with chronic RNA HCV viremia (subtypes 1b+/–1a and 3а/3ab) were prospectively observed who suffered a virological failure of primary interferon-free therapy with original inhibitors in the form of relapse of RNA HCV viremia and aviremic low-level replication RNA HCV in PBMCs (peripheral mononuclears), but then achieved HCV eradication with a repeated course of interferon-free therapy.Results. Two variants of virological failures of primary interferon-free therapy were noted — relapse of RNA HCV viremia and aviremic low-level replication of RNA HCV in PBMCs. A number of unfavorable prognosis signs (individual clinical and laboratory syndromes and laboratory parameters) were revealed, which were observed in most patients who did not achieve HCV eradication using primary interferon-free therapy with antiviral drugs: HCV-associated syndromes of low-grade systemic inflammation (LGSI), benign lymphoproliferation and autoantibody production, a high level viral load of HCV RNA viral load in blood plasma, HBV-coinfection without HBsAg and cirrhosis of the liver in the outcome of chronic hepatitis C. The target result of repeated interferon-free therapy, confirmed by the sustainable virological response after 12 weeks after the end of the treatment (SVR12), was achieved in all «losers» of primary interferon-free therapy.Conclusion. The unfavorable prognostic signs identified in the majority of «losers» of primary interferon-free therapy in the form of individual clinical and laboratory syndromes and laboratory parameters may be associated with potential virological inefficiency of therapy. Based on logistic regression analysis, the value of each of the identified features for predicting different outcomes of primary interferon-free therapy in a large group of patients with HCV is shown. Pangenotypic combinations of GLE/PIB+SOF+/–RBV and VEL/SOF+RBV inhibitors have shown their high antiviral efficacy in the treatment of relapse of RNA HCV viremia and aviremic low-level replication of RNA HCV in peripheral mononuclears for all the patients for whom primary interferon-free therapy was unsuccessful.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43500091","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 : 2022-11-10DOI: 10.22328/2077-9828-2022-14-3-86-93
S. A. Ievkov, M. Bulygin, A. V. Kushnir, K. O. Ershova, Y. I. Bulankov, A. Bespalov, A. Barchuk
Introduction. 44 cases of HIV-infection among the homeless were registered in Saint Petersburg in 2021. At the same time, it is known that the case reporting and medical treatment in Russia are limited by the lack of required document minimum among a large number of them — passport and compulsory medical insurance policy. The cohort of the homeless is heterogeneous and in many countries the predominant risk factors of HIV infection and prevalence are different. So far, the studies of HIV spread among the homeless in Russia are rare.Objective. Assess the prevalence of HIV infection among the homeless in Saint Petersburg.Materials and methods. Cross-sectional study was carried out among the homeless in «places of attraction»: heating points, overnight shelters, care services from May, 24th to October, 1st 2021 and involved 199 participants. There was questionnaire and rapid HIV antibody testing in capillary blood by the set «Wondfo HIV 1,2». The study was completed anonymously.Results. When examining HIV infection was detected in 9 out of 199 participants — 4.5% (CI 95% [1.61%, 7.39%]), thus, HIV prevalence among the homeless is on average higher than in Saint Petersburg (0.81%) and the country (0.78%). The factors, associated with HIV infection, are the use of injection drugs: odds ratio of prevalence in the adjusted model adjusted prevalence ratio (APR)=4.3 (p<0.05, CI 95% [1.1, 17.5]) and incarceration: APR=9.4 (CI 95% [1.1, 82.2]).Conclusion. The results obtained and the factors, defined in the study of risk factors for infection, allow to determine the main directions of HIV prevention among the homeless and to highlight the need for attributing the cohort of the homeless to the «key» population group along with others.
