No 2 (2018)

Objective. To establish the prevalence of chlamydial infection of the upper respiratory tract and the features of its manifestation in different populations. Subjects and methods. A total of 1329 patients were surveyed. Two chlamydia species, such as Chlamydia trachomatis and Chlamydophila pneumoniae, were identified by a set of laboratory diagnostic techniques (direct immunof luorescence assay, enzyme assay, and polymerase chain reaction). Results. The species-specific structure of the identified chlamydiae was investigated in relation to the age and sex of the surveyed patients; there was evidence for the high prevalence of chlamydial infection in patients with acute and chronic inf lammatory diseases of the nose, paranasal sinuses, and nasopharynx. Conclusion. Chlamydial infection of the upper respiratory tract leads to the more frequent occurrence of ENT diseases due to the prevalence of acute and chronic diseases in children and to that of chronic diseases in adults.

Objective. To carry out PCR genotyping (with a high discriminating power) of non-toxigenic Vibrio cholerae strains isolated from environmental objects. Materials and methods. The authors carried out PCR genotyping of a representative sample from 408 non-toxigenic V. cholerae strains isolated from water bodies in the Russian Federation in 1989 to 2016, which was based on the detection of the calculated optimal number (n = 14) of virulence factor genes. A cluster analysis by the unweighted pair group method with arithmetic mean (UPGMA) was used to distribute V. cholerae isolates in 81 genotypes on the basis of different combinations (presence/absence) of these genes. Results. Genotype G10 strains were ascertained to be isolated from the Agur River in the Krasnodar Territory in different years (1993, 1999, 2007), which was suggestive of their persistent potential. In 2015, the likely drift was 89 strains of the other cluster (genotype D4). In addition, 65 V. cholerae ctxA-tcpA+ strains belonging to 26 genotypes were included in both separate clusters and in common ones with ctxA-tcpA-cultures. Conclusion. The proposed approach assists in systematizing the non-toxigenic strains of V. cholerae in terms of establishing (with a high discriminating power) their possible origin, as well as their likely importance in the etiology of acute intestinal infections, which is an important component of epidemiological investigations.

Human herpes virus 6 (HHV-6) is one of the most common herpesviruses in a human population. Two HHV-6 types A and B, which differ in structure and clinical manifestations, have been taxonomically identified since 2012. In Russia, there are only a few studies of the clinical manifestations of HHV-6A and HHV-6B infections. Objective. To describe the clinical features of HHV-6A and HHV-6B infections in children. Subjects and methods. Examinations were made in 59 children aged 1 to 10 years with established HHV-6 infection. Among them, there were 14 clinically healthy children and 45 with manifestations of acute respiratory infection (ARI). A real-time PCR assay with TaqMan probes was used to type HHV-6. Results. HHV- 6A and HHV- 6В infections occurred in 25 and 19 children with ARfi respectively. HHV- 6B infection was dominant among the examined healthy children. HHV-6A infection more often affected children under 3 years old, causing fever with febrile seizures, rash, and upper respiratory tract lesion with catarrhal syndrome. HHV-6B infection more frequently induced acute infectious disease in children aged 3 years and older with the development of non-specific symptoms. In all age groups, HHV-6B infection was characterized by lymphoprohferative syndrome: peripheral lymphadenopathy, hepatomegaly, and lower respiratory tract lesion. Conclusion. In the Moscow Region, children with the clinical manifestations of ARI are found to have both HHV-6A and HHV-6B, while the course of the disease has clinical features. HHV-6B prevails among healthy children.

