The work is devoted to clarify the etiological aspects of the hemorrhagic fever with renal syndrome (HFRS), clinical and epidemiological features that are closely linked to the etiology, as well as to development of methods and products for specific diagnosis and vaccine prevention of hantavirus infection. That regard to hantaviruses a set of virological, immunological and molecular-genetics methods were developed significantly enhance the effectiveness of the specific diagnostics of HFRS. The features of humoral immunity in HFRS were identified and atypical clinical forms of HFRS was istablished; indicators of natural immunity to hantavirus in the population living in different regions of Russia and the former Soviet republics have been identified that allowed us to refine nosological area of HFRS; new, previously unknown natural foci of HFRS, including hantavirus RNA, in the central regions of Russia and in the subtropical zone of Krasnodar region have been identified and studied; 76 strains and 70 isolates of 9 rodent species and one species of birds, as well as from the blood of patients with HFRS and sectional materials from HFRS dead patients have been isolated and identified; new hantavirus species - Khabarovsk, Taimyr-Topografov, Adler, as well as two new genotypes Dobrava/Belgrad virus - Kurkino and Sochi have been identified; species composition of small mammals - the natural reservoir of hantaviruses was the refined; etiological role and epidemiological importance of different hantaviruse types in HFRS incidence structure was established; the existence of new etiologically distinct hantavirus infections with significant epidemiological differences has been proven; manufacturing techniques and methods of control of the culture inactivated vaccine against HFRS has been developed.
Aim: to determine the perspectives for the use of drugs with combined antiviral, anti - inflammatory and immunomodulatory activity on the basis of medical studies of existing antiviral drugs for the treatment of influenza and acute respiratory viral infections in Russia. Materials and methods. A brief review of the antiviral drugs used in Russia for the treatment of influenza and acute respiratory viral infections was conducted on the basis of 37 articles published in Scopus, Web of Science (WoS), and RSCI databases in the period from 1997 to 2018. Results. Resistance to neuraminidase inhibitors (oseltamivir, zanamivir), is slowly developing due to the mutations of the neuraminidase gene H275Y and Q136K. Most influenza A viruses remain resistant to adamantane antivirals. Repeated use of immunomodulators with indirect antiviral action leads to a hyporeactivity of the immune system and, subsequently, to a decrease in their effectiveness. Positive clinical and laboratory data in clinical trials were obtained using Enisamium iodide, a drug with combined action - direct antiviral, and immunomodulatory. Conclusion. According to the WHO strategy, the results of the review demonstrate the need for continued research of medications with combined antiviral and pathogenetic effects on the infectious process caused by influenza and acute respiratory viral infections.
Objective: Improvement of the diagnosis and prognosis of liver disease of viral etiology based on the analysis of clinical and epidemiological characteristics of the course and outcome of viral mixt-hepatitis. Materials and methods There are presented results of the retrospective study of 106 patients with chronic viral mixt-hepatitis (study group), which were under the medical observation for a period from two to five years between 2010 and 2014. The comparison group was consisted of 1,913 patients with chronic hepatitis C. Results and discussion The morbidity of chronic viral mixt-hepatitis in the majority of cases is registered among socially active groups of young and middle age persons, more common among males. Frequent risk factors are the artificial factor (55%), the intravenous drug usage (25%), tattooing (19%). Typical concomitant illnesses are diseases of the gastrointestinal tract and the endocrine system. Chronic viral mixt-hepatitis is mainly caused by a combination of HCV and HBV, and HCV + HBV + HDV also. HCV replication is noted in 64% of cases, the replication of HBV - in 58%, HDV replication - in 20%. Transformation into cirrhosis in patients with mixt-hepatitis C+B+D was recorded in 25% of cases, in mixt-hepatitis C+B cases - in 7.1%. In the group of C+B+D hepatitis patients, viral replication of HBV and HDV without HCV replication transformation into cirrhosis was seen in 36%. In the case of HDV replication alone, the rate of cirrhosis was 25%, while in cases with isolated HBV replication - 14%. In patients with mixt-infection C+B, the development of cirrhosis was registered within subgroup with simultaneous replication of HBV and HCV viruses in 9% cases. An isolated HCV replication, in general was less often, and led to the transformation into cirrhosis in 6% cases. Conclusions. Simultaneous replication of more than one type of hepatitis virus promotes transformation into cirrhosis, in greater extent, simultaneous replication of HBV + HDV, and monoreplication of HDV virus also. In order to prevent further progression of the pathological process it is recommended the well-timed causal treatment order with account for the predominant virus replication.
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