Dysregulated immune response occurring in chronic hepatitis B prevents the virus elimination and contributes to progression of the infectious process. The aim of the study was to evaluate the effectiveness (biochemical, immunological, virological) of combination treatment with tenofovir and Recombinant interleukin-2 in chronic hepatitis B patients. Material and methods. A comparative analysis of the results from laboratory examination of chronic hepatitis B patients in two comparison groups, comparable in sex, age, stage of fibrosis, viral load, was carried out: group I (n = 27) received tenofovir, according to the accepted recommendations, and recombinant interleukin-2 (rIL-2), group II (n = 25) — tenofovir. Results. Before the onset of antiviral therapy all patients with chronic hepatitis B had increased hepatic transaminases, alkaline phosphatase and gammaglutamyl transpeptidase from 1.2 to 5 norms as well as dysregulated cellular immunity factors with significantly decreased absolute count of CD4+, CD8+, CD16+ and increased CD20+ lymphocytes. After 12 months of treatment, patients in observation groups showed normalized cytolysis and cholestasis with insignificant intergroup differences. The level of absolute count of CD4+, CD8+ T-cells and CD16+ lymphocytes in the I group increased (by 24.7%, 24.1%, 34.5%, respectively, all p 0.001 relative to the initial values), not observed in comparison group. The level of CD20+ lymphocytes in group 1 was decreased by 35.9%, and in group 2 — by 7.9% (pI–II 0.001). In group 1, the level of HBsAg after 12 months of treatment became lower by 52% (p 0.001). Conclusion. The conducted pilot study showed that the combination etiopathogenetic therapy of patients with chronic hepatitis B using tenofovir and rIL-2 improves liver functional state, restores the disturbed balance of immunocompetent cells: by increasing level of CD4+, CD8+ T-lymphocytes, CD16+ lymphocytes and reducing the count of CD20+ cells, and also allows to steadily reduce blood serum HBsAg level.
Opisthorchis felineus invasion in human causes inflammatory and dyskinetic disorders of the gastrointestinal tract accompanied by altered phenotypic characteristics in colon microbiota. The aim of research — study an impact of the Escherichia coli isolate phenotypic characteristics on Klebsiella spp. bacteria, isolated from colonic contents of patients with diagnosed opisthorchiasis as well as E. coli antagonistic activity. Materials and methods. The phenotypic properties of 54 E. coli isolates and 8 genus Klebsiella isolates obtained from colonic contents of patients with diagnosed opisthorchiasis were assessed. Identification of isolates and analysis of proteomic profiles were performed using Maldi BioTyper 3.0 software. 204 co-cultivation datasets were analyzed investigating antagonistic activity of E. coli isolates with varying properties on Klebsiella spp. E. coli and Klebsiella spp. isolates were examined by whole genome sequencing. Results. E. coli bacteria with typical phenotypic characteristics showed significantly more prominent antagonistic activity against Klebsiella spp. A significantly higher level of antagonistic activity against K. oxytoca bacteria vs K. pneumoniae strains. The proteomic bacterial strain profiles were divided into clusters depending on the level of antagonistic activity. E. coli molecular serotyping for O- and H-antigens revealed the genes of enterotoxigenic, enteroinvasive and extraintestinal pathogens in 60.0% of cases. Strains with the highest antagonistic activity index, which are carriers of the genes typical to enterotoxigenic E. coli sequence serotypes O6:H1 and O6:H5, were identified. The genome of such strains consisted of the largest number of virulence gene complexes: adhesins, invasins, toxins, bacteriocins. Multilocus sequence typing and sequence serotyping of E. coli and K. pneumoniae strains established their heterogeneity; K. oxytoca isolates were identified as ST242 and ST176. All strains were characterized by homology of antibiotic resistance markers (oqxA, oqxB, fosA) and a variety of beta-lactam resistance gene variants. Conclusion. It was found that E. coli isolates with typical phenotypic characteristics and carriers of virulence gene complexes exhibited significantly more pronounced antagonistic activity against Klebsiella spp. isolated from colonic contents of patients with diagnosed opisthorchiasis.
