The lecture outlines modern ideas about the etiology, features of the epidemic process, mechanisms of damage to the human body, clinical manifestations, diagnosis, treatment and prevention of infection caused by the Nipah virus. Particular attention is paid to the characteristics of individual outbreaks of the infectious process in various geographical regions of the world, early and long-term psychopathological, neurological and cognitive consequences due to human infection with the Nipah virus. The risk factors for the emergence and rapid spread of infection with a very high mortality rate, reaching 100%, are emphasized, which determines the high pandemic potential and hidden threats to human society. Recommendations are outlined for the prevention of transmission of infection caused by the Nipah virus at all levels: from animals to humans, from humans to humans, in medical institutions, which, in the absence of effective vaccine prevention and specific antiviral treatment, are the basis for containing the spread of the infectious process. In this regard, measures taken and planned to provide patients and contact persons with adequate medical and psychological care, features of the development and implementation of effective anti-epidemic, clinical diagnostic algorithms, timely and high-quality social and hygienic monitoring of environmental objects against the backdrop of increasing biological threats from outside, and within the country will minimize the risks of biological threats. The lecture is intended for doctors of various specialties, including infectious disease specialists, epidemiologists, general practitioners, neurologists, psychiatrists, laboratory diagnosticians, radiologists etc.

The review analyzes the distribution, clinical manifestations and complications of preventive vaccination against COVID-19 infection, with an emphasis on the incidence and nature of neuromuscular and neurological complications, measures taken and planned to provide persons who have suffered this disease with adequate medical and psychological care, in order to maintain mental health of people and preservation of sanitary well-being of the population.

The aim. To analyze anamnestic data, clinical and laboratory parameters, and psychoneurological manifestations in patients in the post-COVID period.Materials and methods. After the initial survey of 1,200 respondents who had suffered from a new coronavirus infection (COVID-19), a group of 170 patients was identified based on the presence of complaints about the state of somatic and mental health that have a temporary relationship with the SARS-CoV-2 disease. As part of the study, this group of patients underwent a comprehensive laboratory examination with an assessment of general clinical and biochemical parameters, inflammatory markers and the blood coagulation system. All patients were examined by an infectious disease specialist, a neurologist, a psychiatrist-narcologist and a medical psychologist. The main socio-demographic and clinical laboratory data in the post-COVID period, as well as neurological and psycho-emotional characteristics obtained from 130 participants in 2024, were assessed. In order to study cognitive and executive functions, psycho-emotional state, the following methods were used: Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) and SCL-90 Symptomatic Questionnaire. In addition, each respondent was asked to determine the presence and severity of the main psychopathological, neurological, cognitive and general somatic symptoms using the «Not bothered-Weakly-Moderately-Extremely» scale specially developed for the study, which included up to 38 symptoms.Results and discussion. The majority of the sample were women (80%). Over 2⁄3 of the respondents were of working age, with an average age of 38.2±11.3 years, and 65.3% had mild forms of COVID-19. Repeated cases of COVID-19 were associated with a high risk of blood saturation decrease to ≤93% (p<0.01), while severe COVID-19 was associated with the absence of vaccination (p<0.05). Ferritin levels below 30 μg/L were recorded in 34.1% of women and 9.15% of men, which may indicate a deficiency of iron stores in the body. Hypercholesterolemia was noted in 54.9% of cases, with average total cholesterol levels of 5.52±1.19mmol/L. The total number of NCI cases (2 or more) is associated with a decrease in the number of leukocytes, an increase in the number of platelets in the blood, the percentage of monocytes, a decrease in the level of total protein, an increase in the level of total cholesterol (p<0.05). Neurological symptoms are characterized by pronounced polymorphism, with 15.3% of respondents having exhaustion or absence of superficial abdominal reflexes, 26.9% having mild cognitive impairment, and 7.7% having a significant general decline in cognitive functions. 49.5% of respondents showed signs of anxiety, and 29.4% had depressive phenomena, expressed at the subclinical or clinical level. The severity of distress caused by sensations of bodily dysfunction of a somatic, painful and/or neuromuscular nature is characteristic, as well as mild hypochondriacal tendencies in a separate group of respondents.Conclusion. Comparison of the results of the questionnaire and in-depth study showed that cognitive and psychoneurological disorders are widespread among patients of different age groups, regardless of the severity of the COVID-19. Given the mechanism of direct and indirect effects of SARS-CoV-2 on the brain, it is the symptoms of damage to the nervous system, including cognitive functions and the psychoemotional sphere, that largely determine the clinical symptoms of post-COVID disorders. The complexity and versatility of clinical and laboratory manifestations of post-COVID syndrome require the involvement of specialists of various profiles in working with patients, the need to develop protocols and recommendations for working with people with manifestations of post-COVID syndrome.