介绍2021年，圣彼得堡登记了44例无家可归者感染艾滋病毒的病例。与此同时，众所周知，俄罗斯的病例报告和医疗受到缺乏护照和强制性医疗保险等最低要求文件的限制。无家可归者的群体是异质的，在许多国家，艾滋病毒感染和流行的主要风险因素是不同的。到目前为止，关于艾滋病毒在俄罗斯无家可归者中传播的研究很少。客观的评估圣彼得堡无家可归者的艾滋病毒感染率。材料和方法。2021年5月24日至10月1日，在“景点”的无家可归者中进行了横断面研究，共有199名参与者参与。采用“Wondfo HIV 1,2”试剂盒对毛细管血进行问卷调查和快速HIV抗体检测。这项研究是匿名完成的。后果在检查199名参与者中有9人检测到艾滋病毒感染，占4.5%（CI 95%[1.61%，7.39%]），因此，无家可归者中的艾滋病毒感染率平均高于圣彼得堡（0.81%）和全国（0.78%），是注射药物的使用：在调整后的模型中，患病率的比值比调整后的患病率（APR）=4.3（p＜0.05，CI 95%[1.1，17.5]）和监禁：APR=9.4（CI 95%[11.1，82.2]），允许确定无家可归者预防艾滋病毒的主要方向，并强调将无家可归者群体与其他人一起归因于“关键”人群的必要性。
{"title":"HIV infection in the homeless in Saint Petersburg in 2021","authors":"S. A. Ievkov, M. Bulygin, A. V. Kushnir, K. O. Ershova, Y. I. Bulankov, A. Bespalov, A. Barchuk","doi":"10.22328/2077-9828-2022-14-3-86-93","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-86-93","url":null,"abstract":"Introduction. 44 cases of HIV-infection among the homeless were registered in Saint Petersburg in 2021. At the same time, it is known that the case reporting and medical treatment in Russia are limited by the lack of required document minimum among a large number of them — passport and compulsory medical insurance policy. The cohort of the homeless is heterogeneous and in many countries the predominant risk factors of HIV infection and prevalence are different. So far, the studies of HIV spread among the homeless in Russia are rare.Objective. Assess the prevalence of HIV infection among the homeless in Saint Petersburg.Materials and methods. Cross-sectional study was carried out among the homeless in «places of attraction»: heating points, overnight shelters, care services from May, 24th to October, 1st 2021 and involved 199 participants. There was questionnaire and rapid HIV antibody testing in capillary blood by the set «Wondfo HIV 1,2». The study was completed anonymously.Results. When examining HIV infection was detected in 9 out of 199 participants — 4.5% (CI 95% [1.61%, 7.39%]), thus, HIV prevalence among the homeless is on average higher than in Saint Petersburg (0.81%) and the country (0.78%). The factors, associated with HIV infection, are the use of injection drugs: odds ratio of prevalence in the adjusted model adjusted prevalence ratio (APR)=4.3 (p<0.05, CI 95% [1.1, 17.5]) and incarceration: APR=9.4 (CI 95% [1.1, 82.2]).Conclusion. The results obtained and the factors, defined in the study of risk factors for infection, allow to determine the main directions of HIV prevention among the homeless and to highlight the need for attributing the cohort of the homeless to the «key» population group along with others.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48231988","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 : 2022-11-09DOI: 10.22328/2077-9828-2022-14-3-35-42
L. Kravchenko, M. Levkovich, S. Berezhanskaya, A. Afonin, I. Krukier, O. Puzikova, I. Panova, D. Sozaeva, V. Popova, N. Drukker
Objective. To develop prognostic criteria for the chronic course of cytomegalovirus infection by studying disorders of the regulation of the immune response in children of the first year of life against the background of hypoxic-ischemic CNS damage.Materials and methods. 108 newborns with cytomegalovirus infection occurring against the background of perinatal hypoxicischemic lesions of the central unequal system were examined. All observed patients at 1 and 3 months of life conducted an immunological examination, including the determination of T and B-lymphocytes. Determination of the population and subpopulation composition of peripheral blood lymphocytes, activation markers was carried out by the method of one- and twoparameter phenotyping using reagents from Immunotex (France), FITC (fluorescein isothiocynate) — labeled with CD3+, CD4+, CD8+, CD20+ and PE (phycoerythrin) — labeled CD28+, CD40+. The results were recorded on a BECKMAN COULTER EPICSXL-II flow cytometer (USA) using standard protocols. The observation groups consisted of 78 children (72.2%) with an acute course of the disease (Group 1) and 30 children (27.3%) with a chronic course (Group 2).Results. Of the totality of the studied parameters of the cellular and humoral parts of the immune system, statistically significant for the prognosis of the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage were found: CD8, CD40, CD3+CD28+, CD20+CD40+. Using the PolyAnalist 3.5 Pro CNS package, systems of inequalities were obtained and a formula for predicting the chronic course of cytomegalovirus infection in children in the first year against the background of perinatal hypoxic-ischemic CNS damage was calculated.Conclusion. A statistically significant relationship was found between the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage and the level of CD20, CD4, costimulatory molecules CD3+CD28–, CD20+CD40+. The proposed diagnostic rules can be considered screening markers for the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage in newborns, which makes it possible to start specific therapy in a timely manner.
