According to WHO data about 3% of population are infected by hepatitic C virus (HCV) worldwide. Chronic hepatitis C is the leading cause of cirrhosis and hepatocellular carcinoma, thus it becoming one of the global public health problems. Clinical manifestations are varied and depend mainly of the virus biological properties and its interaction with the host immune system. Determination of virus genotype and subtype is important for a better understanding of the epidemiological and virological features of the disease. The prevalence genotypes hepatitis C virus is varies in different geographical regions of the world. The data about HCV genotypes distribution in some Russian Federation regions are very limited, especially about HCV genotypes prevalence in Siberia, Far East and some rural regions. One of such regions is Yakutia. In our study we identified genetic variants of HCV in chronic hepatitis C patients with moderate and high viral load from Yakutia by direct sequencing of HCV RNA NS5B region. Based on phylogenetic analysis we found the prevalent genotype 1 (88.3%), than genotype 2 (6.7%) and 3 (3.2%) among HCV patients with moderate and high viral load. Our results on the prevalence of subtype 1b are consistent with the data on the connection between this subtype with high levels of viremia, greater duration and severity of liver disease, as well as the development of chronic hepatits C in patients infected by HCV subtype 1b, compared with those infected with other subtypes of hepatitis virus C. The similarity of some Yakutian isolates with isolates from the United States, Brazil and Ireland was found. We discuss HCV subtype 2a isolates identified origin from isolates found in China. First in the territory of the Russian Federation HCV subtype 3g was identified, presumably imported from South Asia. Interconnected use of molecular, virological, demographic and epidemiological methods and information to monitor the infections will contribute to the understanding of the current HCV epidemiology in Russia.

Objective: To estimate the prevalence of genetic variants and features of the molecular epidemiology of HBV in Yakutia residents suffering from HBV.Materials and methods: The study involved 35 patients with chronic hepatitis B from urban and rural areas of Yakutia while most of the group were representatives of the autochthonous population. In the present study we used genotyping by direct sequencing of the Pre-S1 / Pre-S2 / S region of HBV DNA.Results: Based on the phylogenetic analysis of the isolates showed that among patients examined HBV identified only D genotype, which is the most common genotype of HBV in the Russian Federation. It is shown prevalence of HBV subtype D2 (85,8%) compared to the HBV subtype D3 (14,2%).Conclusion: We identified clearly clustered group of HBV isolates and close ties within the group, which suggests the existence of at least four permanent sources of infection, acting for a few years and decades. The systematic application of complex molecular, virological, epidemiological methods and molecular phylogenetics could contribute to the current understanding of the epidemiology of HBV and improve the quality of the traditional methods of supervision in Russia.

Objective : To estimate the prevalence of genetic variants and features of the molecular epidemiology of HBV in Yakutia residents suffering from HBV. Materials and methods : The study involved 35 patients with chronic hepatitis B from urban and rural areas of Yakutia while most of the group were representatives of the autochthonous population. In the present study we used genotyping by direct sequencing of the Pre-S1 / Pre-S2 / S region of HBV DNA. Results: Based on the phylogenetic analysis of the isolates showed that among patients examined HBV identified only D genotype, which is the most common genotype of HBV in the Russian Federation. It is shown prevalence of HBV subtype D2 (85,8%) compared to the HBV subtype D3 (14,2%). Conclusion : We identified clearly clustered group of HBV isolates and close ties within the group, which suggests the existence of at least four permanent sources of infection, acting for a few years and decades. The systematic application of complex molecular, virological, epidemiological methods and molecular phylogenetics could contribute to the current understanding of the epidemiology of HBV and improve the quality of the traditional methods of supervision in Russia.