Aim: to show the importance of the features of the development of Hodgkin’s lymphoma (HL) against the background of HIV infection, possible clinical relationships and consequences of simultaneous diseases in patients, as well as complex therapy. Material and methods. The article presents an analytical review of the problem and retrospective data on 63 patients with HIV[1]associated HL (HIV-HL) who were diagnosed with HL in St. Petersburg hospitals in the period 2000–2017. For the diagnosis of HIV-HL, regulated morphological, immunohistochemical, instrumental and laboratory research methods were used, the tumor stage was determined based on the Cotswolds-modified Ann Arbor classification. The diagnosis of HIV infection was confirmed by the detection of specific antibodies to HIV (and the p24 antigen) during serological and enzyme immunoassay of blood, by immune blotting. The number of copies of HIV RNA and the number of CD4 lymphocytes in the blood of patients were determined using commercial test systems approved for use in the territory of the Russian Federation. The analysis of overall survival was performed using the Kaplan–Meyer method. Statistical processing of the research results was performed using statistical programs MS Excel 2010, GraphPad Prism 8 (GraphPad Software, Inc., USA), SPSS version 22.Results. The study group was dominated by men (73%), the median age was 32 years, in 16 (25.4%) patients HIV and HL were detected simultaneously. The number of CD4 lymphocytes > 500 cl/μl at the HL debut was noted in 33.3% of patients, patients with severe immunosuppression prevailed (50–250 cl/μl in 20 (31.7%), 250–500 cl/μl in 11 (17.5%), less than 50 cl/μl in 11 (17.5%). The amount of HIV RNA>400 kop/ml was noted in 82.5%, HIV infection at stages 4B-5 was detected in 89% of cases, at the time of detection of HL ART was performed in 16 patients. EBV coinfection (77.8%), cytomegalovirus (60%), viral hepatitis (55.6%) with a predominance of viral hepatitis C, common opportunistic infections (tuberculosis, pneumocystis pneumonia, toxoplasmosis of the brain, common candidiasis), simultaneously occurring from 1 to 3 infections were observed in 77.8%. Stage IV HL was established in 54%, III — in 22%, II — in 24% of patients, the presence of B-symptoms was confirmed in 73% of cases. The predominant histological variant of HIV-HL was nodular sclerosis (58 patients), mixed[1]cell sclerosis in 4 patients, with lymphoid predominance in 1 case. Extranodal lesions were observed in 34 (54%), complications of the tumor process in 33 (37.5%) patients. 42 (66.7%) patients received antitumor treatment for HL: line 1 according to the ABVD scheme — 85.7% (80% achieved PET-negative complete remission (CR), according to the VEASORR esc or VEASORR schemes — 33.3%; line 2 — according to the ICE or DHAP schemes (n=10). An objective response was noted in 4 patients, PET-negative response in 2 of them, partial PET-positive regression in 2 patients. Progression was observed in 2 people. Autologous bone marrow transplantation was performed in 2 patients (in partial PET-positive regression); line 3 (n=3) — chemoimmunotherapy with bendamustine, gemcitabine (2 patients underwent autologous bone marrow transplantation). The cumulative life expectancy of patients for 1 year and 2 years was 44% and 37%, respectively, 1-year overall survival was 75%, 2-year — 60%. The factors negatively affecting survival and life expectancy were tumor progression and complications, ECOG≥2 (p=0.0001), candidiasis, pneumonia (p=0.001), viral hepatitis B and C (p=0.045), lack of antitumor treatment and ART (p=0.0001), age younger than 40 years, central nervous system damage, the presence of 1 or more concomitant infections (p=0.024). Conclusion. HIV-HL is one of the most common hematological malignancies, characterized by heterogeneity in its manifestations, polymorphism of pathogenetic and clinical features and relationships. During the dispensary supervision of PLHIV, special attention should be paid to the factors of an unfavorable prognosis of the disease, the timeliness of the appointment of ART and the assessment of the risks of developing lymphoproliferative diseases within the framework of the immune system restoration syndrome (IRIS) in order to increase their survival and quality of life. Further research is needed on the pathogenesis, early diagnosis and effective treatment of lymphomas associated with the human immunodeficiency virus

