No 1 (2011)

The paper gives the current classification and nomenclature of human diseases caused by biological etiological agents. The problem ofprionic diseases assigned to a group of non-communicable human diseases is considered in the epidemiological context. The ecological-and-etiological and ecological-and-epidemiological classification and nomenclature of human diseases caused by infectious, invasive, andprionic agents have been improved.

The paper gives data on the wide prevalence of Batken/Dhori virus in a Crimean-Congo hemorrhagic fever (CCHF) focus in the Astrakhan Region of the Russian Federation and on the possible influence of the virus on the spontaneous infection of Hyalomma marginatum marginatum ticks with CCHF virus (according to the 1980-1990 and 2005-2009 materials). Batken/Dhori virus strains belonging to a non-hemagglutinating variant of this virus have been isolated and are described. Natural mixed strains of Batken/Dhori and CCHF viruses have been also isolated from Hyalomma marginatum marginatum ticks. The interaction of Batken/Dhori and CCHF viruses in experimental and natural conditions is discussed.

The prevalence and features of the manifestation of Helicobacter pylori (Hp) infection were studied in the indigenous population of South Kazakhstan. Tour hundred and forty-six families from the town of Tenger, South Kazakhstan Region, were followed up. There was evidence that Hp infection was considerably prevalent in the population. The native population was found to have some peculiarities of an Hp-associated inflammatory process in the gastric mucosa (GM), which appeared as its obscure clinical picture, dyspeptic syndrome dominating over pain syndrome: belching (30.7%), discomfort after meals (29.3%), nausea (19.5%), stool impairment (15.7%) and diarrhea (4.8%). The pain syndrome, namely short-term episodes of pain were found in 28.8%, gradually increasing pain in 30.9%, including that radiating to the back in 4.1%. Morphological evidence indicate the frequent development of atrophy even with in the presence of a slight contamination and a mild inflammatory process with the more prolonged sustained course of the pathological process, as well as a marked reduction in the blood and GM levels of ferritin, suggesting impairment of local immune responses. The studies has allowed the author to formulate the distinguishing features ofHp infection in Kazakhs living in a South Kazakhstan region, which will permit an adequate assessment to choose appropriate therapy.

The efficacy of imunofan was studied when used in combination therapy for hemorrhagic fever with renal syndrome (HFRS). The drug was used in sixty 18-to-55-year-old 60 inpatients with moderate and severe HFRS. A control group comprised 75 HFRS patients receiving conventional therapy. The addition of imunofan to the combination therapy of HFRS was found to cause a statistically significant reduction in the levels of tumor necrosis factor-a, interleukin-(IL) 4, and 1 L-10 and an increase in those of interferon-y and 1 L-2, to exert a normalizing effect on cellular immunological parameters, and to increase phagocytic induction index and functional reserve capacity, which was accompanied by a positive clinical effect. Imunofan was ascertained to be well tolerated.

The endogenous intoxication syndrome should be studied in patients with acute dysentery, food toxic infections, and salmonellosis, and food toxic infections to unravel the pathogenetic mechanisms underlying these diseases. For this, the authors estimated the level of low and medium molecular weight substances and their protein component (oligopeptides) in plasma, red blood cells, and urine over the course of these diseases. There was a relationship of the study values to the period and severity of the disease and to the completeness of recovery. The estimation of the level of low and medium molecular weight substances and oligopeptides in the plasma, red blood cells, and urine of patients with acute enteric infections may serve as a marker of the intoxication syndrome. The level of the study indicators may be used as additional criteria for the severity of the process, prediction of the development of the disease, and concurrence of complications, as well as a criterion for the completeness of recovery.

The review analyzes the international experience with clinical observations of the development of various secondary infectious diseases at the start of successful antiretroviral therapy in patients with HIV infection and immune reconstitution inflammatory syndrome (IRIS). It presents the clinical results of studying the pathogenetic components leading to the development of IRIS and its incidence depending on the baseline count of CD4+ lymphocytes; considers clinical and laboratory criteria for tuberculosis-associated IRIS; characterizes the clinical manifestations of the most common secondary diseases developing as a manifestation of IRIS; and discusses the present views of management tactics for this category of patients.