[A syphilis marker study of blood component donors]. / Issledovanie markerov sifilisa u donorov gemokomponentov.

Laboratory testing of donor blood is the key point in prevention of hemotransmissive syphilis. The probability of using diagnostic EIA kit RecombiBest antipallidum-strip (AO Vektor-Best, Novosibirsk) is assessed. Ninety-two donor sera were tested. For assessing the sensitivity of the test system, 11 sera of syphilis patients were titrated by double dilutions 1:10 to 1:1280 for each strip. In parallel with this, antibodies to T. pallidum were assessed in the precipitation microtest. EIA proved to be not only highly specific, but more sensitive than precipitation microtest. Antibodies to T. pallidum are detected by EIA in serum dilutions at least two times higher than the minimal titers in the precipitation test. Thus, the above diagnostic kit is recommended for screening of donors of blood and its components.

[The spread of antibodies to cytomegalovirus and Toxoplasma among donors of blood components]. / Rasprostrannenost' antitel k tsitomegalovirusu i toksoplazme u donorov gemokomponentov.

The spread of IgG antibodies to cytomegalovirus and Toxoplasma in the blood sera of 323 donors of hemocomponents was studied. Among young males in the northwestern region of Russia three fourths were found to be seropositive to cytomegalovirus and one third, to Toxoplasma. In older ages the proportion of seropositive persons somewhat increased. In donors with blood group O (I) antibodies to cytomegalovirus occurred almost twice as often (91%) as in donors with blood group AB (IV) (47%). Among donors with blood group AB (IV) the proportion of persons seropositive to Toxoplasma (54%) was twice as great as that among donors with blood group O (I) (27%).

[Improving the detection of antibodies to hepatitis C virus in blood component donors]. / K sovershenstvovaniiu opredeleniia antitel k virusu gepatita C u donorov gemokomponentov.

The Avicenna test system (St. Petersburg) for detecting antibodies to hepatitis C is assessed. Two-hundred and ten sera with increased SGPT activity and 73 samples seropositive in screening by the Aquapast test system (St. Petersburg) were examined. Avicenna system with 3 synthetic peptides as the test objects is characterized by a higher sensitivity and specificity and is recommended for practical use at blood service institutions.

[Method of diagnosis of Epstein-Barr virus infection]. / Metod diagnostiki infektsii virusom Epshtein-Barr.

An original methodological approach to the diagnosis of Epstein-Barr virus (EBV) infection is proposed, consisting in the detection of viral DNA in peripheral blood lymphocytes using in situ DNA hybridization. EBV DNA was found in 6 (50%) patients with lymphomas and in 1 (33%) with infective endocarditis out of 26 examined recipients of blood components. No EBV DNA was found in peripheral blood lymphocytes of 14 regular donors. Normalization of the immune status of a patient and use of blood components containing no EBV is the key factor in the prevention of EBV infection. Biohit test system for in situ hybridization of EBV DNA may be used for diagnostic monitoring of EBV infection and screening of blood and tissue donors.

[Comparative characteristics of a test system for detecting antibodies to hepatitis C virus]. / Sravnitel'naia kharakteristika test-sistem dlia opredeleniia antitel k virusu gepatita C.

The sensitivities and specificities of enzyme immunoassay (EIA) kits for the detection of antibodies to hepatitis C virus (HCV) were compared in donor blood screening. A total of 3308 donors were examined using Akvapast immunodiagnosticum (St. Petersburg), lot 12. Anti-HCV antibodies were detected in 43 (1.3%) subjects. Blood sera of these donors were additionally investigated using other lots of Akvapast, Hepascan (Bioservice, Moscow), Blot-0.5 (Bioservice, Moscow), and immunoComb (France). The studies demonstrated that none of the agents used can be acknowledged as ideally sensitive and specific for the detection of anti-HCV antibodies. Maximally sensitive diagnostic kits should be preferred for the screening of donors of blood components and for other mass surveys. Highly-specific test systems are advisable for profound examinations and diagnostic monitoring. The creation of a system of reference and expert diagnosis of hepatitis C remains a pressing task.

[The problem of cytomegalovirus infection in military blood transfusions]. / Problema tsitomegalovirusnoi infektsii v voennoi transfuziologii.

