Vol 12, No 3 (2022)

In recent years there has been a decline in the number of new cases of human immunodeficiency virus (HIV) infection and in that of deaths associated with this infection in the world, but since modern therapy prolongs survival in people living with HIV (PLHIV), their total number is constantly increasing. At the same time, the prevalence of the disease is growing unevenly in different geographical regions and population groups. Objective. To assess trends in the development of the HIV epidemic in different territories of the Russian Federation in 2021. Materials and methods. The authors analyzed personalized data on all HIV infection cases identified in Russia in 1987-2021; data from federal state statistical observation forms Nos. 2, 4, 61, and 11; and data from the departmental monitoring form of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being. The HIV epidemic stages in the country’s regions were determined according to the WHO and the UNAIDS recommendations. Results. In 1987to December 31, 2021, Russia registered a total of1,562,570 Russians with a laboratory-confirmed diagnosis of HIV infection; 424,974 people of them died. In 2021, a total of 71,019 HIV-infected Russians were diagnosed for the first time and 34,093 deaths were reported; as a result, the overall HIV incidence rates increased to 782.0per 100,000. At the end of2021, there were 1,137,596 PLHIV, i.e. 0.8% of the total population of Russia or 1.5% of the population aged 15 to 49 years. 67.8% of the PLHIV first identified in 2021 reported to have heterosexual contacts only; 27.8% used intravenous narcotic drugs; 3.0% had homosexual contacts, which indicates that the heterosexual population that is not particularly vulnerable groups is increasingly involved in the epidemic process. At the same time, the HIV incidence rates reached high levels among the most vulnerable groups: injecting drug users (27%), men who had sex with men (13%). In 2021, the concentrated HIV epidemic stage was observed in the Russian Federation as a whole and in its most regions, since in 2019 the incidence of HIV infection did not exceed 1% and was significantly more than 5% in vulnerable population groups. At the same time, the generalized HIV epidemic stage was determined in 27 regions, the disease was diagnosed in more than 1% of pregnant women. These regions were inhabited by 35,9% of the population of the Russian Federation. In 2021, only 3.3% lived in 9 regions with the initial HIV epidemic stage. Conclusion. In 2021, the generalization of the epidemic process of HIV infection continued in the Russian Federation due to the spread of HIV among both heterosexuals and in vulnerable groups, which indicates the insufficient effectiveness of antiepidemic measures.

Objective. To identify the main patterns of the epidemic process of HIV infection among the population of the Ryazan Region (RR) and the impact of the COVID-19 pandemic on the course of the epidemic process of HIV infection. Materials and methods. A retrospective epidemiological analysis of the incidence of HIV infection in the RR population over 2011-2020 was carried out using materials from the official statistics of the Directorate of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being and the Center for Prevention and Control of AIDS and Communicable Diseases in the RR. Results. The HIV incidence, prevalence, and mortality rates in the RR tend to increase (1.5,3.5, and 3.6%, respectively). In 2011- 2020, HIV infection was associated with heterosexual (51.4%) and homosexual (3.1%) contacts and intravenous drug use (44.6%). In 2020, there was a decline in the number of detected new cases of HIV infection by 20.8% and in that of the examinees by 8.4%. Conclusion. The HIV infection epidemic situation remains tense in the RR. During the double pandemic, the prognosis in HIV incidence may be worse, which is related to an excessive burden on the healthcare system and can result in a decrease in the number of HIV tests, new detected HIV cases, and the quality of medical care for patients.

Objective. To analyze the prevalence of behavioral risks for HIV infection among men who have sex with men (MSM). Subjects and methods. An anonymous online survey was conducted on the Internet among MSM in 2019 and 2021. Results. The investigation involved 1192 people. In 2021, 15% of the respondents indicated that they had sex with men and women, and 18% reported to be HIV-positive. 18% of the respondents had more than 30 sexual partners per year. 21% of the participants had experienced chemsex; 43% of the MSM used condoms regularly. 17% had never been tested for HIV. The proportion of people who had undergone pre-post or post-test counseling during HIV testing in the healthcare facilities significantly decreased from 45% in 2019 to 32% in 2021. Conclusion. The irregular use of condoms, a large number of sexual partners, and chemsex practice suggest that there is risky behavior among MSM in the transmission of HIV infection. It is necessary to introduce and develop programs to inform MSM about measures to prevent HIV infection and to increase the availability of HIV testing.

