Vol 23, No 1 (2018)
- Year: 2018
- Articles: 7
- URL: https://journals.rcsi.science/1560-9529/issue/view/2558
- DOI: https://doi.org/10.17816/EID.231
Articles
THERAPY OF RECURRENT HEPATITIS C AFTER TRANSPLANTATION OF THE LIVER WITH DIRECT ACTING ANTI-HEPATITIS C VIRUS DRUGS: EXPERIENCE OF THREE RUSSIAN CENTERS
Abstract
The results of a retrospective analysis of the experience of three Russian regional liver transplantation centers in relation to antiviral therapy of recurrent hepatitis C in liver recipients are presented. There were studied six different therapeutic schedules with direct antiviral drugs (DAVD) administered in 91 patients. The frequency of the persistent virologic response in 12 weeks after the completion of therapy (PVR12) amounted to 92.3%. In recipients, the use of a combination of sofosbuvir and daclatasvir seems to be the most promising as following its administration relapses observed in only 3 out of the 57 recipients were associated with drug resistance mutations to NS5A inhibitors. There were no serious adverse events related to the use of DAVD. The frequency of the reactivation of HBV infection against the background of DAVD therapy in liver recipients did not exceed the previously reported frequency of de novo hepatitis B in non-endemic regions. In recurrent hepatitis C patients after the liver transplantation effects of both the virus genotype, the pronouncement of graft fibrosis and the addition of ribavirin, on the frequency of SVO12 have not been revealed.
Epidemiology and Infectious Diseases. 2018;23(1):4-14
4-14
THE CLINICAL PICTURE OF INFLUENZA IN PREGNANT WOMEN
Abstract
Pregnant women are at the high risk for the development of severe both pandemic and seasonal influenza. There were analyzed medical histories of 277 influenza pregnant women observed in 2009-2016. Patients were divided into two groups: I (113 cases, 40.8%) - influenza A women (H1N1) pdm09, II (164 patients, 59.2%) - seasonal influenza pregnant women: A (H3N2) (109 females, 66.5%) or B (55 cases, 33.5%). Most women developed influenza in the second and third trimester of the gestation (114 cases, 41.2%, and 94 cases, 33.9%, respectively). The duration of inpatient treatment of pregnant women in the first group was significantly longer than in cases from the second group (p <0.01). In pandemic influenza pregnant women symptoms, as follows: a rise in body temperature to 38° C and higher (χ2 = 8.360, p <0,01), headache (χ2 = 10.468, p <0.01), dry cough (χ2 = 6.612, p <0.05), dyspnea (χ2 = 21.270, p <0.01), weakness (χ2 = 3.960, р <0.05), nausea and vomiting (χ2 = 8.197, p<0,01) were significantly more frequent than in patients with seasonal form. The severe course of influenza in women from the first group was significantly more frequent than in patients from the second group (χ2 = 17.717, p <0.01). In high pathogenic influenza pneumonia (φ*emp = 4.09, p <0.01) and catarrhal sinusitis (φ*emp = 1.914, р<0.05) were recorded significantly more often in comparison with seasonal form. 238 influenza pregnant women (85.9%) received the antiviral therapy. In influenza women from the first group the course of pregnancy was complicated by the development of edemas (φ*emp = 2.536, p<0.01), chronic fetal hypoxia (φ*emp = 2.247, p <0.05), premature and early discharge of amniotic fluid (χ2 = 4.723, p <0.05) significantly more often than in cases from the second group. Pandemic influenza was characterized by the more severe course due to the prevalence of severe manifestations of the febrile-intoxication syndrome in the clinical picture, high incidence of complications, among which pneumonia was leading and lethality in contrast with seasonal influenza.
Epidemiology and Infectious Diseases. 2018;23(1):15-22
15-22
FEATURES OF THE MECHANISMS OF TRANSMISSION OF HIV: VERBAL COMMUNICATION RESEARCH
Abstract
The aim of the study is to assess the features of the formation and implementation of the risks of HIV infection in the city of Moscow, taking into account the gender, type of contact, number of partners, sexual activity, information on the use of barrier protection means. To develop proposals for raising awareness of key (vulnerable) groups of the population. Materials and methods. A survey study involved 329 patients who were on the primary admission to the AIDS Moscow Municipal Center. Four groups of observation, separated by gender and HIV status, were selected. On the base of absolute values, the relative indices for each studied sigh were calculated, the errors in the representativeness of the relative indices were determined, the reliability of the differences in relative values was estimated, the probability of an error-free forecast was assumed to be equal to or greater than 95% (p ≥ 95%). Results and discussion There is established the high prevalence and significant role of anal intercourses (AIC) in the transmission of HIV infection to both men and women among the residents of the metropolitan region along with the lack of awareness of the potential risks of this form of sexual contact in the transmission of HIV infection. The low frequency of condom use by men practicing the AIC has been revealed. The preventive effect of control by women on the use of condoms by their partners has been confirmed. Conclusion As the main tasks to optimize preventive measures for HIV infection, it is necessary to consider informing key (vulnerable) population groups of the base of women's consultations and medical organizations of the dermatovenerologic profile concerning the potential danger of the AIC and the preventive value of barrier protection.