客观的通过研究缺氧缺血性中枢神经系统损伤背景下出生一岁儿童免疫反应调节障碍，制定巨细胞病毒感染慢性过程的预后标准。材料和方法。108例新生儿巨细胞病毒感染是在围产期中枢不等系统缺氧缺血性病变的背景下发生的。所有观察到的患者在1个月和3个月大时都进行了免疫学检查，包括T和B淋巴细胞的测定。使用来自Immunotex（法国）、FITC（异硫氰酸荧光素）的试剂，用CD3+、CD4+、CD8+、CD20+和PE（藻红蛋白）标记的CD28+、CD40+，通过单参数和双参数表型分析法测定外周血淋巴细胞的群体和亚群组成、活化标记物。使用标准方案将结果记录在BECKMAN COULTER EPICSXL-II流式细胞仪（美国）上。观察组包括78名急性期儿童（72.2%）（第1组）和30名慢性期儿童（27.3%）（第2组），在缺氧缺血性中枢神经系统损伤的背景下，发现CD8、CD40、CD3+CD28+、CD20+CD40+对第一年儿童巨细胞病毒感染慢性病程的预后具有统计学意义。使用PolyAnalist 3.5 Pro CNS软件包，获得了不平等系统，并计算了在围产期缺氧缺血性CNS损伤的背景下预测第一年儿童巨细胞病毒感染慢性病程的公式。结论在围产期缺氧缺血性中枢神经系统损伤的背景下，巨细胞病毒感染的慢性过程的预后与CD20、CD4、共刺激分子CD3+CD28-、CD20+CD40+的水平之间存在统计学显著关系。在新生儿围产期缺氧缺血性中枢神经系统损伤的背景下，所提出的诊断规则可以被视为筛查巨细胞病毒感染慢性病程预后的标志物，这使得及时开始特异性治疗成为可能。
{"title":"Clinical and immunological criteria for prediction of thechronic course of cytomegalovirus infection on the background of hypoxic-ischemic damage of the central nervous system in children in the first year of life","authors":"L. Kravchenko, M. Levkovich, S. Berezhanskaya, A. Afonin, I. Krukier, O. Puzikova, I. Panova, D. Sozaeva, V. Popova, N. Drukker","doi":"10.22328/2077-9828-2022-14-3-35-42","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-35-42","url":null,"abstract":"Objective. To develop prognostic criteria for the chronic course of cytomegalovirus infection by studying disorders of the regulation of the immune response in children of the first year of life against the background of hypoxic-ischemic CNS damage.Materials and methods. 108 newborns with cytomegalovirus infection occurring against the background of perinatal hypoxicischemic lesions of the central unequal system were examined. All observed patients at 1 and 3 months of life conducted an immunological examination, including the determination of T and B-lymphocytes. Determination of the population and subpopulation composition of peripheral blood lymphocytes, activation markers was carried out by the method of one- and twoparameter phenotyping using reagents from Immunotex (France), FITC (fluorescein isothiocynate) — labeled with CD3+, CD4+, CD8+, CD20+ and PE (phycoerythrin) — labeled CD28+, CD40+. The results were recorded on a BECKMAN COULTER EPICSXL-II flow cytometer (USA) using standard protocols. The observation groups consisted of 78 children (72.2%) with an acute course of the disease (Group 1) and 30 children (27.3%) with a chronic course (Group 2).Results. Of the totality of the studied parameters of the cellular and humoral parts of the immune system, statistically significant for the prognosis of the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage were found: CD8, CD40, CD3+CD28+, CD20+CD40+. Using the PolyAnalist 3.5 Pro CNS package, systems of inequalities were obtained and a formula for predicting the chronic course of cytomegalovirus infection in children in the first year against the background of perinatal hypoxic-ischemic CNS damage was calculated.Conclusion. A statistically significant relationship was found between the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage and the level of CD20, CD4, costimulatory molecules CD3+CD28–, CD20+CD40+. The proposed diagnostic rules can be considered screening markers for the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage in newborns, which makes it possible to start specific therapy in a timely manner.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47244958","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 : 2022-11-09DOI: 10.22328/2077-9828-2022-14-3-51-58
S. Voznesenskiy, G. Kozhevnikova, Т. N. Ermak, E. S. Samotolkina, Р. V. Klimkova, Е. V. Abramova
Introduction. The HIV epidemic situation in the Russian Federation remains tense. Low coverage of antiretroviral therapy (ART) contributes to the disease progression in some PLHIV. Many authors point to a high prevalence of different secondary disease combinations.Objective. Studying the structure of secondary disease combinations in inpatients and identifying features of immunological and virological indicators.Materials and methods. There was retrospective analysis of 1440 cases of HIV-infected admission in ICU SBHI «ICH № 2» DZM in 2018–2020. The number of CD4+ cells were estimated in 1185 patients, viral load (VL) is defined in 1173 patients.Statistical analysis is held, using program StatTech v. 2.6.2 (developer — LLC «Statech», Russia).Results. 18,5% of patients had 1 secondary disease, 75,9% were diagnosed a combination of 2 and more various lesions. 