Hepatitis C virus (HCV) infection is one of the most prevalent health problems in the world. Official registration of HCV infections in the Russian Federation started in 1994. Two clinical forms of infection - acute and chronic hepatitis C - are registered separately. Moreover, the HCV national surveillance system also includes reports from laboratories on results from testing similar to 20 population risk groups for antibodies to HCV; approximately 15-16 million tests are performed annually. Modern epidemiological features of HCV infection in the Russian Federation are characterized by low incidence of the acute form of infection (acute HCV; one to two per 100,000) and a dramatic increase in chronic HCV (CHCV) cases. In 2013, the average nationwide rate of newly detected CHCV cases was 39.3/100,000. In the same year, the prevalence of CHCV demonstrating an accumulation of chronically infected patients in the country was much higher -335.8/100,000. Four risk groups were identified as greatly affected by HCV, which were demonstrated by a high prevalence of antibodies to HCV: newborns from chronically infected women, persons from correctional facilities, patients with chronic liver diseases, and clients from clinics for sexually transmitted disease patients and drug users. It was found that several HCV genotypes circulated in different regions of the country; HCV1b had a prevalence of 55%-80% in almost every part of the country. However, in St Petersburg during the final decade of the last century and from 2001-2005, HCV3a subtype expanded circulation among young people due to increased intravenous drug addiction. Intravenous drug users were the major cause of a higher registration of double infection, with two different virus subtypes, and the appearance in Russia of new recombinant virus RF_ 2k/1b. It can be concluded that CHCV infection should be a focus of the health care system in Russia because serious epidemics of liver cirrhosis and hepatocellular carcinoma will be seen in the near future that will require urgent preventive and therapeutic measures.

In recent years, there were published several epidemiological observations concerning the maximum incidence of hepatitis A (HA) shifting into the older age groups, including adolescents aged 15-19 and young adults 20-39 years old, and the reduction of the role of children as a significant risk group. These phenomena have not been sufficiently studied yet and have not received an adequate explanation. The aim of this study is to investigate the age characteristics of the epidemic process of the HA in Russian Federation and federal districts in the modern period to assess the need for routine vaccination of children against the infection, as well as to determine the optimal age for its implementation. There was conducted a comparative analysis of age-related morbidity of Hepatitis A (the proportion of children and adults, the ratio of adults and children’s rates, the intensity of the population) in the federal districts of the Russian Federation in 1999, 2001 and 2010. It was discovered that Hepatitis A remains a significant child problem in Russian Federation. The proportion of children aged 0-14 years among Hepatitis A cases in 2010 (28%) was not significantly different from that in 1999 (40%). In the Far East, Siberia and the North Caucasus the incidence of children is continuously increasing 4-6 times faster than those of adults. These characteristics of the epidemic process of Hepatitis A indicate the need for the introduction of a routine vaccination of children.

High disease burden of chronic virus hepatitis B and C of population in the Republic Sakha (Yakutia) is subject to referring it to endemic territories due to these infections. For a 15-year-old period the disease has been registered at higher rates in the Russian Federation.

The modified algorithm for laboratory confirmation and differential diagnosis of measles infection was developed and used in the laboratory studies of the Russian Laboratory Network (RLN) on Measles/Rubella Surveillance within the routine and active measles infection control. The algorithm consists in detecting the IgM, IgG and IgG avidity measles virus antibodies. To approve the modified algorithm sera samples of 637 patients with the measles diagnosis and 423 patients with rush and fever were studied. The IgG avidity measles testing is advisable in the following cases: a) only one serum sample is available, b) the recommended time interval between the 1st and 2nd sera samples taking is not observed, c) no diagnostic increase in titers of the IgG measles virus antibodies is evidenced, d) for determination of the type of immune response (primary or secondary) and e) to exclude the “false positive” results at the stage of detecting the measles virus IgM antibodies. Moreover the data obtained evidenced the involvement of the nonvaccinated (79.7%) as well as of vaccinated with 1 or 2 doses of measles vaccine (20.3%) population into the measles epidemical process.

