Chronic hepatitis C remains one of the most important socially significant infections for world health. The use of modern highly effective drugs with direct antiviral action allowsto achieve a sustained virological response in patients. At the same time, in a significant number of cases after elimination of HCV infection, the progression of fibrosis continues with the development of its terminal stages and an unfavorable outcome for patients. The article focuses on comorbid pathology, which is a leading factor in this process in patients with chronic hepatitis C who have achieved a sustained virological response and presenting a serious challenge to modern hepatology.
Аbstract. We consider the possibility of optimizing the diagnosis of infection caused by SARS-CoV-2 using polymerase chain reaction in a multi-specialty hospital, repurposed for the treatment of COVID-19 patients, using the example Of the military medical Academy named after S.M. Kirov. The analysis of scientific publications selected in accordance with the purpose of the study, analyzed data from 218 samples of polymerase chain reaction in patients with COVID-19, who were in the clinics Of the military medical Academy named after Sm. Time intervals were established depending on the clinical forms and severity of the infectious process, in which the probability of a positive and negative result of a polymerase chain reaction to SARS-CoV-2 RNA was maximum and minimum. It was shown that during the examination and treatment, molecular biological diagnostics were performed excessively (4 times in more than 50% of patients) and in 97,3% of patients unreasonably early (8,50,4 days). At the same time, the highest frequency of negative results of polymerase chain reaction to SARS-CoV-2 RNA was observed in the period from 9 to 10 and from 12 to 14 days, while it depended on the clinical form and severity of the infectious process. In this regard, the volume diagnosis using polymerase chain reaction should be reduced and to conduct research when entering the hospital, on the 9th-10th day (in patients inapparently forms and acute respiratory diseases, lung flow) and 12-14 days before discharge in patients with moderate and severe course of the infectious process.
Objective: is to develop a model for early diagnosis of mixed infection of the non-erythema migrans form of Lyme borreliosis and tick-borne encephalitis using the assessment of the complete blood count and the blood leukocyte indices of patients in the first week of the disease.Materials and methods. The retrospective clinical study involved Group 1 of 27 patients with the mixed infection of the non-erythema migrans form of Lyme borreliosis and the febrile form of tick-borne encephalitis and Group 2 of 29 patients with the monoinfection of the non-erythema migrans form of Lyme borreliosis, who were hospitalized no later than in the 7th day of the disease. The average age of patients in Groups 1 and 2 was 50.6±3.4 and 49.9±2.3. We analyzed 14 parameters of the complete blood count as well as calculated the leukocyte intoxication index and the body resistance index. Statistical significance assessment was carried out using the chi-square test and ROC analysis. Logistic regression model was developed using STATISTICA 12.0 modules.Results. The levels of the band and polymorphonuclear neutrophils (<0,001 и p=0,002) and the leukocyte intoxication index (p<0,001) were significantly higher and the levels of the body resistance index (p<0.001), lymphocytes (p<0.001) and platelets (p=0.004) were lower in Group 1 than in Group 2. Informative predictors of mixed infection included the body resistance index (AUC=0.77), leukocyte intoxication index (AUC=0.75), the band and polymorphonuclear neutrophils (AUC=0.74), lymphocytes (AUC=0.77), and platelets (AUC=0.70). Logistic regression model has a “very good” predictive value (AUC=0.85) and include two parameters: body resistance index and platelets (×109/L).Conclusion. The developed model has a “very good” predictive value for early diagnosis of the mixed infection of the non-erythema migrans form of Lyme borreliosis and tickborne encephalitis before laboratory diagnosis confirmation.
The morbidity of the new coronavirus infection (COVID-19) in the Russian Armed Forces is decreasing thanks to the sanitary and preventive anti-epidemic measures, the most effective of which is mass vaccination. The purpose of this research was to study the peculiarities of the formation of herd immunity among adolescent students of the Russian Ministry of Defense (MoD) colleges against the background of the COVID-19 epidemic. Materials and methods of the research: according to the epidemic indications, a two-stage seroepidemiological multicenter prospective study of herd immunity to SARS-CoV-2 was carried out in Dec. 2021 - May 2022, against the background of vaccination, among adolescent students of the Russian Defense Ministry colleges. 515 adolescents aged 11 to 17 years old (median age 13 [12; 15] years old) from the two Russian MoD schools located in the city of Saint Petersburg, of which 292 (57%) girls and 223 (43%) boys, were involved in the study. The adolescents were divided into groups based on gender and previous COVID-19 illness e.g., those who already had COVID-19 and those who had not prior to the study. In the second stage of the study the number of samples from boys and girls decreased by 74.3% and 34.4%, respectively, due to the lack of parents’ consent to the vaccination. The assessment of the immunity intensity was carried out using the Anti‐SARS‐CoV‐2 IgG levels in blood serum by enzyme-linked immunosorbent assay (ELISA). Results: the initially high levels of seroprevalence to SARS-CoV-2 were established among both girls and boys (90.4% and 91.5%, respectively, p=0.09) that indicated a latent course of the epidemic process in the studied groups of teenagers. In adolescent girls and boys vaccinated against the background of a previous COVID-19 illness, the combined immunity is formed in 62.3% and 68.1%, respectively (p=0.11). Conclusion: the epidemic process of COVID-19 tends to be latent in organized adolescent groups, being realized in inapparent forms of the infection. Those adolescents who’ve been vaccinated after COVID-19 illness develop the immunity with positive seroconversion dynamics.
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