Purpose of the study. To assess the nature of health complaints, frequency of occurrence, structure and characteristics of neurological, general somatic and mental disorders in people in the post-COVID period. Materials and methods. The main group (n=1000) was represented by people who had a new coronavirus infection, confirmed by polymerase chain reaction (PCR) SARS-CoV-2, from 18 to 60 years old. As part of the study, an extensive survey of the examined individuals was carried out, aimed at identifying the main psychoneurological and general somatic consequences that developed in the period from 4 weeks to 12 months after COVID-19. Results and discussion. The study included 289 men and 711 women (28.9% and 71.1%, respectively). The average age at the time of the examination was 40.2±11.8 years. More than half of the respondents were of working age, had a permanent job or were studying (72.3%), while 17.9% indicated a high level of physical activity before COVID-19. The majority of respondents suffered from mild COVID-19 (76.6%), in 23.4% of cases the disease was moderate. Among somatic (vegetative) disorders as a consequence of COVID-19, the most common complaints were hair loss (49.5%), fatigue in 77.5% of cases, regardless of workload and type of work, and fluctuations in blood pressure in 50.2% of patients. Women complained more intensely about hair loss (χ 2 =60.2608, df=9, p<.001), shortness of breath (χ 2 =17.5025, df=9, p=0.04), interruptions in heart function (χ 2 =22.7863, df=9, p=0.007). Among the respondents, the most common complaints were emotional disturbances, which determined the picture of anxiety and depressive disorders, as well as cognitive impairments in the form of memory loss (69.5%), concentration, difficulties with long-term attention maintenance (65,5%) and switching from one task to another (60%). With the age of the respondents, fatigue increased in intensity (R=0.2, p<0.05), insomnia (R=0.2, p<0.05), anxiety for health and for their close persons (R=0.2, p<0.05), neurological complaints (widespread muscle pain (R=0.3, p<0.05), pain in the spine (R=0.3, p<0.05), gait disturbances (R=0.2, p<0.05), as well as the intensity of general somatic complaints (urinary disorders (R=0.2, p<0.05), shortness of breath (R=0.2, p<0.05), pain and heaviness in the chest (R=0.2, p<0.05), irregular heartbeat (R=0.2, p<0.05), fluctuations in blood pressure (R=0.2, p<0.05). Clear gender differences in the intensity of post-COVID psychopathological manifestations were revealed. Women complained more strongly about post-COVID high fatigue (χ 2 =23.8901, df=9, p=0.004), general malaise (χ 2 =17.9304, df=9, p=0.04) and, accordingly, lower activity and inability to cope with household workload (χ 2 =22.3384, df=9, p=0.008) compared to men. Women had more severe dysmnestic disorders (χ 2 =23.0900, df=9, p=0.006) than men. Women were also characterized by having greater anxiety for close persons (χ 2 =20.5941, df=9, p=0.01) and insomnia (χ 2 =20.2633, df=9, p=0.02) than men. Post-COVID neurological disorders, despite their lower frequency and intensity of manifestations, caused the most significant difficulties in everyday life and predominated in older people. Conclusion. The clinical picture of post-COVID syndrome is represented by a wide range of somatic and neuropsychiatric disorders, which determines the specifics of patient management after the illness. When assessing long-term disorders, it is advisable to rely on the opinions of specialists as part of an interprofessional expert group, to make decisions on the implementation of a clinical diagnostic algorithm for each patient based on a systematic approach, taking into account specific symptoms or conditions. Preliminary results of our study showed that special attention should be paid to women at the stage of treatment of acute infection and rehabilitation, due to the higher incidence of psychoneurological complications of COVID-19 in them. Given the risks of long-term consequences of COVID-19 and the possibility of reinfection, it is critical to integrate basic and clinical research data to optimize cognitive preservation and quality of life for patients.