The actuality of a problem of cytomegaloviral infection in military transfusiology is substantiated by the increasing number of immunocompromised recipients, mass use of hemocomponent therapy in prophylaxis and correction of anemia, thrombohemorrhagic and immunodeficient syndromes. Cytomegaloviral infection in the recipients of hemocomponents may have unfavourable consequences, such as the development of mononucleosis, enhanced sensitivity to opportunistic infectious agents as a result of virus-induced immunodepression, graft rejection, risk of the development of oncologic diseases, atherosclerosis, disorders in the processes of reparation and regeneration. In the northwestern part of Russia the cytomegaloviral antigens are disclosed in 65-75% of men, age 18-23. Actual tasks are the following: put into practice cytomegaloviral antigens test for donors, make a wide use of effective leukocytic filters for leukocyte removal from hemotransfusional medium, minimize posttransfusion immunosuppression, determine recipients who need transfusions of hemocomponents prepared from seronegative donors.

[Specific and substitute markers of hepatitis C in screening donor blood]. / Spetsificheskie i surrogatnye markery gepatita s pri skrininge donorskoi krovi.

The efficacy of specific and substitute markers of hepatitis C was compared in donor blood screening. 2615 blood donors were examined using two EIA kits for detection of HCV antibodies. The presence of nonspecific markers of non-A non-B hepatitis was also checked. 1.3% of the donors were found to carry HCV antibodies. This necessitates donor blood testing for anti-HCV antibodies using EIA. Such measure reduces three-fold the risk of the virus transmission with blood components and preparations. The preference should be given to more sensitive test systems of the second generation, whereas less sensitive, but more specific, test systems are more valuable for accurate diagnosis and treatment effects assessment in HCV infection. It would be appropriate to perform compulsory examinations for HCV infection in medical staff. This will entail efforts on development of the infection diagnostic verification criteria and preventive measures.

[Alanine aminotransferase--a surrogate marker of viral hepatitis]. / Alaninaminotransferaza--surrogatnyi marker virusnogo gepatita.

Examinations of 4457 blood donors (about 80% were men aged 18 to 30) revealed an increased level of serum glutamic-pyruvic transaminase (SGPT) in 82 (1.8%). Specific markers of viral hepatitis C were detected in 15.9%, of hepatitis B in 12.0%, of hepatitis D in 2.0%, of hepatitis E in 8.0%, of hepatitis A in 2.0% of sera with high SGPT levels. Mandatory screening of blood donors revealed specific markers of viral hepatitis in 15.9% of cases, additional testing detected these markers in 10.9% cases more. A conclusion is made that an increase of SGPT activity is an independent surrogate marker of viral hepatitis.

[The hepatitis C problem in transfusions in military medicine]. / Problema gepatita C v voennoi transfuziologii.

The article contains data on viral hepatitis C, its etiological factor, epidemiology, methods of diagnosis and prophylaxis. It's high time to conduct 100% screening control of donors for viral hepatitis C antibody, using national test system of fermental analysis. The authors worked out the method of "dry drop" to study the serum for hepatitis C virus antibody.

[The military medical aspects of HIV infection]. / Voenno-meditsinskie aspekty infektsii VICh.

PIP: During 1988-89 the medical department of the S. M. Kirov hospital diagnosed 50 HIV-infected military personnel who had contracted the disease in Africa. Among 270,000 prisoners from 17 countries the rate of HIV infection ranged from 11% to 26%. Among US Army recruits the rate of HIV seropositivity was found to be 1.5%. Among Navy soldiers the rate was 0.24%. During 1985-87, in the navies of different countries, 2051 men had contracted HIV infection, most of whom had no idea about transmission and prevention. At the Kirov military hospital during 1988-89 a comparison of HIV infection rate was made involving 545 people. Among foreigners the rate was 17.2 times higher than among citizens. In a massive screening experiment involving 47,447 people in Kalmykia a rate of 2.9% was found among local citizens compared to 1.9% among foreigners. Diagnosis relies on various antibody tests, of which the Welcozyme test system has yielded only a 2.3% rate of false positive results. In 1989 the immunological status of 73 false positive results from 20 HIV-infected people was examined. These investigations revealed that the absolute amount of T-4 cells, the index of differentiation of T-4/T-8, and the functional activity of lymphocytes diminished in the infected people, while a slight increase of T-8 count did occur. The study of the blood lymphocytes showed that in the infected people the activity of lactate dehydrogenase and mitochondrial isoforms of malate dehydrogenase decreased somewhat, while the activity of succinate dehydrogenase and especially of glucose-6-phosphate dehydrogenase increased. In persons infected with HIV, the T- suppressor cell count increased and T-helper cell count decreased, which leads to the decrease of the functional indices of the immune system. Military health services are obliged to inform the servicemen about AIDs for health protection and the spouses of those infected with HIV should also be notified.^ieng