The aim: To establish changes in hematological parameters of endogenous intoxication, nonspecific reactivity, activity of inflammation in HIV-infected persons, to improve verification of the clinical stage of the disease. Materials and methods: Anamnestic, clinical, laboratory data. The statistical processing was performed in the Microsoft Office Excel 2010 and IBM SPSS Statistic 23 computer software, variational statistics processing (Student’s t-criteria). Results: 51 HIV-infected were examined (main group) and 44 clinically anamnestic healthy blood donors (comparison group). The study included 46 patients (5 were withdrawn due to failure to meet criteria – severe septic condition). All patients were divided into three groups: A1 – all patients, 46 persons, men 76.0%, women – 24.0%; A2 – 11 people with I-III stages of HIV infection, men 72,7%, women – 27,3%; A3 – 35 HIV infected with stage IV disease, men 76.0%, women – 24.0%. All patients had an increase in intoxication indices and sex-dependent changes. Nonspecific reactivity indices in group A1 were above the norm, independent of gender except the index of neutrophils and lymphocyte (NLR). Below the norm is the immunoreactivity index (IR), the lymphocyte-monocyte ratio index (LMR), the lymphocyte index (Ilymph), the index of allergization (IA). Indices of nonspecific reactivity of A2 patients exceeded the norm and were independent of sex, with the exception of IR, Ilymph, IA, which were reduced. Non-specific reactivity indices are increased in HIV-infected group A3. Below the norm were IR, LMR, Ilymph, IA. Analyzing the activity indexes of inflammation, it became clear that the Krebs index (KI) was increased in all groups of patients; lymphocyte-granulocyte index (ILG) in groups A1 and A3 is less than normal, unlike patients in group A2, where it remained within the normal range. The leukocyte ratio and erythrocyte sedimentation rate (ILESR) in A1 and A3 have increased rates, unlike in A2, where the index is smaller. Conclusions: Men are predominantly HIV positive. The systemic immune response is more pronounced in women. There is a progressive impairment of immunological reactivity, indicating an immunodeficiency of the cell type with a decrease in nonspecific anti-infective protection. Patients with stage IV of HIV infection have moderate and severe inflammatory reactions, impaired reactivity, and are more pronounced in women.
The aim of the study – investigating the features of clinical symptoms in HIV-positive people in the early stages of the disease and their pathogenetic justification. The study used theoretical methods based on the analysis and synthesis of studying the information of the modern world from the PubMed and Scopus databases, clinical observations, as well as deductive-inductive methods. Conclusions. As a result of the war in Ukraine, the epidemiological control of infectious diseases on the territory of the country was violated. HIV-infection and the absence or atypicality of its clinical symptoms in infected patients deserve special attention, which is based on a detailed understanding of the pathological processes of neuroAIDS. Damage to astrocyte cells disrupts the connection of cells of the structural and functional complex of the brain with other cells and forms the fundamental basis for understanding clinical symptoms. Most often in the form of: neuropsychic, cognitive somatic and neurological disorders. The pathogenic effect of the virus contributes to spasm of cerebral microvessels, is the cause of local hypoxic lesions, microstrokes, and in late cases – lacunar cerebral infarcts. The active involvement of brain cells in the pathogenesis of HIV-infection has been confirmed by many studies. Along with standard diagnostic methods, it is advisable to use psychoneurological and cognitive tests and scales. A number of shortcomings have been identified that can reduce the reliability of diagnostic studies when establishing a diagnosis. Understanding the pathogenetic picture will allow choosing «indicators» for the general diagnostic scheme and increasing the probability of establishing the correct diagnosis, adjusting ART and predicting the further development of the disease.
HIV infection is a human disease with progressive dysfunction of the body's immune system and a long asymptomatic course. In 2021, there were 42 million HIV-positive people in the world. Today, 341,084 infected people are officially registered in Ukraine. One in one hundred citizens aged 15 to 50 is a carrier of retrovirus. In 2019, the World Health Organization (WHO) confirmed the beginning of a pandemic of a new infectious disease caused by the SARS-CoV-2 virus. The report of the Global Fund to Fight AIDS and the data of International Charitable Foundation "Public Health Alliance" («Альянс громадського здоров’я») state that COVID-19 can seriously disrupt the health care system as well as medical services providing to HIV-infected people in many countries. Objective. To study the impact of the COVID-19 pandemic on the current HIV epidemic and case registration in Ukraine. Materials and methods. To complete the tasks, the statistical and epidemiological data of the WHO and the Ministry of Health of Ukraine on the current epidemiological state of HIV infection during 2017–2021 and COVID-19 during 2020–2021 were used. The results of epidemiological studies were processed with the help of the method of variation statistics using computer programs Microsoft Office Excel 2010, SPSS Statistics and online calculator (http://medstatistic/calculators/calchit.html). Results and discussion. The epidemiological data provided by the WHO, the Ministry of Health of Ukraine and the International Charitable Foundation "Public Health Alliance" on the epidemiological status of HIV infection in 2017–2021 and COVID-19 during 2020–2021 were analyzed. The COVID-19 pandemic has negatively affected the provision of diagnostic, preventive and curative services to HIV-infected people. This is confirmed by a decrease in the number of rapid tests for retrovirus in 2020 by 4.1 times compared to 2019. The reduction in the number of new cases of HIV, AIDS and mortality from terminal disease in 2020–2021 occurred by an average of 1.5–2.4 times compared to the period before the pandemic caused by coronavirus. These data simultaneously correlated with an increase in COVID-19 cases, the number of rapid tests for coronavirus, and were inversely proportional. The COVID-19 pandemic will significantly increase the incidence of HIV in Ukraine and raise the number of new AIDS cases and deaths. Conclusions. The pandemic caused by COVID-19 affected the provision of diagnostic, prophylactic and treatment services to HIV-infected people. There is an inversely proportional trend between the number of confirmed cases of HIV infection and cases of COVID-19. The increase in the incidence of COVID-19 occured in the autumn–winter period, which corresponded to the period of declining levels of HIV diagnosis.
Мета – вивчення впливу нейроспецифічних білків на розвиток нейро-СНІДу, встановлення перспектив їх визначення з метою ранньої діагностики ВІЛ-інфекції. У дослідженні використовували теоретичні методи, які включали аналіз та синтез вивчення сучасних світових наукових публікацій та клінічних спостережень, дедуктивно-індуктивні методи. Висновки. В Україні, як і у всьому світі, відбувається активне поширення та пізнє виявлення ВІЛ-інфекції. Стандартні методи лабораторної діагностики не можуть забезпечити якісну ранню діагностику хвароби. Швидке проникнення вірусу у центральну нервову систему (ЦНС) створює труднощі для диференційної діагностики з подальшим формуванням стійкості до антиретровірусних препаратів. Поки ВІЛ у крові залишається протягом тривалого прихованого періоду, збудник активно реплікується у клітинах мозку і призводить до розвитку нейро-СНІДу. Зв’язки та особливості накопичення матриксу ВІЛ-білка р-17 у ЦНС, активність транскрипційного трансактиватора, регуляторного білка Vpr залишаються недостатньо вивченими. Нейроспецифічні білки як маркери вірусного патологічного процесу у нервовій системі людини потребують особливої уваги та вивчення. Перегляд основ ранньої діагностики ВІЛ-інфекції дасть можливості посилити епідеміологічний контроль та запобігати новим випадкам хвороби, що у підсумку приведе до зменшення фінансового навантаження щодо цієї проблеми не лише в Україні, а й у багатьох країнах світу.
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