The high prevalence of the hepatitis B virus (HBV) in population occurs mainly due to numerous mechanisms formed in the process of the virus evolution, contributing to its survival under immunological pressure. The review presents the most complete systematization and classification of various HBV protective mechanisms basing on their influence on different parts of congenital and adaptive immune response. The analysis of literature data allows for the conclusion that two basic principles underlie the mechanisms: the strategy of the «stealth virus» (virus’s escape from recognition by the immune system) and strategy of immunosuppression. The stealth virus strategy is performed as follows: special strategy of the HBV replication which prevents the recognition by the receptors of congenital immune system; occurrence of the vaccine escape mutants; isolation of the virus in host cells and tissues providing its inaccessibility to T-cells along with hyperproduction of subviral particles as traps for specific antibodies. The core principle of the immunosuppression implemented in hepatitis B therapy is based on the phenomenon of the viral apoptotic mimicry. The result of this interaction strategy is dysfunction of NK and NKT-cells, inactivation of dendritic cell functions, and suppression of the adaptive immune response. The review demonstrates that interaction between HBV and the immune system of the macro organism is in some kind of «dynamic equilibrium» depending on numerous factors. Specific molecular targets of the viral impact are described. We propose to expand the research on the influence of the host’s genetic factors on the development of congenital and adaptive immune response against HBV, especially during the real infectious process which results in the improvement of approaches to the therapy by developing personalized treatment methods.
Background: The significant reduction of measles and rubella morbidity and child mortality, which allowed WHO to set a target for their elimination by 2010, is one of the finest examples of the vaccine prevention effectiveness in the fight against infectious diseases. However, in the period from 2010 to 2019 there was a controversial situation with respect to measles, characterized by the presence of high vaccination coverage of the population on the one hand, and an increase in the incidence on the other. Obviously, the key point in resolving these contradictions is to analyze the susceptibility of the population. Aim: Of the study was to assess the susceptibility of Moscow population to measles in the context of factors affecting its formationю. Methods: Epidemiological, serological, statistical methods and GIS technologies were used in the work. The serological study (using the solid-phase ELISA method) included 2410 blood serum samples collected between 2013 and 2017 from healthy residents of Moscow aged from birth to 60 years. On the basis of documents on sanitary and epidemic investigation of measles cases in Moscow (20132015) a relational database under the management of MySQL Database Management System was formed, based on the analysis of which the coverage of the population with preventive vaccinations was estimated. Results: Оn average, the proportion of seronegative persons to measles in 20162017, compared with 20132014 (20.5%) increased and amounted to 29.0% mainly due to the group over 36 years. The most vulnerable were children aged 12 years and 36 years, where the share of the immune persons amounted to 51,5% and 37.9%, respectively, at low coverage in a planned manner (55,9% [95% CI, 52.2 per cent; of 59.5%] and 75,3% [95% CI, 73.3 per cent; for 77.2%]). The proportion of vaccinated persons who lost post-vaccination immunity under the influence of factors preventing its formation (from 3.6% to 21.6% in the group of 714 years; from 11.8% to 26.4% in the group of 1517 years) was calculated. The possibility of visualizing the spread of measles on electronic maps for the territorial and temporal analysis of the epidemic situation is shown. Conclusions: It is reasonable to assume that over the time, the proportion of people who have suffered measles will decrease, and the proportion of people not covered by vaccination or lost post-vaccination immunity - increase, that can lead to a decrease in herd immunity and requires correction of vaccination work. The proposed information and analytical system for monitoring the epidemiological situation allows to work quickly with heterogeneous resources and choose on electronic maps the area of interest from the global level (country) to the local (house), which is necessary for the adoption of scientifically based preventive and epidemiological measures.
The study is devoted to the clinical examination of frequently ill children in the North-Eastern regions of Russia and the laboratory detection of markers of herpesvirus infections, as well as pneumocystosis and the establishment of the relationship with their immune status.62 children aged 8—15 years were examined. Samples of serum and blood cells, sputum on markers of herpesvirus infections and pneumocystosis by ELISA, indirect immunofluorescence reaction and rapid culture method were studied. Assessment of humoral immunity and determination of circulating immune complexes was performed by solid-phase enzyme immunoassay and immune turbodimetric analysis.The study shows the etiological role of herpesviruses. Active infection (acute, reactivation) was caused in 9.7% of cases of HSV-1,2, 12.9% — EBV, 6.5% — CMV, 19.4% — HHV-6. This is indicated by a large number of convalescents: with EBVI — 40.3%, HSVI — 27.4%, HHVI-6 — 8.1%, CMVI — 4.8%. Also, a significant number of children were found and latent form. The formation of the circulating immune complexes (CIC) is a physiological mechanism of protection of the body, and their excessive accumulation indicates the development of inflammatory processes and autoimmune diseases. In the increase in CIC observed mainly in individuals with latent infection: HSVI — 29.4%; HHVI-6 — 20.8%; CMVI — 16.7%, EBVI — 11.9%. It is important to note that in almost half of the cases the increase in CIC level occurred simultaneously with the increase in the concentration of total IgE. A survey of children on Pneumocystis showed that among them, dominated native — 11.3%, in which the sputum was identified pnevmotsisty. It should be noted that one child was found mixed infection with reactivated CMVI. Acute infection was diagnosed only in 6.4% of the patients.
The purpose of the study To estimate the prevalence of markers of herpesvirus infections and pneumocystosis in patients of the hematological department. To identify whether the contamination of hematological patients with hepatitis B and C (HBV, HCV) affects on the activation of opportunistic infections (OIs). Materials and methods There were examined 94 patients of the hematological department, including 48 patients with markers of HBV infection and 46 cases without them. Obtained results Markers of acute OIs (simple herpes virus type 1- 6,4%, EBV - 14,9%, CMV - 6,4%, and Human Herpesvirus 6- 13,8% and 33,0% of pneumocystosis) in hematological patients were determined more frequently than in donors. Comparative analysis of the data revealed the excess of the proportion of cases with markers of acute HHV-6 infection in hematological HBV patients in comparison with a group of hematologic patients without markers of HBV infection (22,9% against 4,4%, p
The ratio of gene IL28В genotypes (rs12979860 C>T, rs8099917 T>G) were studied in patients with chronic hepatitis C (CHC) and in the comparison group (patients with chronic hepatitis B) in the Moscow region. Genotypes СС (rs12979860) and ТТ (rs8099917), which are the predictors ofsustained virological response to the antiviral therapy, were found in 26% and 55% of CHC patients and in 45% and 71% patients in the comparison group, respectively. The differences in these groups are statistically significant..There was reveled an absence of differences in the frequency of detection of gene IL28В genotypes in CHC patients, in dependence on the HCV genotype. There was advanced an opinion that that the inclusion of Simple Nucleotide Polymorphism in the gene IL28B, as another parameter to be monitored, will increase effectiveness of the monitoring. The monitoring of Single Nucleotide Polymorphism (SNP) in IL28B gene in the system of the epidemiological surveillance for hepatitis C, as another parameter to be monitored will allow to increase its efficacy. There was determined the place of the monitoring for Single Nucleotide Polymorphism (SNP) in IL28B gene in the system of the epidemiological surveillance for hepatitis C an the parameters which extend the information base required for the formation of an epidemiological forecast.
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