Aim of the study. To analyse the incidence and pattern of emotional suffering and internalised stigma, as well as their impact on adherence to antiretroviral therapy (ART) in young patients living with perinatal HIV infection. Materials and methods. We studied 105 patients with perinatal HIV infection (53 men (50.4%) and 52 women (49.6%)), describing their medical, social and laboratory characteristics such as CD4-lymphocyte count (cells/μL) and HIV RNA detection (copies/mL) in blood at the moment of their transition to adult follow-up and 3 years afterwards. We performed an in-depth crosssectional psychological and psychometric study of 41 patients aged 18–25 (23 men (56%) and 18 women (44%)) with perinatal HIV infection monitored since childhood at the dispensary department of the AIDS Centre. The following methods were used: the HADS scale (Hospital Anxiety and Depression Scale, 1983), the “Major Stigma Factor Test” (2015) with questions adapted for HIV disease and the Morisky-Green Medication Adherence Scale. A survey of 105 patients with HIV PPI was conducted: 53 men (50.4%), 52 women (49.6%), their social status and the course of HIV infection were characterized (the number of CD4 lymphocytes (cells/μL) and HIV RNA in blood plasma (copies/mL) retrospectively at the age of 18 on the moment of transition to an adult dispensary and in dynamics (~ 3 years later). Then 41 patients aged 18–25 years (23 (56%) men, 18 (44%) women) were selected from the main group using a continuous method and an in-depth cross-sectional psychological and psychometric examination was conducted using the HADS scale (Hospital Anxiety and Depression Scale, 1983); “A test to identify the leading factor of stigmatization” (2015) [with modification of questions for HIV infection; adherence assessment scales (Morisky-Green)]. Results and discussion. The incidence of stigma/internalised stigma was more frequent in men than in women and was associated with long-term ART intake. All other stigma/internalised stigma factors (individual, family/friends, social) were not statistically significant. Depressive states were more often found in women than in men. Our ART adherence analysis did not yield statistical differences. The average age of patients at the time of the study was 20.9±1.5 years. The duration of the disease is comparable to the age of the study group which is due to infection. The average age of HIV infection detection was 2.5±4.2 years. In 79% of patients ART was started at the age of 7.2±4.5 years. According to the results of the patient survey, 5.8% of respondents created their own family (including with the birth of 1 child), and only one in five (20%) reported having a job, 8.6% had a disability. The existing dependence on nicotine, as well as the experience of alcohol and drug consumption (recreational use) were noted in 12.3%, 4.7 and 2.8% of patients, respectively. Conclusion. This study showed correlations between decreased adherence to ART, emotional suffering and internalised stigma in patients with perinatal HIV infection. Psychocorrection and psychopharmacological treatment may prove effective for stabilising patients’ mental state, reducing internalised stigma factor and consequently increasing adherence to treatment. In light of the high frequency of depressive disorders associated with stigma/internalised stigma in young people with perinatal HIV infection, it is advisable to put available effective diagnostic methods and tools (scales, questionnaires) in the daily clinical practice of infectious disease physicians and paediatricians for early detection of mental disorders.
The aim of the study : to assess the vascular endothelial status (based on brachial artery ultrasound data and the Celermajer test) and glucose metabolism markers (insulin, glucose levels, HOMA-IR index) in young patients with perinatal HIV infection. Materials and methods . The study included 83 young HIV-infected patients aged 18 years or older registered at the St. Petersburg AIDS Center. The main group (n=57) consisted of patients with perinatal HIV infection (PHIV), while the control group (n=26) included individuals infected via sexual transmission. Results and discussion . In the main group, 46 patients (80.7%) had normal blood glucose levels (3.3–5.5 mmol/L), compared to 11.6% in the control group. Normal insulin levels were observed in 84.2% of the main group and 77% of the control group. A pathological HOMA-IR index was significantly more frequent in the main group (p0.05). Both groups exhibited early signs of endothelial impairment at ages 20–25, with intima-media thickness (IMT) within normal ranges. However, males with PHIV showed significantly more frequent deviations toward increased IMT (p=0.049). Conclusion . Markers of glucose metabolism disorders, insulin resistance, and vascular endothelial dysfunction were identified in young patients with perinatal and sexually acquired HIV. However, PHIV patients demonstrated earlier and more pronounced changes.