This publication reflects modern ideas about the main aspects of etiology, pathogenesis and the latest achievements of clinical practice in the field of the most common primary and secondary immunodeficiency. The features of laboratory diagnostics of congenital immunodeficiency, risk factors and early clinical guidelines that allow the patient to suspect an immunosuppressive state are considered. Special attention is paid to the problem of secondary immunodeficiency, their prevalence and polyetiology. When covering immunopathogenesis, infection caused by the human immunodeficiency virus (HIV), attention is paid to the multimorbidity of clinical manifestations of HIV-associated immunosuppression and concomitant diseases, the importance of timely administration of antiretroviral therapy (ART) and its role in the development of immune reconstitution syndrome (IRS). The criteria for the diagnosis of SVI based on their own experience and the opinion of foreign colleagues, the tactics of patient management are presented in detail.

The review analyzes the distribution, clinical manifestations and complications of monkeypox in humans with an emphasis on neuropsychiatric disorders that are important for human socialization and the necessary medical and social interventions in order to maintain a regime of sanitary well-being in society.

OBJECTIVE : Assess the degree of elaboration regarding mechanisms of the nervous system damage in HIV infection to further evaluate SARS-CoV-2, as a possible contributing factor in emergence and worsening psycho-neurological pathology in HIV-infected patients. MATERIALS AND METHODS : The analytical review was conducted using the medical database PubMed. More than 20 domestic and 30 foreign publications were studied on the mechanisms of the nervous system damage in HIV infection and SARS-CoV-2 between 2019-2022.Some preliminary study was conducted. Outpatient charts data of 146 HIV-infected patients were analyzed; a confirmed diagnosis of COVID-19 mild or moderate form (between 2020-2022) appeared in 42 (25,8%) cases (1 st group). The comparison group (2 nd group) included 40 patients without HIV infection, but suffered COVID-19, who were surveyed after signing voluntary informed consent. The survey data provided insight into the frequency and severity of neuropsychiatric manifestations and their possible connection with COVID-19. RESULTS : The high neuroinvasive and neurotropic HIV potential was demonstrated and implemented in a variety of ways and mechanisms that manifests in clinical practice by the appearance of diverse neuropsychiatric symptomatology. The study proved the influence of HIV infection on ACE-2 receptor expression by neurovascular cells (NVC) and also revealed some other features, contributing to the potentiation of SARS-CoV-2 invasion in CNS. The results of the preliminary study showed that in the group with HIV-infected 9 patients (21,4% of recover from COVID-19) experienced long-term neuropsychiatric manifestations after coronavirus infection, while all patients had long-term suppressed HIV viral load against the backdrop of regular ARV therapy and satisfactory immune status (CD4+ T-lymphocytes count). In the group without HIV infection after COVID-19 22 (55%) patients experienced neuropsychiatric complications, estimated by them as “extremely strong”. DISCUSSION : Although the study did not reveal a clear link between the presence of immunodeficiency in HIV infection and manifestation of neuropsychiatric pathology after COVID-19, further research is needed to define mutual influence of HIV and SARS-CoV-2 on the emergence of neuropsychiatric pathology. CONCLUSION : Considering a lack of research, where the results obtained could reliably confirm increased risk of complications from the nervous system, caused by SARS-CoV-2 against the backdrop of the existing HIV infection, there is reason to believe that this problem remains relevant today. This dictates the need to examine closely neurological status in patients of this category and monitor neurological complications.