The aim of this study was to assess the prevalence of occult hepatitis B infection among blood donors in St. Petersburg, as well as to characterize the identified virus isolates. The study material was represented by 2800 blood plasma samples collected in 2019 from blood donors living in St. Petersburg. The ELISA study for HBV marker rate consisted of HBsAg, anti-HBs IgG, anti-HBcore IgG. HBV DNA was analyzed by nested PCR with real-time hybridization-fluorescence detection on three targets allowing to determine virus DNA at low viral load, including HBsAg-negative chronic hepatitis B. Hepatitis B serological markers were detected in 69.43% of those surveyed, HBsAg was found in 0.43% of individuals, and all of which donated blood first time. A significant excess of the anti-HBcore IgG antibodies occurrence among primary donors (15.1%) compared with repeated/regular donors (7.48%) was shown. The prevalence of virus DNA in the group was 3.14%, including 2.71% of cases in HBsAg-negative CHB. Based on phylogenetic analysis of 88 isolates, HBV subgenotypes were determined in the following order: D1 and D2, 40.91% each, D3 and A2, 9.09% each. While determining the serological subtype in detected isolates, the serotype ayw3 (52.27%) vs ayw2 (46.59%) and adw2 (10.23%) prevailed. Drug resistance mutations, including compensatory ones, were detected in six examined patients (6.82%). In all genotype D isolates, multiple amino acid substitutions were identified in the RT, SHB, MHB, LHB, and Core regions; mutations in the preCore region were detected in 21.59% samples. In the MHR of the HBV genotype D genome, twenty-six positions were identified in which amino acid substitutions occurred, and all isolates showed modifications at positions 113, 114, 131, 134, 159, 161, 168, in 76 — at position 122, in 68 — at position 127, in 36 — at position 118, in 24 — at position 128. In HBV A2 isolates, mutations T113S, S143T, Y161F were identified. Nine isolates in the preCore region showed a polymorphism including a stop codon W28*W; in five isolates the W28S substitution was shown in the same position, and the W28*S variant was found in one more sample. The high incidence of HBsAg-negative CHB cases among blood donors, as well as the predominance of HBV isolates that simultaneously carry mutations resulting in diagnostic failure of HBsAg tests and prophylactic failure of immunoglobulin or vaccines and virus reactivation, mutations that contribute to disease progression obviously pose a threat to health and require to be further examined.
Introduction. Since May 2022, an unusually large number of new monkeypox infections-a previously rare viral zoonotic disease, mainly reported from central and western Africa has been reported globally, and the World Health Organization (WHO) declared a global health emergency in July 2022. We aimed to systematically review the monkeypox virus epidemiology, pathogenesis, transmission, presentations, and outcomes. Materials and methods. Our aim is to systematically review the epidemiology, pathogenesis, manifestations, and outcomes of Monkeypox disease. We searched the keywords in the online databases of PubMed, Embase, Scopus, and Web of Science and investigated all English articles until December 2022. In order to ascertain the findings, this study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. In order to optimize the quality, this review study benefits from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. To minimize any probable bias risk, we utilized the Newcastle-Ottawa Scale (NOS) risk assessment tool. Results. The most prevalent symptoms were rash and fever. The infection was accompanied by different complications such as, but not limited to, encephalitis (mainly in children), septicemia, bacterial cellulitis, retropharyngeal and parapharyngeal abscesses, etc. A wide range of hospitalization from 3.7% to 100% has been reported. The mortality rate ranged from 0% to 23%, which mainly occurred in infants and children. High mortality of the monkeypox rate was reported among pregnant women. The mortality rate of monkeypox is lower among women and those who received the smallpox vaccine compared to men and those who did not receive the vaccine. A wide range of the overall second-rate attack was reported, which is more pronounced in unvaccinated patients. Conclusion. In our systematic review of 35 studies on monkeypox, we cast light on the existing evidence on its epidemiology, pathogenesis, manifestation, and outcomes. Further studies are needed to elucidate the natural history of the disease in various patients’ population, as well as detailing the monkeypox attack rate.
Relevance. Due to the large-scale vaccination campaigns against the SARS-CoV-2 coronavirus taking place worldwide, the question arises as to how vaccination may affect complete blood count (CBC) parameters in COVID-19 cases. Research objective: assess differences in complete blood count parameters in COVID-19 patients based on their vaccination status. Materials and methods. A review of publications was conducted describing and presenting the complete blood count parameters in patients with verified COVID-19, by stratifying them into vaccinated and unvaccinated individuals against the SARS-CoV-2 virus-caused disease. Subsequently, a meta-analysis of the results for each CBC parameter was carried out by describing identified differences among patients with mild and moderate COVID-19, lacking comorbidities affecting CBC indicators. Results. The analysis conducted allowed to determine that the complete blood count parameters do not exceed the reference range in most cases in both groups, excepting those of individuals with a severe disease course. The exception is the erythrocyte sedimentation rate (ESR) (42 [20.5–63.5] (∑n = 107, Me [Q1–Q3])) mm/h in unvaccinated individuals. Also, a slightly lower absolute lymphocyte count is observed in vaccinated individuals (0.95 [0.58–1.62] × 109/L (∑n = 441, Me [Q1–Q3])). There is a twofold greater range of leukocyte quartile values in vaccinated individuals compared to unvaccinated individuals: 7.07 [4.07–12.31] × 109/L (∑n = 555, Me [Q1–Q3]) vs 5.68 [4.02–8.34] × 109/L (∑n = 2202, Me [Q1–Q3]). A similar pattern is observed for monocytes. Conclusion. Conducting a meta-analysis of laboratory parameters in COVID-19 cases among vaccinated and unvaccinated individuals allows for determining the effectiveness of vaccination as well as identify the major trends in dynamic changes for essential blood parameters among unvaccinated and vaccinated individuals in general or with certain immunobiological preparations.
