[Anti-CD4 autoimmunity in HIV-infected persons in Russia].

The frequency of anti-CD4 antibodies was determined in the sera or plasma derived from the patients infected with HIV-1 belonging to different genetic subgroups. The anti-CD4-antibodies in a dilution of > or = 1:1000 were found in 14% of the patients infected with the gagA/envA virus characteristic for injectable drug users in East Europe. The frequency of autoimmune antibodies among the HIV-infected patients with envB virus was substantially less (4.4%). Competitive ELISA using monoclonal antibodies to different CD4 domains demonstrated that irrespective of the viral genotype, the autoimmune epitope is located within the D4 or D3/D4 domains of CD4 receptor.

[Determination of the level of antibodies to CD4 in serum of patients with malignant lymphomas and of HIV-infected individuals]. / Opredelenie urovnia antitel k CD4 v syvorotke krovi u bol'nykh zlokachestvennymi limfomami i u VICh-infitsirovannykh lits.

Hardphase ELISA was used to compare the blood sera of patients with malignant skin lymphomas and HIV infection and of healthy volunteers for autoimmune antibodies to CD4. Antibodies to CD4 were not detected in the volunteers (30 sera) and in the patients with malignant skin lymphomas (52 patients with different disease stages). The antibodies were found in 4 of 11 HIV cases.

[Distribution and features of infection with hepatitis viruses B and C during hemodialysis treatment]. / Rasprostranennost' i osobennosti infitsirovaniia virusami gepatitov B i C v usloviiakh lecheniia gemodializom.

The prevalence of hepatitides B and C was evaluated in 140 patients treated by hemodialysis. Almost half of patients (48%) had acute hepatitis B which completely resolved. Acute hepatitis B was detected in 6% in the course of observation. In 6% chronic hepatitis B was diagnosed, and in 24% chronic hepatitis C. A combination of hepatitides B and C was diagnosed in 2% patients. Only 12% patients were not infected with hepatitis. Genotype 1b predominated in patients with HCV infection (73%); genotypes 1a, 21, and 3a were equally incident (9%). Replication of HBV and HCV in patients with uremia under conditions of hemodialysis was detected in 83 and 86% patients, respectively. Relationship between HBV and HCV infection and the duration of hemodialysis treatment was analyzed. The percentage of non-infected patients persistently decreased, and the time course of HBV and HCV infection was different. Infection with HBV after the beginning of hemodialysis occurred sooner (16.0 +/- 4.0 months) than with HCV (30.2 +/- 4.6 months, p < 0.04). The levels of SGPT and SGOT in patients with various manifestations of HBV and HCV infection treated by hemodialysis were followed up.

[Regularities in the spread of hepatitis C virus and its genotypes in Russian and countries within the former USSR]. / Zakonomernosti rasprostraneniia virusa gepatita C i ego genotipov v Rossii i stranakh SNG.

The incidence of markers of hepatitis C virus (HCV in the blood of 4216 normal subjects living in the European Russia (Northern, North-Western, Central, Central Chernozem, Volga-Vyatka, Volga, and North Caucasian regions), in the Urals, in Siberia (Eastern Siberian region), in the Far East, and in Monogolia is assessed. The incidence of antibodies to HCV varied from 0.7% in the Central region to 3.8% in the Central Chernozem and 10.7% in Mongolia. HCV genotyping (identification of 1a, 1b, 2a, 2b, and 3a genotypes) was performed using 469 RNA of HCV-positive sera of donors and patients collected in Russia, Moldova, Turkmenistan, and Mongolia. The 1b genotype predominated everywhere (68.9%), its incidence being the highest in Moldova (96%). Unclassifiable variants of HCV were found in 28 (6%) of sera. The regularities of HCV genotypes circulation in the European Russia were the same as in other European countries, whereas their prevalence in Eastern Russia was rather like that in China or Japan. The prevalence of genotypes did not depend on the clinical manifestations of diseases caused by HCV.

[Cytomegalovirus infection in women of reproductive age with an at-risk obstetrical history]. / Tsitomegalovirusnaia infektsiia u zhenshchin reproduktivnogo vozrasta s otiagoshchennym akusherskim anamnezom.