INTRODUCTION: The period of the current COVID-19 pandemic is associated with a prolonged situation of uncertainty; in the preference of styles and strategies for overcoming the intellectual and personal potential of a person is presented in the unity of the processes of cognitive evaluation, experience and choice of ways to solve a problem (stressful) situation.OBJECTIVE: To study the interrelationships of decision-making style as a reflection of individual differences in coping with uncertainty and emotional creativity as a factor of self-realization in young people who have had COVID19 infection.MATERIALS AND METHODS: We examined 100 convalescents aged 18.2±2.25 years, including 50 men (Group M) and 50 women (Group G) (the age difference between the groups is not significant). The main transferred clinical forms of COVID-19 infection were the inapparent form — 42.0% (group M — 32 people, group G — 10 people), acute respiratory viral infection — 56.0% (group M — 17 people, group G — 39 people) according to the Russian versions of the Melbourne Decision Making Questionnaire (MDMQ) and the Emotional Creativity Inventory (ECI).RESULTS: In both groups of examined individuals after COVID-19 infection with all clinical forms of the disease, the strategy of «vigilance», considered as productive, is of the greatest importance in the decision-making process; unproductive strategies are not expressed, which is important for the subsequent medical and psychological support of convalescents.DISCUSSION: In both groups of examined individuals after suffering COVID-19 infection in all clinical forms of the disease, the «vigilance» strategy, considered as productive, is of the greatest importance in the decision-making process; unproductive strategies are not expressed, which is important for the subsequent medical and psychological support of convalescents. It is noted that the interaction between the factors of emotional creativity is expressed not only in an increase in creativity when high values coincide on two or more faces, but also in the fact that low values of one component can be compensated by high values of another.CONCLUSION: It is noted that the interaction between the factors of emotional creativity is expressed not only in an increase in creativity when high values coincide on two or more sides, but also in the fact that low values of one component can be compensated by high values of the other.

Many infectious diseases still have medical and social significance, the late detection and untimely treatment of which causes persistent health disorders, leading to early disability. Drug therapy has significantly reduced mortality among people on the background or after infections, increasing the duration and quality of life. However, lesions of the nervous system in human immunodeficiency virus (HIV), viral hepatitis, new coronavirus and other infections, and related neurocognitive disorders cause great concern, are accompanied by complex and clinically important problems.The authors conducted an analytical review of publications and their own research based on the experience of implementing cognitive training in neurocognitive rehabilitation programs that have proven their effectiveness for patients with cognitive disorders against the background of socially significant infections and comorbid conditions.

The organization of the North-Western District Center for AIDS Prevention and Control (AIDS Center) originates from the onset of the HIV epidemic in the Russian Federation. Over the 35 years of work, the staff of the AIDS Center has made an invaluable contribution to the development of HIV diagnostics, the introduction of new clinical and preventive technologies, patient counseling, and training of qualified personnel. The anniversary article highlights the main stages regarding establishment of the AIDS Center as a structural unit of the Saint Petersburg Pasteur Research Institute. The versatile naturally multidisciplinary functions and tasks related to the AIDS Center organization, its major Russia-wide and global achievements are considered. Special attention is paid to the long-term international cooperation, the results of diverse implemented programs and projects supported by the World Health Organization (WHO) as well as the Joint United Nations Programme on HIV/AIDS. The AIDS Center continues to cooperate with the main scientific facilities such as the Pavlov First Saint Petersburg State Medical University, Institute of Experimental Medicine, N.P. Bekhtereva Institute of the Human Brain of the Russian Academy of Sciences, etc. The ongoing joint research invariably contributes to assessing the epidemiology and clinical course of various viral infections and comorbid conditions. The knowledge acquired becomes regularly summarized and published in a series of monographs, journal articles being presented demonstrated at conferences of various levels. Currently, the AIDS Center is represented by several structural divisions continuing to conduct practical and scientific activities on investigating HIV and viral hepatitis.