The modified algorithm for laboratory confirmation and differential diagnosis of measles infection was developed and used in the laboratory studies of the Russian Laboratory Network (RLN) on Measles/Rubella Surveillance within the routine and active measles infection control. The algorithm consists in detecting the IgM, IgG and IgG avidity measles virus antibodies. To approve the modified algorithm sera samples of 637 patients with the measles diagnosis and 423 patients with rush and fever were studied. The IgG avidity measles testing is advisable in the following cases: a) only one serum sample is available, b) the recommended time interval between the 1st and 2nd sera samples taking is not observed, c) no diagnostic increase in titers of the IgG measles virus antibodies is evidenced, d) for determination of the type of immune response (primary or secondary) and e) to exclude the "false positive" results at the stage of detecting the measles virus IgM antibodies. Moreover the data obtained evidenced the involvement of the nonvaccinated (79.7%) as well as of vaccinated with 1 or 2 doses of measles vaccine (20.3%) population into the measles epidemical process.

Since discovery of Hepatitis C virus in 1989 and starting of official registration of acute and chronic cases of Hepatitis C (HC) in the Russian Federation in 1994 there are a lot of data demonstrating epidemic process development of HCV infection in the country as well as features of HCV epidemiology.

AIM Study molecular epidemiology of hepatitis C (HC) in 5 departments of hemodialysis (DH) in St. Petersburg. MATERIALS AND METHODS Sequences of nucleotides of 93 isolates including 67 isolates from patents of 5 DH and 26 isolates from patients, who never had hemodialysis in anamnesis, were obtained in 2010 by a method of limited sequencing of NS5B region of HC virus genome. Phyologenetic analysis was carried out by using PHYLIP veision 3.69 program package. Evolution differences were evaluated in DNADIST program using F84 algorithm. Phylogenetic trees were constructed by using nearest neighbor and UOGMA methods in PHYLIP program package. RESULTS Subtype 1b was established to dominate in all the DH (69.2 - 92.9%) and the same isolates of HC virus were detected in DH, that were isolated for the first time in 1999. Comparatively higher proportion of isolates of HC subgenotype 3a (26.7 - 30.8%) was detected in 2 of 5 DH in 2010. The same proportion of 3a isolates was detected in the control group. CONCLUSION The fact that HC 3a virus isolates were detected in DH in a higher proportion is proof that they have successfully integrated into circulation among dialysis patients over the last decade. ,

Since discovery of Hepatitis C virus in 1989 and starting of official registration of acute and chronic cases of Hepatitis C (HC) in the Russian Federation in 1994 there are a lot of data demonstrating epidemic process development of HCV infection in the country as well as features of HCV epidemiology.

Abstract. Hemo-contact viral hepatitis B and C is significant public health problem in hospitals and particularly in hemodialisys units. To define modern situation of the problem the retrospective study of viral hepatitis B and C registration in hemodialysis units in Saint-Petersburg in 1997–2007 as well as testing of 295 patients from four units for serological markers of hepatitis B and C (HBsAg, anti-HBs, anti-HBc, anti-HCV) have been conducted. It was determined that registration of hepatitis B in the study period was 5,2 cases per 1000 patients/per year, hepatitis C — 8,2 cases per 1000 patients/per year. These rates were significantly higher than in the total city population. The serological markers of ongoing or past HBV/HCV infection were revealed in 78,3 per 100 patients. Obtained results confirm intensive viral circulation in hemodialysis units. Additional study of transmission routes using molecular epidemiology techniques is required.

The study was aimed to evaluate vaccine prevention of hepatitis A in occupational risk groups in Russian Federation over 2011-2013. Epidemiologic analysis method was used. Data array for the analysis included information about 1,162,619 individuals vaccinated against hepatitis A throughout the country. Findings are that during the studied period a total of 470,278 adults over 18 years were vaccinated (i.e., 0,4% of all population of this age). Among occupational risk groups subjected to anti-hepatitis A vaccination within immunization calendar on epidemic indications, major (29%) share was presented by catering enterprises workers and individuals engaged into food trade and supply. Other occupational risk groups (workers maintaining water supply systems and sewerage system, medical staff, preschool institution teachers, etc) demonstrated significantly lower levels of being vaccinated. Vaccination against hepatitis Ain occupational risk groups should be in a focus of prophylactic measures, as will help to control over hepatitis A spread.