Studies aimed at the detection of cytomegalovirus infection (CMVI) in women of reproductive age with obstetric complications in their medical history were carried out. 230 women aged 17-44 years were examined with the use of virological and serological tests. As the result of complex examination, CMVI markers were detected in 159 (69%) of women. Three forms of CMVI were detected in the examined women: latent (30%), reactivated (14%) and persistent (25%). This investigation revealed that the most complete detection of CMVI and the evaluation of its activity in women with obstetric complications in their medical history requires the combined use of virological and serological tests.

Prevalence of hepatitis C virus and distribution of its genotypes in Northern Eurasia.

We tested hepatitis C virus (HCV) antibody in 4216 sera collected from healthy people living in European part of Russia (including Northern, North-Western, Central, Central-Blacksoil, Volga-Vyatka, Volga, and North-Caucasian regions), non-European part of Russia (the Urals, East-Siberia, and the Far-East regions) and Mongolia. Prevalence of HCV antibody varied significantly by regions, ranging from 0.7% in Central region of European part of Russia to 10.7% in Mongolia. Genotyping of HCV (into 1a, 1b, 2a, 2b, and 3a) was performed on 469 sera from blood donors and patients (in Russia, Moldova, Turkmenistan, and Mongolia) who were positive for both HCV antibody and RNA. Genotype 1b was the most dominant genotype irrespective of regions (68.9%), with the highest rate in Moldova (96%). HCV unclassifiable into genotypes 1a-to-3a was found in 28 (6.0%) samples: particularly 4 of 10 samples from Lipetzk were untypable. Overall, HCV genotypes in European part of Russia were more similar to those in European countries, while those in Eastern part of Russia more similar to China or Japan. Genotype distribution was not associated with the clinical expression of HCV disease: acute hepatitis, chronic hepatitis or liver cirrhosis.

[The diagnosis and clinical characteristics of cytomegalovirus infection in HIV-infected subjects]. / Diagnostika i klinicheskaia kharakteristika tsitomegalovirusnoi infektsii u VICh-infitsirovannykh lits.

Out of 180 HIV carriers active cytomegalovirus (CMV) infection was found in 30 patients, in 16 cases the infection manifested clinically. Most of the latter were patients with HIV infection IIIb or IIIc stage against persistent lowering of CD4-lymphocyte count under 100/mm3. Active CMV infection may be determined most significantly by the following criteria: high or moderate concentrations of CMV DNA in the blood, low concentrations of blood CMV DNA in the presence of long-term (at least 3 months) persistence of anti-CMV IgM and isolation of urinary CMV. CMV infection manifested usually as a generalized disease with typical signs of retinitis, myelitis, erosive-ulcerative colitis. Most patients had thrombocytopenia, functionally defective platelets. CNS involvement predicts poor prognosis in CMV-infected HIV carriers.

[Prevalence of genotypes of the hepatitis C virus, circulating in northwestern and central parts of Russia]. / Rasprostranenie genotipov virusa gepatita C, tsirkuliruiushchikh na territoriiakh severo-zapadno i i tsentral;no i chaste i Rossii.

Testing of 90 sera for antibodies to hepatitis C virus (HCV) by genotyping methods resulted in determination of the genotype in 83 cases: 47 cases with 1b genotype, 27 with 1a, 7 with 3a, 1 with 2a, and 1 with 2b genotype. Hence, preliminary data indicate the predominance of HCV genotype 1b among patients with hepatitis C in these regions of Russia.

[The current problems in the epidemiology and prevention of enteric viral hepatitis in Russia]. / Aktual'nye voprosy épidemiologii i profilaktiki énterial'nykh virusnykh gepatitov v Rossii.

