HIV-infected patients have been provided with medical care for 30 years in Primorskiy territory. The article gives the information about medical care from its formation to the present day. The role of specialists of regional center for AIDS and infectious diseases control in achievements of stabilizing epidemic of HIV-infection is emphasized. The article presents gender, agу composition of patients and modes of HIV transmission. It shows achievements of preventive care to reduce the number of perinatal infections with increasing number of childbirths and number of women with HIV-infection in Primorskiy territory. It is shown that early medical examination of HIV-infected patients is one of the main factors to extend life-span and to increase quality of life. The ultimate goal of preventive care for specialists of center for AIDS control, volunteers, members of non-profit organizations is a formation of healthy lifestyle in people in Primorskiy territory and prevention not only HIV-infection but also viral hepatitis with parenteral route of infection, and drug addiction as well.

Literature review covers viral hemorrhagic fevers (VHF) in countries of Asian part of Asia-Pacific Region. We presented regional extensiveness and tendencies of incidence of most prevailing VHF such as Dengue fever, hemorrhagic fever with renal syndrome, and severe fever with thrombocytopenia syndrome, and also possibilities to prevent them. We approach a problem of specific treatment of VHF considering mechanisms of action and cytotoxicity of drugs, and tendencies of usage of less toxic pluripotential recovered from hydrobionts of Pacific Ocean as well.

We have analyzed literature data related to contagion issue and Acinetobacter baumannii strains circulation in hospital conditions; we have considered questions of development of resistance to antibiotics, invasion factors and quorum sensing that enables them to bear significant changes of environmental conditions such as drying and cleaning with detergents. Carbapenems have before used as a drug of choice to treat infections caused by A. baumannii. However resistance improvement of bacterium to this group of antibacterial drugs caused by β-lactamases of groups B and D makes further therapy with carbapenems senseless. We have assessed the role of process of formation of biofilms by A. baumannii strains, which facilitate bacteria persistence in human body and serve as important virulence factor. Organizing effective and dynamic infection control in resuscitation and intensive care departments is considered to be an important trend in quality management and healthcare services.

Morphological and functional disorders of digestive system in HIV-infection are found throughout the entire gastrointestinal tract: in oral cavity, esophagus, stomach, small and large intestine, liver, pancreas gland, gallbladder. A literature review on etiology and clinical manifestations of gastrointestinal tract in HIV-infected patients is presented. It is shown that digestive system affection in HIV-infection is caused not only by direct virus action but also by influence of opportunistic agents, and by chronic inflammation and immunodeficiency aggravation without antiretroviral therapy. Against the background of a specific treatment, gastrointestinal damage can develop due to polypharmacy. The use of probiotics may be considered a promising trend of intestine biocoenosis recovery in patients with HIVinfection.

Objective is to assess and to update treatment approaches with antiretroviral drugs for patients with HIV-infection in Primorskiy territory.
Methods: We analyzed antiretroviral therapy regimen to prevent ant to treat disease using materials of annual reports of territories and chronological data in Primorskiy territory for 2016–2018.
Results: In 2018 the percentage of patients with HIV and having received antiretroviral therapy regimen of the total number of patients with HIV held under dispensary control in Primorskiy territory was 64 %. We recorded the increase of the proportion of patients with newly prescribed antiretroviral therapy up to 22.7 % against 15 % in 2017 and those who resumed treatment – up to 4.6 % against 2.9 % in 2017. 3863 patients in total received antiretroviral therapy regimen in 2018 (without including Main Directorate of the Federal Penitentiary Service data) which is higher than in 2017 (3333 patients – 55.4 %) and in 2016 (3046 – 50.6 %). We recorded the increase in numbers of patients who resumed antiretroviral therapy regimen up to 179 people in the reference year (in 2017 – 99, in 2016 – 70 people).
Conclusions: Taking into account governmental funding to control HIV-infection it is necessary in an accurate and timely manner to assess economic expenditures and to pharmacoeconomically justify antiretroviral therapy regimen as a main mechanism of medical and preventive services in this disease.

