No 3 (2012)

Notification of cases of infectious diseases depends on a variety of factors, among which the sophistication of the normative legal base that regulates the organizational aspects of epidemiological surveillance; the number of health care facilities that detect and register infectious diseases; and the quality of laboratory diagnosis are of the greatest importance. The organizational aspects of a sexually transmitted infections (STI) monitoring system have been analyzed to elaborate its improvement proposals. The existing STI morbidity rates reflecting the stabilization and decreased activity of an epidemic process are suggestive of only the lower efficiency of notification of new STI cases.

Objective. To study the detection rate for hemocontact virus infections (HVI) (HIV infection, hepatitis B and C) in individuals who had made autoaggressive actions and to form a social nosological portrait of a group of suicidents who were found to have laboratory markers of HVI. Subjects and methods. The study enrolled 688 patients admitted to the N.V. Sklifosovsky Research Institute of Emergency Care (RIEC) after making autoaggressive actions. The patients of the RIEC, admitted for different types of urgent pathology unassociated with suicidal attempts (21 231 samples), and those of Moscow therapeutic-and-prophylactic institutions (TPI) were examined as a comparison group (233,867 samples were tested for hepatitis B and C and 456,955 samples for HIV infection). Results. Mechanical injury is a leading somatic pathology in the patients admitted after autoaggressive acts; alcoholism and alcoholic and endogenous psychoses are a leading psychological pathology. In the suicidents, the detection rates for laboratory markers of hepatitis B and C and HIV infection were 2, 4.4, and 10 times, respectively, higher than those in the patients of all Moscow TPIs. The subjects with pathopsychological, behavioral, and social characteristics form a risk group in terms of both the rate of autoaggression and the probability of HVI. The high risk of autoaggressive behavior and significant infection rates in this category of persons with HVI infection are likely to be due to the social models of citizen’s behavior. Conclusion. Autoaggressive actions are part of the complex range of the body’s neuropsychic activity and due to a diversity of social and personality causes, including the somatic and psychosomatic health status.

Objective. To study the rate of human papillomavirus (HPV) and sexually transmitted infections (STI) and to analyze the factors influencing the spread of these infections among students from a Moscow medical higher educational establishment. Subjects and methods. Subjects and methods. The rate of 13 types of high-risk HPV and 2 types of low-risk HPV was studied using a real-time multiplex polymerase chain reaction (PCR) assay, by examining vaginal and cervical samples from 401 women. High-risk HPV was detected in 21.2% of women younger than 26 years of age and only in 14.6% of older women. HPV types 16, 51, 56, and 39 were most common. HPV types 6 and 11 were found only in 2.2% of the women younger than 26 years of age. STIs were detected in 5.8% of the women less than 26 years of age and only in 2.4% of the older ones. Results. The detection rate of HPV depends on the number of sexual partners and the age of onset of sexual activity. It was higher in women with a history of 2-3 sexual partners in the part year. According to their questioning results, 7.1 and 42.1% of the medical students had first sexual intercourses under 16 or 18 years of age, respectively. HPV was detected significantly more frequently in a group of women who had started a sexual life under 20 years of age (30.1%) than in those who had at the age of 20 years or later (15.2%). The detection rates for HPV and STI were not different in groups of women using or not using barrier methods of contraception. In women with STI, HPV detection rates were twice higher than those in women without STI.

Objective. To develop a real-time PCR-based test system for the detection of Kemerovo virus RNA in different types of material examined. Subjects and methods. The fragment of polymerase gene nucleotide sequence was chosen as a target. A TagMan probe was developed for detection. Results. The real-time PCR-based test system was first developed to determine Kemerovo virus RNA. Conclusion. The use of the developed test system is scheduled to determine the basic epidemiological characteristics of Kemerovo virus in the Russian Federation.

The review gives the results of Phases II and III international clinical trials of the efficacy and safety of antiretroviral therapy regimens incorporating the novel HIV nonnucleoside reverse transcriptase inhibitor (NNRTI) rilpivirine. The drug has the similar efficacy as the existing first-generation NNRTI agents, but a lower potential for toxicity. The important benefit of rilpivirine is that it has no negative effect on lipid metabolism, which is particularly important for patients having a higher cardiovarscular risk. The absence of cross-resistance presents a possibility of using this drug in patients with efavirenz and nevirapine resistance mutations. Rilpivinrine has been recently registered as first-line therapy in the USA, Europe, and Canada. At present, further investigations are called for the virological efficacy of the drug in patients with high baseline HIV RNA levels and in treatment-experienced patients.

The authors present the experience of the multidisciplinary clinic in studying the clinical picture, course, prognosis, and treatment of polyarteritis nodosa associated with hepatitis B virus infection, by using the clinical observation as an example and analyzing the data available in the literature and their findings.

The aim of the program «The chronic virus hepatitides in children and teenagers» is to organize specialized medical care to children and teenagers with chronic viral hepatitis and to provide all public health sectors with trained specialists and up-to-date diagnostic and treatment technologies.