The presence of great differences in the activity of the epidemic process of hepatitis A (HA) in some regions of Russia is shown and the data necessary for establishing the structure of HA foci in groups of children, as well as the proportion of different forms of the disease registered in such foci (the icteric form in 22.7% of patients, the obliterated form in 11.3% of patients, the nonicteric form in 45.5% of patients and the asymptomatic form in 20.5% of patients), are presented. The study revealed that the shedding of HA virus occurred at an early stage (5-10 before a rise in alanine aminotransferase activity in the blood was registered), its excretion lasted for a short time (till jaundice appeared) and no chronic carriership of HA virus was registered. The hospitalization of HA patients after the appearance of jaundice was proved to be unjustified, while measures aimed at the rupture of the fecal-oral mechanism of the transmission of HA virus were shown to have good prospects. The epidemiological features of hepatitis E (HE) are considered. HE cases constituted 2-3.6% of all patients with acute viral hepatitis in Moscow (all these cases were brought from Central Asia). The outbreaks of this infection in the countries of Central Asia were shown to be due to the transmission of the infective agent by the water route. The data on the first results of the use of high-titer specific immunoglobulin for the prophylaxis of HE among 135 pregnant women (only one of these women contacted HE, while in a similar group of women used for control 4 HE cases were registered) are presented.

[The enhancement of the diagnostic reliability of immunoblot for HIV-1 antibodies by enriching the preparation for immunoblot with the HIV-1 gp120 protein]. / Uvelichenie diagnosticheskoi dostovernosti immunoblota na antitela k VICh-1 za schet obogashcheniia preparata dlia immunoblota belkom gp120 VICh-1.

The diagnostic value of original immunoblot system depends on the availability of enveloped protein GP120 because it is the antibodies to this polypeptide that frequently indicate the running virus infection. This polypeptide is lost during purification of viral material but remains free in culture medium. The extraction of GP120 from culture fluid with immunosorbent based on sepharose 4B with ligated immunoglobulins from HIV-1-infected persons enriched the preparation for immunoblot with proteins increasing its diagnostic value.

[Clinical picture of congenital Cytomegalovirus infection in infants in their first year of life]. / Klinicheskaia kartina vrozhdennoi tsitomegalovirusnoi infektsii u detei pervogo goda zhizni.

A study was made of the clinical picture of congenital cytomegaloviral infection in 40 children of the first year of life. The diagnosis was established on the basis of demonstration in all the patients of IgM antibodies to cytomegalovirus (IgM anti-CMV) by EIA with the aid of the commercial test systems. Besides, 81% of the children were found to have cytomegalic-specific cells in urine, 17.6% in saliva, and 72.5% demonstrated IgG anti-CMV (in accordance with EIA). The majority of the patients (70%) were born premature. The most typical clinical signs of congenital cytomegaloviral infection were adynamia, jaundice, liver and CNS injury, prenatal hypotrophy; 45% of the children had developmental abnormalities and stigmas of dysembryogenesis. In 97.5% of the mothers, the pregnancy ran a pathological course. The disease history often pointed to miscarriages (10%) and death of the children due to intrauterine infection in the early times after birth (15%).

[The characteristics of the HIV isolated from HIV-infected persons and AIDS patients on the territory of the CIS]. / Kharakteristika VICh, vydelennykh ot VICh-infitsirovannykh lits i bol'nykh SPIDom na territorii SNG.

HIV strains were isolated from HIV-infected patients and AIDS patients in CIS. A total of 81 HIV isolates were obtained. The isolates were identified by using immunofluorescence and enzyme immunoassay, by determining the activity of reverse transcriptase, immunoblot, electron microscopy, polymerase chain reaction. Of the 81 isolates 79 were HIV-1 and 2 HIV-2. The strains differed in their infectivity, the kinetics of virus antigen accumulation, and the spectrum of susceptible cell lines. The viruses isolated may be assigned as two groups: high and low infective. The biological properties of the national HIV isolates were shown to be similar to the prototype HIV strains isolated elsewhere.

[The detection of antibodies to HIV protein p24 in human blood sera by the method of lanthanide immunofluorescent analysis]. / Vyiavlenie antitel k belku p24 VICh v syvorotkakh krovi cheloveka metodom lantanidnogo immunofliuorestsentnogo analiza.

