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We studied the risk factors, etiology, clinical features and the effectiveness of therapy of COVID-19-associated pulmonary aspergillosis (CAPA) in adult patients. In this retrospective study, we included 45 patients with proven (7%) and probable (93%) CAPA. The ECMM/ISHAM, 2020 criteria were used to diagnose CAPA. A case-control study was conducted to study the risk factors of CAPA; the control group included 90 adult COVID-19 patients without IA. In CAPA patients, the main underlying diseases were diabetes mellitus (33%), and hematological and oncological diseases (31%). The probability of CAPA developing significantly increased with lymphocytopenia >10 days (OR = 8.156 (3.056–21.771), p = 0.001), decompensated diabetes mellitus (29% vs. 7%, (OR = 5.688 (1.991–16.246), p = 0.001)), use of glucocorticosteroids (GCS) in prednisolone-equivalent dose > 60 mg/day (OR = 4.493 (1.896–10.647), p = 0.001) and monoclonal antibodies to IL-1ß and IL-6 (OR = 2.880 (1.272–6.518), p = 0.01). The main area of localization of CAPA was the lungs (100%). The clinical features of CAPA were fever (98% vs. 85%, p = 0.007), cough (89% vs. 72%, p = 0.002) and hemoptysis (36% vs. 3%, p = 0.0001). Overall, 71% of patients were in intensive care units (ICU) (median—15.5 (5–60) days), mechanical ventilation was used in 52% of cases, and acute respiratory distress syndrome (ARDS) occurred at a rate of 31%. The lung CT scan features of CAPA were bilateral (93%) lung tissue consolidation (89% vs. 59%, p = 0.004) and destruction (47% vs. 1%, p = 0.00001), and hydrothorax (26% vs. 11%, p = 0.03). The main pathogens were A. fumigatus (44%) and A. niger (31%). The overall survival rate after 12 weeks was 47.2%.

Введение В последние месяцы человечество столкнулось с коварной инфекцией, вызванной новым штаммом коронавируса человека (SARS-CoV-2), харак-теризующейся довольно высокой летальностью, которая, по данным разных исследований, колеблется в широких пределах (от 0,5 до 15%). Причины значительного числа летальных исходов во Резюме Новая коронавирусная инфекция (COVID-19) представляет собой глобальную проблему человечества. Среди её важнейших аспектов, требующих углублённого изучения,-патогенез и морфологические изменения при тяжелых формах заболевания.

Background and Aims:A high prevalence of hepatitis delta virus (HDV) infection, the most severe form of viral hepatitis, has been reported among persons living with HIV (PLWH) in Europe. We analysed data from a large HIV cohort collaboration to characterize HDV epidemiological trends across Europe, as well as its impact on clinical outcomes. Methods:All PLWH with a positive hepatitis B surface antigen (HBsAg) in the Swiss HIV Cohort Study and EuroSIDA between 1988 and 2019 were tested for anti-HDV antibodies and, if positive, for HDV RNA. Demographic and clinical characteristics at initiation of antiretroviral therapy were compared between HDV-positive and HDVnegative individuals using descriptive statistics. The associations between HDV infection and overall mortality, liver-related mortality as well as hepatocellular carcinoma (HCC) were assessed using cumulative incidence plots and cause-specific multivariable Cox regression.Results: Of 2793 HBsAg-positive participants, 1556 (56%) had stored serum available and were included. The prevalence of HDV coinfection was 15.2% (237/1556, 95%

Chronic hepatitis B (CHB) is a significant public health problem worldwide. The aim of the present review is to summarize the actual trends in the management of CHB in pregnant women. The prevalence of hepatitis B virus (HBV) infection in pregnant women is usually comparable to that in the general population in the corresponding geographic area. All women have to be screened for hepatitis B surface antigen (HBsAg) during pregnancy. Additional examinations of pregnant women with CHB may include maternal hepatitis B e antigen, HBV viral load, alanine aminotransferase level, and HBsAg level. The management of pregnancy depends on the phase of the HBV infection, which has to be determined before pregnancy. In women of childbearing age with CHB, antiviral therapy can pursue two main goals: Treatment of active CHB, and vertical transmission prevention. During pregnancy, tenofovir is the drug of choice in both cases. A combination of hepatitis B immunoglobulin and vaccine against hepatitis B should be administered within the first 12 h to all infants born to mothers with CHB. In such cases, there are no contraindications to breastfeeding.

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Objectives The aim of this study was to assess the impact of hepatitis B virus (HBV) infection on non‐liver malignancies in people living with HIV (PLWH). Methods All persons aged ≥ 18 years with known hepatitis B virus (HBV) surface antigen (HBsAg) status after the latest of 1 January 2001 and enrolment in the EuroSIDA cohort (baseline) were included in the study; persons were categorized as HBV positive or negative using the latest HBsAg test and followed to their first diagnosis of nonliver malignancy or their last visit. Results Of 17 485 PLWH included in the study, 1269 (7.2%) were HBV positive at baseline. During 151 766 person‐years of follow‐up (PYFU), there were 1298 nonliver malignancies, 1199 in those currently HBV negative [incidence rate (IR) 8.42/1000 PYFU; 95% confidence interval (CI) 7.94–8.90/1000 PYFU] and 99 in those HBV positive (IR 10.54/1000 PYFU; 95% CI 8.47–12.62/1000 PYFU). After adjustment for baseline confounders, there was a significantly increased incidence of nonliver malignancies in HBV‐positive versus HBV‐negative individuals [adjusted incidence rate ratio (aIRR) 1.23; 95% CI 1.00–1.51]. Compared to HBV‐negative individuals, HBsAg‐positive/HBV‐DNA‐positive individuals had significantly increased incidences of nonliver malignancies (aIRR 1.37; 95% CI 1.00–1.89) and NHL (aIRR 2.57; 95% CI 1.16–5.68). There was no significant association between HBV and lung or anal cancer. Conclusions We found increased rates of nonliver malignancies in HBsAg‐positive participants, the increases being most pronounced in those who were HBV DNA positive and for NHL. If confirmed, these results may have implications for increased cancer screening in HIV‐positive subjects with chronic HBV infection.

За годы наблюдения в Санкт-Петербурге ВИЧ-инфицированными женщинами рождено 9057 детей, 3241 из которых-за последние 5 лет. Количество родов у ВИЧ-инфицированных женщин в городе остается стабильным в течение нескольких последних лет. Несмотря на низкую частоту перинатальной передачи ВИЧ, анализ ситуации по оказанию помощи ВИЧинфицированным женщинам на этапе планирования беременности и в течение беременности позволит оптимизировать данную работу и в перспективе снизить вероятность перинатального инфицирования. Цель исследования-провести анализ оказания медицинской помощи серодискордантным парам и ВИЧ-инфицированным женщинам на этапе планирования беременности, в течение бе-ременности и родов для дальнейшего снижения частоты перинатальной передачи ВИЧ в Санкт-Петербурге. Материалы и методы Проведен проспективно-ретроспективный анализ медицинских карт 2442 беременных женщин, закончивших беременность родами в Санкт-Петербурге в 2014-2017 гг. В ходе проведения анализа оценены количество желанных беременностей в исследуемой группе, сроки постановки на диспансерный учет при беременности и начала профилактики перинатальной передачи ВИЧ, охват химиопрофилактикой при беременности, в родах и новорожденных. Статистическая обработка материала проводилась с использованием программ Exel, «Statistica 10».