275 different combinations of secondary diseases are recorded: from 50 combinations of 2 secondary lesions to 4 combinations of 7 nosological units. Ме VL in patients with no secondary diseases — 13 303 copies/ml, with 1 secondary disease it increased 3,2 times (42 926) (p<0,001). Similar changes are detected with 3, 5 and 6 diseases. Ме number of CD4+ lymphosytes in the absence of a secondary pathology — 223 cells/mcl. As the number of secondary diseases increases from 1 to 4, we observe consistent reduction in the number of CD4+ lymphosytes; in a combined secondary pathology Ме CD4+ cells did not exceed 100 cells; with 4 and more secondary diseases this figure did not exceed 20 cells in mcl. Correlation analysis of CD4+ cells and the number of combined secondary diseases revealed the presence of moderate connection tightness on the Chaddock scale (rxy=0,356, p<0,001). The depth of immunodeficiency also affects the outcome of the disease: (M±SD) CD4+ cells in the group of the dead were 101±153 (95% DI: 91–112), in the group of survivors — 198±226 (95% DI:172–224; p<0,001).Conclusion. Combined secondary disease among patients of ICU infectious hospital were diagnosed in 75.9% patients. There were differences by VL level which increased with the growth of combined lesion number; more significant correlation was found between the amount of CD4+ cells and the number of secondary diseases. The obtained results are confirmed by reduced likelihood of a favorable outcome of the disease with increasing number of combined secondary diseases.
{"title":"Immunological and virological features of combined secondary diseases in patients with HIV-based immunodeficiency","authors":"S. Voznesenskiy, G. Kozhevnikova, Т. N. Ermak, E. S. Samotolkina, Р. V. Klimkova, Е. V. Abramova","doi":"10.22328/2077-9828-2022-14-3-51-58","DOIUrl":"https://doi.org/10.22328/2077-9828-2022-14-3-51-58","url":null,"abstract":"Introduction. The HIV epidemic situation in the Russian Federation remains tense. Low coverage of antiretroviral therapy (ART) contributes to the disease progression in some PLHIV. Many authors point to a high prevalence of different secondary disease combinations.Objective. Studying the structure of secondary disease combinations in inpatients and identifying features of immunological and virological indicators.Materials and methods. There was retrospective analysis of 1440 cases of HIV-infected admission in ICU SBHI «ICH № 2» DZM in 2018–2020. The number of CD4+ cells were estimated in 1185 patients, viral load (VL) is defined in 1173 patients.Statistical analysis is held, using program StatTech v. 2.6.2 (developer — LLC «Statech», Russia).Results. 18,5% of patients had 1 secondary disease, 75,9% were diagnosed a combination of 2 and more various lesions. 275 different combinations of secondary diseases are recorded: from 50 combinations of 2 secondary lesions to 4 combinations of 7 nosological units. Ме VL in patients with no secondary diseases — 13 303 copies/ml, with 1 secondary disease it increased 3,2 times (42 926) (p<0,001). Similar changes are detected with 3, 5 and 6 diseases. Ме number of CD4+ lymphosytes in the absence of a secondary pathology — 223 cells/mcl. As the number of secondary diseases increases from 1 to 4, we observe consistent reduction in the number of CD4+ lymphosytes; in a combined secondary pathology Ме CD4+ cells did not exceed 100 cells; with 4 and more secondary diseases this figure did not exceed 20 cells in mcl. Correlation analysis of CD4+ cells and the number of combined secondary diseases revealed the presence of moderate connection tightness on the Chaddock scale (rxy=0,356, p<0,001). The depth of immunodeficiency also affects the outcome of the disease: (M±SD) CD4+ cells in the group of the dead were 101±153 (95% DI: 91–112), in the group of survivors — 198±226 (95% DI:172–224; p<0,001).Conclusion. Combined secondary disease among patients of ICU infectious hospital were diagnosed in 75.9% patients. There were differences by VL level which increased with the growth of combined lesion number; more significant correlation was found between the amount of CD4+ cells and the number of secondary diseases. The obtained results are confirmed by reduced likelihood of a favorable outcome of the disease with increasing number of combined secondary diseases.","PeriodicalId":37381,"journal":{"name":"HIV Infection and Immunosuppressive Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446001","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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