The issues of diagnosis and treatment of nervous system damage in the new coronavirus infection (COVID-19) remain relevant, regardless of information and experience in treating such patients, accumulated nowadays. The review contains updated data on the ways of SARS-CoV-2 invasion, examines mechanisms of central nervous system damage: direct virus-induced damage, immune dysfunction, excessive thrombo-inflammation, coagulation disorder, cytokine and metabolic imbalance, hypoxia, etc.; it presents clinical examples with one variant of damage — the development of Guillain-Barre syndrome that, to some extent, allows to confirm the virus neurotropism. Doctors’ knowledge about this infection is constantly expanding, new information appears on its various neuropsychiatric effects during an acute period and post-COVID syndrome, on symptoms, treatment and prevention strategy. These data enables to understand better the reasons for developing the main clinical manifestations, from a headache or myalgia to more severe symptoms, such as a stroke, psychosis and anosmia, severity and reversibility of their course. Although several hypothesis of CNS damage pathogenesis in COVID-19 are being discussed, the unified pathophysiological mechanism of many dysfunctions remains unclear, and, probably, additional factors, such as social isolation during a pandemic, presence and treatment in the intensive care unit, premorbid somatic status of a patient, contribute to the development of some registered nervous system disorders.

COVID-19, having not completed its epidemic development, gradually passes into the stage of prolonged diseases, which at the clinical level is designated as «postcovid syndrome». The symptomatology of these negative phenomena is quite diverse, covers the dysfunction of many organs and systems, and deserves the formulation of polymorphism of secondary and delayed complications. They are based on the consequences of the transferred acute phase of inflammation, systemic prolonged metabolic and structural disorders, including the studied genetic disorders. Possible causes of polymorphism of disorders and their manifestations in the postcovid period are considered.

Objective. Analyse the prevalence of combined HIV/TB infections in the territory of Chechen Republic for 2013–2020.Materials and methods. The research was held by «the Republican Centre for AIDS Prevention and Control», Grozny and «The Republican Centre of Phthisiopulmonology», Grozny. It analysed the data of outpatient and inpatient charts of 148 HIVinfected with tuberculosis, identified in the period from 2013 to 2020 and being under dispensary observation in the Republican Centre of AIDS Prevention and Control, Chechen Republic.Results and discussion. The study reports that HIV prevalence in absolute terms and figures per 100.000 people decreased from 223 (16,8) in 2013 to 117 (7,9) in 2020. It should be noted that with the growth in number of checked people, tuberculosis prevalence as well as in the case of HIV infection decreased in absolute terms and figures per 100.000 of the population in the sampling period. If in 2013 it amounted 466 (35,1), in 2020 it was already 299 (20,2). Among HIV-infected citizens of Chechen Republic 167 people with tuberculosis were also detected in the sampling period. From among the combined HIV- and tuberculosis infected, 148 people subjected to regular medical check-up. The prevalence of combined HIV/TB infections per 100.000 people tended to decrease from 2013 to 2020 as well as the overall HIV prevalence without tuberculosis and tuberculosis without HIV. These changes are quite significant from 1,6 to 0,06.Conclusion. The issues of HIV infection combined with tuberculosis remains actual for all constituent entities of the Russian Federation, including Chechen Republic, based on socio-economic, demographic, epidemiological and clinical reasons. The decline in incidence and prevalence of HIV, tuberculosis and combined HIV/TB infections in the territory of Chechen Republic in 2013–2020 may have occurred due to increase in the level of economic development, favourable social programs and stabilization of demographic situation, демографической ситуации, overall reduction of substance abuse, including parenterally injectable. There is also improvement of material and technical equipment, staffing of infectious and anti-tuberculosis service. It is required to have further study of the epidemic process specificities of socially significant infections (HIV, TB, viral hepatitis) that acquire new features and characteristics during the pandemic of the new coronaviral infection.

