[Experience of anticipatory therapy with IL-6 receptor inhibitors and perspectives for its use in the evolution of COVID-19].

The Advisory Board chaired by the chief specialist in infectious diseases of the Ministry of Health of Russian Federation, Professor V.P. Chulanov was held on June 18, 2022 in Saint Petersburg. Aim. The main purpose of the Board was following discussion: the analysis of the real-world data of levilimab as an anticipatory therapy for COVID-19 in hospitalized patients; the review of the experience and perspectives of levilimab as an anticipatory anti-inflammatory option for outpatient patients who meet defined clinical and laboratory criteria. Results. The analyzed data on clinical efficacy and safety formed the basis of recommendations proposed by experts for the use of levilimab in the inpatient and outpatient medical care for COVID-19.

[Features of dermatological pathology on the background of HIV-infection].

Over the past decade, there has been an increasing number of patients infected with HIV. The disease gradually leads to a pronounced immunodeficiency and death. In the vast majority of patients, polymorbidity phenomena are noted, which leads to the need for a differentiated interdisciplinary approach to their management. The knowledge of dermatologists of other dermatological aspects of HIV-infection by dermatologists and doctors will allow timely early detection of HIV-infected patients and avoid diagnostic errors. A clinical follow - up was carried out which showed issues of diagnostics while examining patients with HIV infection in outpatient practice.

[Review of current and future directions of antiviral therapy of influenza and acute respiratory viral infections in Russia].

AIM: to determine the perspectives for the use of drugs with combined antiviral, anti - inflammatory and immunomodulatory activity on the basis of medical studies of existing antiviral drugs for the treatment of influenza and acute respiratory viral infections in Russia. MATERIALS AND METHODS: A brief review of the antiviral drugs used in Russia for the treatment of influenza and acute respiratory viral infections was conducted on the basis of 37 articles published in Scopus, Web of Science (WoS), and RSCI databases in the period from 1997 to 2018. RESULTS: Resistance to neuraminidase inhibitors (oseltamivir, zanamivir), is slowly developing due to the mutations of the neuraminidase gene H275Y and Q136K. Most influenza A viruses remain resistant to adamantane antivirals. Repeated use of immunomodulators with indirect antiviral action leads to a hyporeactivity of the immune system and, subsequently, to a decrease in their effectiveness. Positive clinical and laboratory data in clinical trials were obtained using Enisamium iodide, a drug with combined action - direct antiviral, and immunomodulatory. CONCLUSION: According to the WHO strategy, the results of the review demonstrate the need for continued research of medications with combined antiviral and pathogenetic effects on the infectious process caused by influenza and acute respiratory viral infections.

[The clinical laboratory characteristic of primary acute cytomegalovirus infection in non-immunocompromised adult patients].

The purpose of study is the clinical laboratory characteristic of acquired acute cytomegalovirus infection in nonimmunocompromised adult patients. The sampling included 75 patients with acquired acute cytomegalovirus infection admitted to the specialized clinical infection hospital of the Minzdrav of the Krasnodar kraii. The verifcation of diagnosis was implemented using serological tests and polymerase chain reaction. It is demonstrated that males of younger age are most often infected with acute cytomegalovirus infection in the Krasnodar kraii. The disease takes its course in a generalized form. In clinical picture symptoms of intoxication (long-term temperature increasing, weakness), hepatomegaly with increasing of activity of hepatic enzymes, splenomegaly, monolymphocytosis prevail. In most of patients, manifestation of affection of upper respiratory tracts are observed and less frequently - community-acquired pneumonia. The alteration of immune status of patients in dynamics of disease was typical for acute faze of viral infection process with transition to a latent one. At the same time, certain percentage of patients preserved inhibition of neutrophil chain of immunity during re-convalescent period, hence developing menace of bacterial complications. The complex treatment with inclusion of etiotropic anti-viral pharmaceutical Gancyclovir with duration of 8,4±0,4 days resulted in normalization of fever, relief of organic affections and also disappearance of viral DNA from blood. The rate of wrong preliminary diagnoses (85.3%) at referral of patient to hospital testifes complicacy of clinical diagnostic of acute cytomegalovirus infection, conditioned by absence of pathognomonic symptoms under this disease. The last circumstance determines expediency of inclusion into algorithm of examination of patients with unidentifed genesis of fever, hepatosplenomegaly, lymphadenopathy, monolymphocytosis, increasing of activity of hepatic enzymes the analysis of antibodies to antigens of cytomegalovirus (IgM CMV, IgG CMV, avidity of IgG CMV) using enzyme-linked immunosorbent assay and also detection of DNA CMV in blood and urine using polymerase chain reaction technique. The alterations of immune status during re-convalescent period observed in one third of patients determine necessity of their dispensary observation.

