No 2 (2015)

Objective. To define the practical adequacy of a model and numerical patterns in the prevalence of hepatitis B (HB) in the areas of the federal districts of the Russian Federation. Materials and methods. To create an epidemiological model of hepatitis B, the investigators used the materials of scientific literature on its pathogenesis and epidemiology, the data of the Federal State Statistics Service on population size and those from the Federal Center of Hygiene and Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare, on HB morbidity in the period 1997-2012, as well as information of the Reference Center for Viral Hepatitis on HB virus transmission routes and vaccination in different age groups in the Federal Districts of the Russian Federation in 2009-2012. The epidemiological model of HB was based on the mathematical theory of epidemics. The model was realized as the computer program HBV-escapemut» by the computer simulation technology EpidMod for Windows developed at the N.F. Gamaleya Research Institute of Epidemiology and Microbiology, Ministry of Health of Russia. Results. The use of the model could establish numerical patterns of HB prevalence in the areas of the Federal Districts and in Russia as a whole. The identifiable parameters were found to have a slight spread in values for the areas of 7 federal districts: the proportion of the population most at risk of HB (risk groups) in different federal districts was 10-13% of the population aged over 14 years in a given area; and X1 (the average frequency of HB virus transmission) was estimated within the range of 0.29-0.314. The findings and the similarity in the trend in the incidence of acute HB in the areas of the federal districts are indicative of the unity and synchronism of influencing factors that are responsible for the prevalence of HB in different homogeneous population groups most at risk of its infection. Conclusion. Our investigations have indicated that the elaborated computer-based epidemiological model of HB is reliable and adequately reflects the manifestations of an epidemical process of HB in the areas of the Federal Districts and Russia as a whole, which may predict with a high degree of certainty. Consideration of the new data on the prevalence of vaccine-induced escape mutants of HB virus in the areas of the federal districts will be able to predict medium-term trends in their prevalence with a higher degree of certainty, which is essential for evidence-based counteraction planning.

This paper covers the problems of epidemiological safety associated with rapid blood glucose monitoring in patients of different healthcare facilities. It gives foreign authors’ data on the rate of glucose meter contamination with blood in different units of hospitals in the USA. The paper also presents facts on the role of blood-contaminated glucometers in the hospital transmission of hepatitis B virus. It shows it necessary to give meticulous attention to the mode and procedures of glucometer processing in healthcare facilities before each manipulation to measure capillary blood glucose levels in order to minimize the risk of blood-borne infections.

In February 2014, an Ebola virus fever outbreak occurred in the Republic of Guinea and then spread to a number of neighboring countries with a total population of about 25 million people. To prevent the spread of this menacing disease to the Russian Federation, a diagnostic real-time RT-PCR system was developed to detect RNA from Ebola Zaire virus in biological samples. The analytical sensitivity of the system was 1-2 x 10 3 GE/ml. Its high specificity was shown using a representative genetic viral and bacterial specimens and samples from clinically healthy individuals.

Antiviral therapy for chronic hepatitis C (CHC) is undergoing revolutionary changes: standard dual therapy is being gradually substituted by the triple therapy regimens containing the direct-acting antivirals (DAAs), pegylated interferons and ribavirin. The safety and tolerability of dual and triple therapies are comparable. Novel DAAs combinations make possible to achieve a sustained virologic response in 90-100% of patients with CHC in shorter periods have been designed in recent years. Moreover, interferon-free antiviral regimens have a good safety profile, which allows their use in patients with cirrhosis and in those who have contraindications to interferon-containing therapy. The review presents the characteristics of the main classes of DAAs and the results of completed clinical trials of interferon-free regimens.

The paper gives the results of a number of studies (DUET, TRIO, and others) that demonstrate the virological and immunological efficacies and safety of antiretroviral treatment (ART) regimens containing etravirine (ETR) for patients who have been previously treated with ART and had drug- or multidrug-resistant HIV. The SENSE study shows that Grade 1-4 neuropsychiatric adverse events (AEs) are significantly less frequently recorded in patients taking ETR than in those receiving efavirenz. There are two clinical examples of successfully switching patients to an ETR-containing ART regimen for previous treatment-emergent AEs. Based on both the results of foreign studies and own findings, the authors establish that ETR used in the ART regimens in patients with HIV/CHC co-infection, including in those treated for CHC with Peg, IFN, and ribavirin, is effective and safe. Elevated Al/AT levels in some patients suggest the activity of CHC or its inadequate treatment efficiency rather than the hepatotoxicity of an ABT regimen containing ETR. The performed investigations provide a rationale for the use of ETR as part in the ART regimens in case of both previous treatment failure and current treatment-emergent AEs, as well as in patients with HIV/CHC co-infection.