OBJECTIVES: To study the interrelationships of decision-making style as a reflection of individual differences in coping with uncertainty and emotional creativity as a factor of self-realization in young people who have had COVID-19.MATERIALS AND METHODS: We examined 100 convalescents aged 18.2±2.25 years, including 50 men (Group M) and 50 women (Group G) (the age difference between the groups is not significant). The main transferred clinical forms of COVID-19 were the inapparent form — 42.0% (group M — 32 people, group G — 10 people), acute respiratory viral infection — 56.0% (group M — 17 people, group G — 39 people) according to the Russian versions of the Melbourne Decision Making Questionnaire (MDMQ) and the Emotional Creativity Inventory (ECI).RESULTS AND DISCUSSION: In both groups of examined individuals after suffering COVID-19 in all clinical forms of the disease, the «vigilance” strategy, considered as productive, is of the greatest importance in the decision- making process; unproductive strategies are not expressed, which is important for the subsequent medical and psychological support of convalescents. It is noted that the interaction between the factors of emotional creativity is expressed not only in an increase in creativity when high values coincide on two or more faces, but also in the fact that low values of one component can be compensated by high values of another.CONCLUSION: The data obtained are important for conducting medical and psychological support for convalescents and for preventing the formation of professional burnout, and for quick adaptation to various life situations, and for motivation to prevent the occurrence of changes in functional states after suffering COVID-19.

The article discusses the epidemiological, etiopathogenetic, clinical, and diagnostic aspects of central nervous system damage in COVID-19. The SARS-CoV-2 virus can pass through physiological barriers and reach the bloodstream or lymph, spreading in the central nervous system of an infected person, infect host cells through many metabolic pathways, which determines the features of the clinical picture of neuropsychiatric and behavioral disorders in the patient, represented by a spectrum of phenotypes (syndromes), one way or another associated with the main infectious process. As a rule, this is a clinical diagnosis based on the results of a comprehensive examination of a patient with COVID-19. Direct virus-induced damage, immune dysfunction, excessive inflammation, thrombophilia/hypercoagulation, cytokine and metabolic imbalance, and autoimmune changes that are pathogenetic mechanisms in developing neuropsychiatric diseases in patients with COVID-19 are described. The review substantiates the need for a comprehensive examination, an interdisciplinary approach, and multicomponent therapy of patients with a new coronavirus infection. Dynamic monitoring of COVID-19 convalescents will allow us to objectively talk about the risk of developing long-term consequences of SARS-CoV-2 infection, and maintaining clinical alertness regarding the possible development of neurological symptoms in most patients with the new COVID-19 coronavirus infection will help to provide effective assistance both in the acute period of the disease and during recovery, recovery and comprehensive rehabilitation: neurological, psychological, musculoskeletal.

On November 18–19, 2021, the XIII Scientific and Practical Conference with national participation «HIV infection and immunosuppression was held in St. Petersburg. Socially significant infections as a cause of medical and social problems».