Objective. To assess awareness of pre-exposure prophylaxis (PrEP) against HIV infection among healthcare specialists, medical students, and charitable foundation volunteers. Subjects and methods. The investigation involved respondents of 3 groups. Group 1 consisted of 73 healthcare workers; Group 2 included 75 five- and six-year medical students of faculties of pediatrics, general medicine, and medicine; Group 3 comprised of 26 volunteers of the «Shagi» (Steps) Regional Charitable Public AIDS Control Foundation. All the groups underwent a survey using the continuous sampling on the days of both face-to-face and Internet surveys. Results. The mean HIV PrEP awareness self-assessment score was 5.36 in Group 1, 4.88 in Group 2, and 5.69 in Group 3. Group 1 respondents mainly received information about the method from scientific literature, in the learning process, and from the Internet (25.9, 22.2, and 12.9, respectively). Group 2 respondents did this in the process of learning, from the Internet, from scientific literature (42.4, 32.2, and 15.3%, respectively). The charitable foundation employees did this in the process of learning, from the Internet, from scientific literature (46,2, 36,6, and 15,4%, respectively). Respondents in this group mentioned PrEP more often when answering an indicator question about the HIV transmission prevention methods known to them (p < 0.05). Conclusion. Poor self-awareness among the surveyed medical professionals, medical students, and non-profit organization employees is one of the main barriers to PrEP method use.

Objective. To assess memory function and asthenia in HIV-infected patients receiving antiretroviral therapy (ART). Subjects and methods. In September to December 2021, a survey and testing were done in 73patients: 47men and 26 women aged 18 to 62 years. Their median age was 39.0 years; 69.9% of the respondents had higher and incomplete higher education; 21.9% had secondary specialized education. All the patients received ART; the median CD4 lymphocyte count at the time of the survey was 636.5 cells/μL. All the respondents had an undetectable viral load. The patients were given a subjective asthenia rating scale (Multidimensional Fatigue Inventory (MFI-20)). Auditory verbal memory was assessed using the results of tests for memorizing 6 words in a given order and 2 series of 3 words. Visual memory was evaluated by the results of a test for memorization of 6 figures. Results. The span of auditory verbal memory in direct reproduction was within the normal range in most of the subjects. At the same time, this indicator in delayed reproduction showed a more pronounced deficit than that in the direct reproduction. Under the complicated conditions for verbal presentation (the use of homogeneous interference), there was a substantial decrease in the ability to directly reproduce verbal stimulus information. None of the subjects was able to repeat 2 series of 3 words at 20 minutes after presentation. There was no evidence for a statistically significant effect of age, gender, a history of trauma, psychoactive substances use, and previous COVID-19 infection on auditory verbal memory function in the analyzed group of patients receiving ART. The most unfavorable level of asthenia self-assessment was noted on the lower motivation scale. Visual memory in the examined patients was better preserved than auditory verbal memory. Conclusion. When consulting on adherence to follow-up and treatment of HIV infection, it is advisable to use visual methods for information transfer more widely, for example, along with verbal ones, to employ written recommendations.

The review contains historical information about the discovery of Bartonella, the causative agents of known and little-known human diseases, such as cat-scratch disease, trench fever, and bacillary angiomatosis. The paper presents their clinical characteristics, data on the main properties of Bartonella and the epidemiology of the disease. An expansion of the geographical range of pathogens, socioeconomic conditions, and a low level of well-being, as well as the presence of conditions that reduce the protective functions of the body, lead to an increase in the incidence of various forms of Bartonellosis infection.

Objective. To investigate and laboratorily confirm the effect of miramistin9 (benzyldimethyl-myristoylamine-propylammonium (BMPA)) on the infectious activity of SARS-CoV-2 in vitro. Materials and methods. The investigators used cultured Vero CCL-81 cells derived from the monkey kidney and the laboratory SARS-CoV-2 strain Dubrovka. They applied cultural, virological, molecular biological, and statistical studies. All experiments used the original pharmaceutical substance BMPA chloride (OOO «INFAMED», Russia). Results. The study of BMPA cytotoxicity in the cultured cells indicated that its CTD50 was 0,0091±0,002%, and the MTC was 0.005%. The original drug had a pronounced virucidal activity against SARS-CoV-2, by completely suppressing its infectivity at a concentration of0.005% or higher. An additional experiment identifying the result by virus titration and in the virus-specific real-time RT-PCR assay confirmed complete virus inactivation in the range of non-toxic concentrations of0.01-0.0025%. Conclusion. The original pharmaceutical substance BMPA chloride in vitro exhibits a pronounced virucidal activity at the concentrations corresponding to that of the active substance in miramistin (0.01%), and even at lower concentrations (0.005 and 0.0025%).