A competitive time-resolved fluoroimmunoassay (TR-FIA) system for the detection of antibodies to protein p24 of HIV was developed on the basis of monoclonal antibodies. The advantages of this test system over analogous enzyme immunoassay system and commercial test system "Antigen" (USSR) were demonstrated. The newly developed test system of TR-FIA was used for examination of sera from HIV-infected persons.

[The sensitivity of rhesus and cynomolgus macaques to the human hepatitis A virus]. / Chuvstvitel'nost' makak rezusov i iavanskikh makak k virusu gepatita A cheloveka.

Hepatitis A infection characterized by virus excretion in feces, synthesis of specific IgM antibody, increased activity of alanine aminotransferase in the blood serum, and a complex of morphological lesions in the liver typical of acute hepatitis was reproduced in M. fascicularis (M. f.) and Macaca rhesus (M. r.) using 2 strains of hepatitis A virus (HAV) isolated from human patients. The incubation period varying from 9 to 23 (mean 16) days in M. f. and from 12 to 35 (mean 18) days in M. r. in primary infection shortened to 1-12 (mean 10) and 3-6 (mean 5) days in the process of virus passage from monkey to monkey. The disease was observed to run both manifest forms (except jaundice) typical of human HA and an inapparent form in which the level of enzymes remained within normal limits but HAV could be detected in feces, anti-HAV-IgM in the blood serum, and morphologically acute hepatitis in the liver. Immune electron microscopy of both the initial material and in monkey feces at the levels of all three passages revealed complexes consisting of spherical viral particles 27-29 nm in size coated with antibodies. The immune complexes formed upon addition to the fecal extracts under study of IgG isolated both from human convalescent sera and from sera of experimentally infected monkeys collected in the acute stage of the illness.

[Experimental model of hepatitis A in rhesus monkeys (Macaca mulatta) infected with human hepatitis A virus]. / Eksperimental'naia model' gepatita A na makakakh rezusakh (Macaca mulatta), zarazhennykh virusom gepatita A cheloveka.

The focus of this paper is characterization of Hepatitis A experimental model obtained for the first time in rhesus monkeys (M. mulatta) infected with fecal isolate from a patient with Hepatitis A (HAV-H1). Monkeys were susceptible to oral and intravenous routes of HAV inoculation. The disease could be reproduced regularly in 4 passages as a result of which HAV strain continuously pathogenic for M. mulatta has been established. All 17 infected monkeys developed Hepatitis A with characteristic (except jaundice) patterns: shedding of virus with the stool, elevations of serum alanine aminotransferase level, appearance of IgM anti-HAV, morphological changes developed in the liver. Our data have demonstrated that the course of experimental Hepatitis A infection in M. mulatta is similar (in many respects) to that observed in man.

[The use of immunoenzyme analysis in studying the etiologic structure of influenza morbidity in 1985-1988]. / Primenenie immunofermentnogo analiza dlia izucheniia étiologicheskoi struktury zabolevaemosti grippom v 1985--1988 gg.

In the periods of epidemic increases in the incidence of influenza in 1985-1988, approximately 600 patients with clinical diagnoses of ARVI and influenza were examined for the presence of viral antigen in nasopharyngeal washings by solid-phase enzyme-immunoassay and for antibody rises in paired blood sera. The use of modified SPEIA and original test sera for influenza type A and B viruses in rapid diagnosis of influenza made it possible to decode the etiology of the epidemic situations in 1985-1988. Influenza A and B virus antigens were detected in a high portion of the examined nasopharyngeal washings. The analysis of the distribution of positive results in the detection of viral antigen in the clinical specimens and in influenza serodiagnosis demonstrated a high correlation of the results (93.9%). The etiological pattern of influenza in recent years is characterized by simultaneous circulation in the human population of influenza A (H1N1, H3N2) and B viruses, as reflected by detection of mixed infections in 1-3% of the cases.

[A possible variant of a false diagnosis of infection with the human immunodeficiency virus]. / Vozmozhnyi variant lozhnoi diagnostiki infitsirovaniia virusom immunodefitsita cheloveka.

