Vol 18, No 5 (2013)

The objective of the study was to investigate risk factors for the development of non-Hodgkin's lymphoma (NHL) in HIV-infected patients with hepatitis С virus (HCV) coinfection. A total of 37 HIV-positive subjects with NHL treated in the Moscow Center for Prevention and Control of AIDS between 2009 and 2013 were included in the study. HIV patients were divided into 2 groups: 23 cases with HCV coinfection and 14 patients without HCV coinfection. At the time of making the diagnosis of NHL 90% of patients had CD4 cell count < 350 cell/mm 3. The mean CD4 cell count in the first group (120±123 cell/mm 3) was significantly lower (p=0,035), than in patients without HCV coinfection (267±253 cell/mm3). At the time of making the diagnosis of NHL 70% of patients had HIV viral load ≥5,00 log10. The mean viral load was 5,47±1,09 log10 copies/ml in the first group and 4,06±2,03 log10 copies/ml in the second group (p=0,033). At the time of making the diagnosis of NHL 78% of patients did not receive combination antiretroviral therapy (cART). In most patients who received cART virologic suppression unsufficient and CD4 cell count remained to be low. Risk factors associated with an increased risk of NHL in HIV-infected patients with HCV coinfection are low CD4 cell count, high HIV viral load and lack of effective cART. Timely initiation of cART followed by complete virologic suppression and CD4 recovery are key factors to prevent NHL in HIV-infected patients.

Despite the fact that over the last few years downward trend in the incidence of acute forms of viral hepatitis B continues, the incidence of chronic hepatitis B (CHV) has increased by 2.5 times since 1998. To date, there are a sufficient number of antiviral drugs, but their use is associated with a set of contraindications, as well as the development of resistance. In this study there was performed an evaluation of a new national drug " Stimforte " in patients with chronic viral hepatitis B (CVHB - DNA positive, HBsAg - positive) at the stage of exacerbation. In the study there were included 28 patients with chronic hepatitis B (HBsAg positive), at different grades of activity, at a stage of viral replication. The diagnosis of chronic hepatitis B was made on the presence in a history acute viral hepatitis for more than 1 year, complaints, hepatolienal, astenovegetative, cytolytic syndromes, the presence of DNA-HBV, anti-HBcore IgM, HBsAg. After 1 course of treatment with " Stimforte " the well-being of patients has improved: in 30% of patients asthenic- vegetative syndrome had disappeared, weakness, fatigue and dyspeptic symptoms were decreased. The use of "Stimforte" in chronic hepatitis B with positive HBsAg at the stage of exacerbation contributed to a more rapid normalization of such indices as ALT, AST, compared with those in the control group. Long-term biochemical and virological remission was achieved in 40 %. It is established that during the treatment the viral load was reduced progressively until the undetectable or low level of HBV DNA and anti-HBc IgM disappeared. In only one case an allergic reaction was observed, which has not hindered to perform a complete course of treatment. No other side effects were detected. The inclusion of the drug "Stimforte" in the complex therapy of patients with exacerbation of chronic hepatitis B reduces the time of recovery of immune status and functional activity of IFN system and contributes to reduction of the viral load or elimination of the virus.

In the paper an analysis of modern chemotherapy preparations for the treatment of influenza is presented, there are given the main characteristics of drugs - mechanisms of action, spectrum of antiviral activity, efficacy parameters. The analysis of the current state of research on the development of anti-influenza drugs has been performed.

An epidemiological analysis of basic indices in obstetric aid in the Omsk region in comparison to nationwide data for 2007 to 2011 has been performed. There was identified unfavourable situation of reproductive and demographic characteristics - high incidence of extragenital morbidity in women, increasing the proportion of antenatal losses among as both term as preterm infants also, the prevalence of perinatal mortality in maternity institutions in districts, if compared with similar institutions in the city. There were determined main causes of stillbirth: certain conditions emerging in the perinatal period and intrauterine hypoxia, birth asphyxia. Low indices of neonatal health: a high level of prematurity, a number of infants with developmental retardation, and fetal hypoxia have been ascertained. The directions for improvement of the work of perinatal services in Russia have been suggested.

In the article there is presented the most complete to date information on the incidence of Crimean hemorrhagic fever (CHF) in endemic countries in Europe, Africa and Asia, with allowances made for the first publications in the 40-ies of XX century to 2012. According to available sources, the total number of cases of CHF in this period was 7924, out of which 2180 in the Russian Federation, 1820 in Turkey, 1554 in Bulgaria, 553 in Uzbekistan, 286 in China, 264 in Kosovo, 260 in Kazakhstan, 265 in Africa (including 180 in South Africa).

In the paper there is presented the life and creative work way of a prominent epidemiologist of our country, a talented organizer of medical health care, well-known public figure, a wonderful teacher, chief epidemiologist of the Navy during World War II, corresponding member of the Academy of Medical Sciences of the USSR, Professor, General-Major of Medical Service Andrey Yakovlevich Alymov/