[CLINICAL-EPIDEMIOLOGICAL CHARACTERISTIC OF WEST NILE FEVER IN KRASNODAR REGION].

AIM: Clinical-epidemiological characteristic of West Nile fever on the territory of Krasnodar Region in multi-year dynamics. MATERIALS AND METHODS: Manifestations of epidemic process and clinical symptoms of West Nile fever (WNF) on the territory of Krasnodar Region were analyzed retrospectively from 1988 to 2013. Results of epidemiologic observations wiih inclusion of monitoring of arbovirus circulation, carried out by Prichernomorskaya Station of Plague Control and Centre of Hygiene and Epidemiology in Krasnodar Region were used. Clinical course of verified WNFwas studied in 62 patients, treated in the Specialized Clinical Infectious Hospital ofKrasnodar in 1999-2012. RESULTS: Clinical-epidemiologic characteristic of cases of West Nile fever morbidity on the territory of Krasnodar Region is presented. The presence of acting foci of arbovirus infections was noted. Clinical signs of the disease are established, patients allocated into groups that require examination for West Nile fever. CONCLUSION: Complex of entomologic-virologic monitoring, prophylactic and counter-epidemic measures was determined, that allow to prevent emergence of dangerous epidemiologic manifestations of foci of the disease in the future.

[The acquired overt cytomegalovirus infection (primary form and reactivation) in adult immune safety patients].

The analysis was applied to clinical course of disease in 102 patients with acquired overt cytomegalovirus infection (75 patients with primary form, 27 patients with reactivation). The primary form of acquired overt cytomegalovirus infection was identified on the basis of detection in enzymoimmunoassay of CMV-lgM under negative CMV-IgG or CMV-IgM and CMV-IgG with avidity less that 50%. The reactivation was diagnosed under identification of CMV-IgG with avidity 50% and more with low indicators of CMV-IgM. The acquired overt cytomegalovirus infection occurs more often in males of young age and proceeds mainly in generalized medium severe form with fever, intoxication and hepatosplenomegaly. The clinical differences are limited by higher rate of generalized forms of disease, febrile fever, weakness, hepatomegaly with increasing of activity of aminotransferase of blood serum, manifestation of signs of affection of respiratory tracts and increase of number of atypical mononuclear leukocytes of peripheral blood in patients with primary form of acquired overt cytomegalovirus infection as compared with reactivated infection.

[The role glucose-6-phosphate dehydrogenase in pathogenesis of anemia in leptospirosis]. / Rol' gliukozo-6-fosfatdegidrogenzy v patogeneze anemii pri leptospiroze.

The activity of glucose-6-phosphate dehydrogenase (G-6-PDG) of plasma and erythrocytes, levels of erythrocytes, hemoglobin, free hemoglobin and reticulocytes in different periods of illness were assessed in 30 men with severe icteric leptospirosis and anemia. Elevation of plasma G-6-PDG activity, levels of free hemoglobin (FH) and reticulocytes were found. Hemolysis was more pronounced at the height of the disease. One of the causes of hemolysis in severe leptospiral jaundice may be deficiency of erythrocytic G-6-PDG which is inheritable male disease. Low G-6-PDG activity of erythrocytes on the second week of the illness preceded anemia in 83.3% cases which could be a prognostic criterion of developing anemic syndrome. Combined treatment of leptospirosis with administration of tocopherol acetate resulted in a significant fall of plasma FH and G-6-PDG, of severity and duration of anemia versus the control group.