The authors describe a patient who demonstrated positive blood responsiveness to the nuclear antigens of human immunodeficiency virus (HIV) (p17, p31 and p55), observed steadily for 1 year and 4 months. The donor's disease history consideration made it impossible to include him in one of the known groups at risk for HIV infection whereas the lack of any changes in immunoblotting enabled one to exclude the diagnosis of HIV infection. The given case and other similar cases form the basis for introducing the second parallel screening during blood testing for HIV infection to bar the use of such blood for transfusion.

[Specific immunity in preschool children at high risk of infection with hepatitis A virus]. / Spetsificheskii immunitet u detei preshkol'nogo vozrasta v usloviiakh vysokogo riska infitsirovaniia virusom gepatita A.

The dynamics of postinfection immunity to hepatitis A (HA) in preschool children was studied for 2 years in an area with a high activity of the epidemic process. In primary examinations by radioimmunoassay, anti-HAV were found in 82% of the subjects. The degree of the immunity intensity was found to be markedly variable: in 21% of the children the titre of anti-HAV was 1:10, in 28%-1:40, in 37%-1:160, in 14%-1:640. One year later, in the group of children with titres 1:10-1:40 the antibody level increased from 4- to 64-fold in 66% of the subjects. The rate of increase expressed in mean coefficients of antibody rise were the higher the lower the initial anti-HAV titres were. In the children with the initial titre below 1:10 this value approached 100, and anti-HAV-IgM were found in half of the examined subjects, one third of them having experienced the jaundice form of HA. The children with titres of 1:10-1:40 were found to have both manifest (14% and 11%, respectively) and asymptomatic (only anti-HAV-IgM) forms of HA. In the group of children with titres of antibody of 1:160-1:640 neither manifest HA forms nor anti-NAV-IgM could be detected. In this group the anti-HAV titre increased 4-fold or more in only 9% whereas a decrease was observed in 59% (with titre of 1:160) and in 73% (with titre of 640). No changes in anti-HAV levels were observed in 32% and 18%, respectively. Thus, the results of the study indicate that at low levels of postinfection immunity reinfection with HAV is possible and may run both manifest and asymptomatic course.

[Immune structure and rubella incidence in pregnant women in Moscow]. / Immunostruktura i zabolevaemost' krasnukhoi u beremennykh zhenshchin Moskvy.

The immune structure of the Moscow City population (mostly, pregnant women) in relation to rubella virus antigen. Specific antihemagglutinins were found in 82%-93% of pregnant women, depending on their age. Examination of sera from 207 pregnant women who had contacts with rubella patients demonstrated clinically manifest rubella verified serologically in 9.2%, and asymptomatic form of rubella in 8.6%. By an immunochemical method (treatment of sera with staphylococca reagent) specific rubella IgM were found in 7 (100%) pregnant women who had experienced clinically manifest rubella, and in 6 (14.3%) pregnant women with asymptomatic rubella.

[Serological proof of the existence of a variety of non-A, non-B hepatitis with a fecal-oral transmission mechanism]. / Serologicheskie dokazatel'stva sushchestvovaniia raznovidnosti gepatitia ni a, ni B s fekal'no-oral'nym mekhanizmom peredachi.

An outbreak of hepatitis in one of Siberian regions mainly among adults of 19-35 years of age was studied. The epidemiological studies showed the infection to spread by the fecal-oral mechanism of transmission. In 90% of the patients the disease was mild, in 10% of moderate severity; no severe forms or fatal outcomes were observed. This refers also to pregnant women irrespective of the term of pregnancy. Among 78 subjects examined, antibody to hepatitis A virus of the IgM class (anti-HAV-IgM) were detected in 14%, HBsAg in 6%. No rise in titer of total anti-HAV in the convalescent period (within 3-6 months) was observed. Immune electron microscopy studies of fecal extracts from patients revealed immune complexes of virus particles 32-35 nm in size which were formed only with sera from patients in the acute stage and convalescents from this outbreak (to a lower degree). Negative results were obtained with sera containing anti-HAV and antibody to hepatitis non-A-non-B virus (HnAnB) with fecal-oral transmission mode from India, Central Asia, and Afghanistan. These data attest to the distinct nature of this causative agent among HnAnB viruses with the fecal-oral transmission mechanism.