Objective. To evaluate the virologie efficiency of dual antiretroviral therapy (ART) [lopinavir/ritonavir (LPV/r) + lamivudine (3TC)] in treatment-experienced HIV-1-infected patients in the routine clinical settings of the Russian Federation. Subjects and methods. The multicenter non-interventional study was conducted in 13 federal and republican centers for prevention and control of AIDS and communicable diseases in 12 regions of the Russian Federation. The inclusion criteria were an age 18 years or older, plasma HIV-1 RNA < 50 copies/ml for at least 6 months on any triple ART of a total duration of at least 6 months; and clinically indicated switching to the LPV/r + 3TC regimen. The exclusion criteria were contraindications to the dual regimen or previous participation in this program. The patients received LPV/r + 3TC therapy according to their physician’s prescription and the local drug label at daily doses of 800/200 mg + 300 mg for 48 weeks. Data on HIV-1 viral load (VF) were collected at each visit. The primary endpoint was the proportion of patients on dual therapy with an undetectable HIV-1 RNA level at week 48. The secondary efficacy endpoints were the proportion of virologicaily suppressed patients at week 24, VL load and CD4+ T-cell counts at weeks 24 and 48. The safety assessment included HIV ART resistance testing, anthropometric measurements, blood chemistry evaluation, and the rates of serious and non-serious adverse events (AEs). The results were interpreted using descriptive statistics methods. Results. Between November 2015 and May 2017, the investigation enrolled 216 HIV-infected Caucasian male and female patients aged 20 to 69 years (mean age, 38.1 + 8.5 years; median age, 36.0 years); out of them, 202 (93.52%) patients completed the per-protocol study; 14 (6.48%) patients discontinued prematurely because of various reasons. The proportion of patients with an undetectable HIV-1 RNA level was 100% (95% Cl, 98.31-100.0) at Visit 1 (enrollment), 98.1 % (95% Cl, 95.17-99.48) at Visit 2 (week 12), 99.5%> (95% Cl, 9729-99.99) at Visit 3 (week 24), 100% (95% Cl, 98.21-100.0) at Visit 4 (week 36), and 100% (95% Cl, 98.18-100] at Visit 5 (week 48). At Visit 2 (week 12), VT + 50 copies/ml was recorded in 4 patients; in 2 of them, ineffective therapy (VT 3 400 copies/ml) was confirmed by repeated assays. One patient with a therapy failure was found to have a number of nucleoside and non-nucleoside reverse transcriptase inhibitor mutations. The СD4+ -lymphocyte cell counts increased significantly during ART versus at baseline; the mean week 48 increment in СD4+ -lymphocyte counts was 111.75 ± 184.48 cells/mm3(95% Cl, 86.15-137.34) or 1.43 ± 6.31% (95% Cl, 0.55-2.31). The patients well tolerated the TPV/r + 3TC regimen. There were no statistically significant changes in the mean anthropometric and laboratory values as compared to the baseline ones. Clinically significantly abnormal ATT, AST, blood glucose, and total cholesterol levels were recorded in 4 (1.9%) patients at weeks 24 and 48. The spontaneous reporting method showed that a total of 3 (1.4%) patients had 9 AEs. They all were non-serious and regarded by the attending physician as being unrelated to TPV/r + 3TC therapy. Six cases of AEs in 2 (1.9%) patients were related to gastrointestinal tract disorders (abdominal pain, diarrhea, dyspepsia, and vomiting); 3 (1.4%) patients terminated their participation in the study early due to pregnancy. Conclusion. Switching treatment-experienced HIV-1 infected patients to the TPV/r + 3TC regimen ensured maintenance of virologie suppression and improvement of an immune response during the 48-week follow-up. The proposed therapy regimen showed a good tolerance and a favorable safety prof ile.

Objective. To study the intensity of the epidemic process of giardiasis in a large industrial region (Donetsk) according to long-term morbidity trends. Materials and methods. Giardiasis incidence rates in Donetsk over 2001-2017 were analyzed according to statistical data. The average incidence rates per 100,000 population in different corresponding age groups (under 1 year, 1-4, 5-9, 10-14, 15-17 years and older) were compared to identify risk groups. Morbidity rates were also estimated in children attending and not attending preschool institutions. Results. During 17 years, there was a marked tendency to reduce the incidence of giardiasis by 3.16 times. The pediatric population was, on average, 11.51 times more often infected with Giardia. The age group at risk for this disease is children aged 5-9 years. Socially organized children are less frequently ill. Conclusion. Among the population of the large industrial region, there is an intense epidemic process of giardiasis in preschool children, especially in those who do not attend preschool institutions.

The paper presents the material of the 6th All-Russian Congress of Bacteriologists and Epidemiologists of the RSFSR, which was held in Moscow on May 3-5, 1922. The Congress discussed infectious diseases control measures, vaccination, the development of research on the diagnosis and prevention of infectious diseases, as well as proposals for the setting-up and structure of sanitary and epidemiological surveillance in the country.