Epidemiology and Infectious Diseases. 2018;23(1):23-29
23-29
THE PATIENT HAS LISTERIOSIS MENINGITIS AT 33-34 WEEKS OF PREGNANCY. THEMULTIDISCIPLINARY SOLUTION
Abstract
In connection both with the continuing prevalence of the listeriosis disease, and polymorphism of clinical manifestations, as well as the high lethality rate, it is necessary to better understand this problem. Listeriosis infection often affects patients with the weakened immunity, the elderly persons, pregnant women, and newborns. In particular, in pregnant women, the risk of infection with listeriosis is 18 times higher than in the general population. This feature is due to cell-mediated immune suppression in pregnant women and placental tropism of the causative agent of listeriosis L. monocytogenes. The problem of listeriosis during pregnancy includes the maternal, fetal and neonatal disease. Listeriosis in a pregnant woman is usually characterized by a sharp onset, rapid development, and a high incidence, and often it does not take much trouble. Along with this, there are cases of asymptomatic, complicated and atypical variants of the disease, which requires a high degree of clinical awareness of various specialists and the implementation of adequate screening. Fetal listeriosis is characterized by the high mortality rate amounting to up 25-35%, depending on the gestational age at the time of the onset of infection. Clinical manifestations of listeriosis in newborn infants depend on the time and pathway of infection (antenatal or intranatal infection). Neonatal listeriosis can manifest as sepsis or meningitis with severe consequences and high mortality rate (up to 20%). The appropriate treatment of maternal listeriosis is aimed at preventing the fetal disease, it also has important therapeutic value for newborn babies. The empirical use of antibiotics may appear to be ineffective for listeria. Amoxicillin or ampicillin are at the first line of the treatment in pregnant women, alone or in the combination with gentamycin, followed by trimethoprim /sulfamethoxazole. The aim of the work is to summarize the available knowledge about the problem of listeriosis, including the features of the course of the disease during pregnancy, with presenting the example of a clinical case. The article reports a clinical case demonstrating the clinical problem of listeriogenic meningitis in a pregnant woman aged 35 years. Data showing different treatment strategies are also presented.
Epidemiology and Infectious Diseases. 2018;23(1):30-39
30-39
LIVER PATHOLOGY MANIFESTATIONS BY OPISTHORCHIASIS, DIAGNOSIS AND PREVENTION
Abstract
Research objective: identification of the nature of liver damage in residents of endemic territory with a chronic phase of opisthorchiasis. In 273 patients with chronic phase of opisthorchiasis, by the absence of markers of viral, autoimmune hepatitis and aggravating factors (drug and alcoholic nature) and duration of invasion for at least five years, there were revealed pronounced pathomorphological changes of cytolytic syndrome (40,3%) to liver fibrosis (2,6 %) and carcinogenesis (1,1%). The nature of the pathology (according to ultrasound, computed tomography, liver biopsy) indicated the development of steatosis and steatohepatitis (in 42,9% and 8,8% of cases observed, respectively) with hepatomegaly (57,5%) and disorders of pigment metabolism in 19,4% of patients. In 15,7%, hyperbilirubinemia with predominance of the indirect fraction was a manifestation of Gilbert’s syndrome. The presented data should be taken into account when conducting differential diagnosis, etiological interpretation of liver pathology in the group of unspecified hepatitis and cirrhosis for timely diagnosis of opisthorchiasis, complete dehelminthization and prevention of development of adverse outcomes in such patients.
Epidemiology and Infectious Diseases. 2018;23(1):40-43
40-43
THE DIFFICULTIES OF EARLY DIAGNOSIS OF FASCIOLIASIS IN HUMANS (DESCRIPTION OF CLINICAL CASE)
Abstract
Fascioliasis is one of the common types of helminths. Most disease affects cattle and, less frequently, the infestation occurs in humans. Caucasus Pathological changes associated with migration of worms through the liver parenchyma within 4 to 6 weeks. Characteristic features of the early stage are fever and leukocytosis with eosinophilia. Deworming is assigned after the extinction of the symptoms of the acute stage. The clinical case presented in details.
Epidemiology and Infectious Diseases. 2018;23(1):44-49
44-49
PROBLEMS OF TREATMENT OF TOXIC HEPATITIS ON THE BACKGROUND OF CHRONIC VIRAL LESION OF HCV-ETIOLOGY. CLINICAL EXAMPLE OF SUCCESSFUL THERAPY
Abstract
Epidemiological and clinical-laboratory features of the course of drug-induced and viral liver damage are considered. Clinical observation of severe toxic liver damage in a patient suffering from chronic viral hepatitis “C” is given. The authors share the experience of successful therapy.
Epidemiology and Infectious Diseases. 2018;23(1):50-56
50-56