The purpose statement is to study the medical and social status and radiological changes in the CNS in women of reproductive age with HIV/HCV co-infection.Materials and methods. The main group (n=36) consisted of patients with HIV/HCV and co-infection. The comparison group (n=36) consisted of women infected with HIV only. Within the framework of this study, clinical, laboratory (general clinical, biochemical, immunological, virological), and instrumental methods of research were used. All women with HIV/HCV and coinfection underwent indirect liver elastometry. The list of radiation research methods included PET/CT with FDG and MRI of the brain. Statistical processing and comparison of the results was carried out using MS Excel 2010 and GraphPad Prism 8 (GraphPad Software, Inc., USA) in accordance with the standards of mathematical statistics. The criterion of statistical significance of the findings was the value of p<0.01. Results and discussion. According to the criteria for inclusion in the study, patients in the comparison groups had an acceptable level of social adaptation, satisfactory indicators of the immune status, in 2⁄3 cases they achieved virological suppression against the background of antiretroviral therapy. HCV RNA was detected in 25 women (69.4%), pronounced manifestations of fibrotic changes in the liver were found in 6 (12.8%) patients. Radiation studies of the CNS revealed structural changes in 1⁄3 of cases, disorders of glucose metabolism of various localizations in all women with HIV/CHC. In patients with co-infection, compared with women infected with HIV, hypometabolism of glucose in various parts of the brain is significantly more often detected. Conclusion. As a result of a comprehensive clinical and neuroimaging examination, certain changes in the metabolic function of the brain were identified, which are characteristic of women with HIV/HCV co-infection. The use of PET/CT with FDG in some cases makes it possible to detect preclinical signs of VANR, as well as possible early manifestations of neurological disorders. Key words: human immunodeficiency virus, viral hepatitis C, HCV, chronic hepatitis C, CHC, women of reproductive age, central nervous system, PET, MRI, structural changes, metabolic disorders>˂ 0.01.Results and discussion. According to the criteria for inclusion in the study, patients in the comparison groups had an acceptable level of social adaptation, satisfactory indicators of the immune status, in 2⁄3 cases they achieved virological suppression against the background of antiretroviral therapy. HCV RNA was detected in 25 women (69.4%), pronounced manifestations of fibrotic changes in the liver were found in 6 (12.8%) patients. Radiation studies of the CNS revealed structural changes in 1⁄3 of cases, disorders of glucose metabolism of various localizations in all women with HIV/CHC. In patients with co-infection, compared with women infected with HIV, hypometabolism of glucose in various parts of the brain is significantly more often detected.Conclusion. As a result of a comprehensive clinical and neuroimaging examination, certain changes in the metabolic function of the brain were identified, which are characteristic of women with HIV/HCV co-infection. The use of PET/CT with FDG in some cases makes it possible to detect preclinical signs of VANR, as well as possible early manifestations of neurological disorders.

Objective. Description of clinical forms of chronic HCV infection in the observed patients, clarifications of options and causes of virological failures of primary interferon-free therapy (DAAT/1) and the results of repeated interferon-free treatment (DAAT/2).Materials and methods. 8 patients with chronic RNA HCV viremia (subtypes 1b+/–1a and 3а/3ab) were prospectively observed who suffered a virological failure of primary interferon-free therapy with original inhibitors in the form of relapse of RNA HCV viremia and aviremic low-level replication RNA HCV in PBMCs (peripheral mononuclears), but then achieved HCV eradication with a repeated course of interferon-free therapy.Results. Two variants of virological failures of primary interferon-free therapy were noted — relapse of RNA HCV viremia and aviremic low-level replication of RNA HCV in PBMCs. A number of unfavorable prognosis signs (individual clinical and laboratory syndromes and laboratory parameters) were revealed, which were observed in most patients who did not achieve HCV eradication using primary interferon-free therapy with antiviral drugs: HCV-associated syndromes of low-grade systemic inflammation (LGSI), benign lymphoproliferation and autoantibody production, a high level viral load of HCV RNA viral load in blood plasma, HBV-coinfection without HBsAg and cirrhosis of the liver in the outcome of chronic hepatitis C. The target result of repeated interferon-free therapy, confirmed by the sustainable virological response after 12 weeks after the end of the treatment (SVR12), was achieved in all «losers» of primary interferon-free therapy.Conclusion. The unfavorable prognostic signs identified in the majority of «losers» of primary interferon-free therapy in the form of individual clinical and laboratory syndromes and laboratory parameters may be associated with potential virological inefficiency of therapy. Based on logistic regression analysis, the value of each of the identified features for predicting different outcomes of primary interferon-free therapy in a large group of patients with HCV is shown. Pangenotypic combinations of GLE/PIB+SOF+/–RBV and VEL/SOF+RBV inhibitors have shown their high antiviral efficacy in the treatment of relapse of RNA HCV viremia and aviremic low-level replication of RNA HCV in peripheral mononuclears for all the patients for whom primary interferon-free therapy was unsuccessful.