A clinical and epidemiological study for 14 years was conducted. Among TB patients, the percentage of persons with mixed infection (TB+HIV infection) increased during the observation period from 10 up to 64%. About one third of them had a pleura reaction with an accumulation of fluid between pleura’s petals. Pleuritis in patients with mixed infection were characterized by special features: pleurisy complicated another form of tuberculosis more often, in one-third of patients (29,8%) pleural liquid had hemorrhagic type, Mycobacterium tuberculosis in the pleural fluid was detected six times more often. The level of activity of adenosine deaminase and neopterin in the exudate of patients with tuberculosis and HIV infection remained significantly higher than in the control group of persons. These data can be useful in the diagnostics of specific diseases in HIV-infected patients.

AIMDetermine the frequency of antibodies to surface (anti-HBs) and core (anti-HBc) antigens of hepatitis B in population of St. Petersburg of various age for evaluation of protective herd immunity against hepatitis B virus (HB).MATERIALS AND METHODSBlood sera of 970 individuals (491 males, 479 females) of 10 age groups from 0 to 50 years and older were examined for the presence of anti-HBs and anti-HBc IgG by enzyme immunoassay using commercial diagnostic test-systems.RESULTSIn general anti-HBs at the level of 5 mIU/ml and above were detected in 603 of the examined individuals (62.2%). Anti-HBs at the level of 10 mIU/ml and above were detected in 53.9%. The frequency of anti-HBs in protective titers in males and females in general turned out to be similar (52.6% and 55.2%, respectively). Juxtaposition of age-specific parameters of seroprotection and acute HB morbidity in St. Petersburg revealed an inverse correlation of medium strength (r = - 0.54).CONCLUSIONResults of the study confirm high effectiveness of the program of HB vaccine prophylaxis in St. Petersburg and emphasize the necessity of further implementation of broad measures of population immunization against HB.

Heterogeneity of hepatitis B virus and its link with clinical course of infection and its outcomes remains one of priority directions of researches in Republic Sakha (Yakutia), as the region with high incidence of this disease. Blood serum samples with chronic hepatitis, registered in dispensary of various regions of the Republic Sakha (Yakutia), have been investigated. On the basis of results of the research by means of molecular - biological methods in the republic a genotype D was considered as the dominating genotype at patients with CHB, and sufficiently a large number of patients are infected simultaneously by two genotypes, most intensively circulating in the territory of Republic (A, D, C). For adequate therapy of such diseases it is necessary to consider characteristics of excreted isolates.

Abstract. The information concerning incidence, prevalence and morbidity of chronic viral hepatitis (CVH) in the territories of the Russian Federation for the period 1999–2009 is presented in the analytical review. The special attention is paid to multiyear dynamics of CVH registration, to diseases distribution by the Federal areas and separate territories as well as to CVH incidence in different age groups.

Abstract. Hemo-contact viral hepatitis B and C is significant public health problem in hospitals and particularly in hemodialisys units. To define modern situation of the problem the retrospective study of viral hepatitis B and C registration in hemodialysis units in Saint-Petersburg in 1997–2007 as well as testing of 295 patients from four units for serological markers of hepatitis B and C (HBsAg, anti-HBs, anti-HBc, anti-HCV) have been conducted. It was determined that registration of hepatitis B in the study period was 5,2 cases per 1000 patients/per year, hepatitis C — 8,2 cases per 1000 patients/per year. These rates were significantly higher than in the total city population. The serological markers of ongoing or past HBV/HCV infection were revealed in 78,3 per 100 patients. Obtained results confirm intensive viral circulation in hemodialysis units. Additional study of transmission routes using molecular epidemiology techniques is required.