INTRODUCTION:Vpr is a multifunctional auxiliary HIV-1 protein. Oligomerisation is a prerequisite for the entry of Vpr into the virion and its subsequent participation in the early stages of HIV-infection. To date, natural amino acid substitutions in Vpr associated with disease progression were identified; the possibility of creating therapeutics based on Vpr is being considered. The aim of the study is to investigate Vpr features in the most common genetic variants of HIV-1 circulating in the Moscow region in 2019-2020. MATERIALS AND METHODS:HIV-1 samples obtained from 231 patients of the AIDS Prevention and Control Center in the period 2019-2020 were studied according to the scheme: proviral DNA extraction, amplification of the vpr gene, sequencing, and data analysis. Consensus Vpr sequences of the most common genetic variants in Russia and their spatial structures, variability of Vpr variants of HIV-1 sub-subtype A6 in patients with different stages of the disease were studied. RESULTS:Features of Vpr protein in different genetic variants of HIV-1 could influence the formation of their oligomeric forms. No sites with statistically significant differences in the frequency of amino acid substitutions were identified in patients with different stages of disease. CONCLUSION:Vpr protein of HIV-1 genetic variants circulating in Russia may have differences in functional properties. Vpr-A6 variants had low variability in patients with different stages of the disease, and therefore Vpr-A6 can be considered as a target for the development of therapeutic agents.
Aim of the study. Comparative analysis of clinical manifestations and laboratory indicators of acute HIV infection in patients detected in different epidemic periods with a 10-year difference (2008–2013 and 2018–2022). Materials and methods. An analysis of 142 inpatient records of patients detected in the acute stage of HIV infection in the period from 2008–2013 in the ‘Botkin Clinical Infectious Diseases Hospital’ (‘Botkin Hospital’) and 110 outpatient records of patients detected in the “Centre for the Prevention and Control of AIDS and Infectious Diseases” (“Centre for the Prevention and Control of AIDS and Infectious Diseases”) was conducted., in whom acute stage of HIV infection was detected from 2018– 2022 in “Botkin Hospital”. We evaluated clinical and laboratory results of patients in different years of infection. Results and discussion. Over the ten years of the HIV epidemic in the city of St. Petersburg, new trends in the clinical picture of the acute stage of HIV infection can be found. Over the period 2018–2022, the overall intoxication syndrome severity decreased: fever was more often febrile (72%), lasting from 3–5 days, myalgia — 20%, arthralgia — 15%, mouth mucosal aphthae were found in 7% of patients, skin rashes were observed only in 34%, and lymphadenopathy — 30%. Gastrointestinal disorders were also noted in 28%. Of the secondary and opportunistic infections, OPC prevailed in 83%, oesophageal mycosis in 17%, and serous meningitis in 17%. The median CD4-lymphocyte count was 24–573 kL/μL. Conclusion. the data obtained show that the acute stage of HIV infection has become easier, with a decrease in the intensity and duration of the febrile period, less frequent skin manifestations, secondary diseases, and higher CD4 lymphocyte counts. As a result, diagnosis of the acute phase of HIV infection is difficult for primary care physicians. In any person presenting with signs or symptoms of a viral infection (influenza, infectious mononucleosis, rubella, enteroviruses, etc.), acute HIV infection must be included in the differential diagnosis.
The hepatitis B virus (HBV) and the disease it causes have been actively studied for over 50 years. Recent estimates provided by the World Health Organization indicate that approximately 1 in 22 (4.5%) individuals with chronic hepatitis B have antibodies to the hepatitis D virus (HDV). The exact global prevalence of hepatitis D remains unclear due to differences in the sensitivity and specificity of diagnostic tests and the lack of standardized testing systems. In Russia, patients with hepatitis D are not subject to mandatory registration, and the routes of transmission are similar to those of hepatitis B. The disease is often diagnosed at a late stage (e.g., liver cirrhosis) due to the lack of widespread targeted screening for HDV antibodies among HBsAg-positive patients; about two-thirds of patients are unaware of their infection status. The study of socio-epidemiological and clinical-laboratory characteristics of HIV-positive patients co-infected with chronic hepatitis B and delta agent is of significant scientific and practical interest.The aim of this study was to conduct a comparative analysis of socio-epidemiological and clinical-laboratory features of HIV-positive patients with chronic hepatitis B and delta agent compared to patients without HIV infection. Materials and Methods. The study included 50 patients under observation at the city AIDS center, of whom 24 were diagnosed with HIV infection and chronic hepatitis B+D (Group 1), and 26 had chronic hepatitis B+D without HIV infection (Group 2). The mean age of the patients was 46.7±0.5 years, with 34 males (68.0%) and 16 females (32.0%).Results and Discussion. The “social profile” of HIV-positive patients with chronic hepatitis B+D is characterized as follows: these individuals are typically intravenous drug users, lack higher education, are unemployed, not in formal marriages, and have an HIV infection duration of more than 8 years, often with stage 4A HIV infection according to the Russian classification. All patients in this group were receiving antiretroviral therapy, and the vast majority were also on antiviral therapy for chronic hepatitis. Conclusion. Thus, HIV-positive patients with chronic hepatitis B+D significantly differ from those with chronic hepatitis B+D alone in terms of infection routes, education level, marital status, disease duration, aminotransferase levels, and hematological abnormalities. In both groups, severe liver fibrosis (F3-F4) predominated, accounting for a total of 70%. Antiviral therapy for chronic hepatitis B+D using bulevirtide represents a promising direction for the elimination of HBV and HDV and requires further study and analysis.