Objective: assessment of dynamics of biological hazard of morbidity of tickborne encephalitis and other tickborne transmissible feral herd infections in the Republic of Altai.
Methods: Statistical data of disease control and prevention service of the Republic of Altai was used. Calculation of prognostic value of incidence was done by building of connectionist model with a time series forecasting method.
Results: Ranking of administrative territories allowed us to divide Republic districts into three groups: with high (from 25 per 100 thousand population), medium (15–24.9 per 100 thousand population), and low (up to 14.9 per 100 thousand population) levels of incidence of tickborne encephalitis. The Turochaksky and Ongudaysky districts were assigned to the group with a high incidence, and the Kosh-Agachsky area was assigned to the group with a low incidence.
Conclusions: Using the connectionist model it was established that during 5-year period (2013–2017) forecasting levels of tickborne encephalitis incidence exceeded the actual ones with average relative error ±0.1 and were 9.18 per 100 thousand population on average. During this period the difference in absolute values of prognostic and actual values was ten cases (i.e. two cases per year). The difference between these indicators, taking into account the small average relative error, can be explained by unaccounted cases of tickborne infections, which are clinical manifestations of tickborne encephalitis and are considered by ICD-10 as “fever of unknown origin” (R50).

Objective: to conduct organometry of thymus gland of white rats which were in the conditions of inhalation exposure to formaldehyde, and to build a regression model of the relationship between the length and width of the organ.
Methods: The study was done on 72 white male rats with initial body weight 130–150 g, aged 3 months old. Exposure to formaldehyde at a concentration of 2.766 mg /m3 was carried out daily for 60 minutes from 10 to 90 days in different observation groups. We measured the body weight of animals, the absolute and relative weight and size of the thymus gland. A regression analysis of the dependence of the length of the body on its width was carried out.
Results: The average absolute mass of the thymus of rats exposed to formaldehyde for 20 days was 224.17 mg, which was 14.9 % lower than the control values. The created model of dependence of the thymus length on its width is described by the formula Y=2.7+1.25×X, where Y is the length and X is the width.
Conclusions: As a result of the influence of formaldehyde, a decrease in the absolute mass of the thymus is observed. However, its relative mass does not differ from the indicators of the corresponding norm. Formaldehyde exposure to rats leads to reduction of the size of the thymus gland. The created model of dependence of the thymus length on its width allows predicting the values of the dependent variable.

Objective: to develop preventive activities to prevent changes in health of officers of departmental security service of railway transport.
Methods: We performed a comprehensive hygienic assessment of work conditions in work places of 1378 people. The state of health was assessed according to incidence rates with temporary disability according to N.V. Dogle and A.Ya. Yurkevich methodology, and according to the results of periodic medical examinations. Materials for the study of diseases with temporary disability were forms of temporary disability, medical records of outpatients. The study of non-professional potential risk factors for health disorders was carried out using the ‘Questionnaire on the study of conditions and lifestyle factors’.
Results: We identified leading production factors that determine harmful working conditions and can have an adverse effect on health. The main occupational groups related to the protection of railway facilities, cargo and transport show a high category of occupational health risk for workers. A high level of morbidity with temporary disability among the representatives of the production staff of departmental security service of railway transport has been determined. We detected significant correlations between potential risk factors and incidence rates with temporary disability. We identified priority professional and nonprofessional factors that influence the incidence rate.
Conclusions: We developed, scientifically substantiated and implemented a system of measures to prevent the adverse influence of production factors on the health of departmental railway transport workers.

Objective: assessment of working conditions of employees of test laboratory center (TLC) of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing to scientifically justify preventive measures for their health maintenance.
Methods: The study was done at 116 working places of specialists of the department of sanitary and hygienic laboratory investigations (SHLI) of TLC using hygienic, laboratory, sociological and statistical methods. Measurement of chemical and physical factors of occupational environment was done. Hygienic assessment was done according the “Guidelines on hygienic assessment of occupational environment factors and working process. Criteria and classifications of working conditions”.
Results: We have determined a complex of occupational harmful factors and have assessed working conditions of basic professional groups of the department of SHLI. We have established final class of working conditions - harmful, 1st degree (class 3.1).
Conclusions: Working conditions at work places of department employees, depending on the extent to which hygienic standards are exceeded, can have an adverse effect on the body and cause functional changes that stop when contact with harmful factors is interrupted.

Objective: assess risk factors and for the formation of deviations in human health and determine methods for their prevention using screening methods.
Methods: We examined 38 men and 60 women aged from 21 to 60 y.o., applied to Vladivostok Clinical Diagnostic Center for 2014–2015. We assessed the medical history and risk factors for the development of various diseases, physical development, the functional state of the cardiovascular system, respiratory function, metabolic processes and laboratory parameters. Based on the results of a comprehensive survey, the actual nutrition, functional and adaptive reserves of the body were evaluated. An individual program of recovery was drawn up for each patient.
Results: Only 3 % of patients did not have risk factors. 34.2 % of men and 60 % of women were hereditary tainted with cardiovascular diseases and metabolic disorders; 18.4 % of men and 5 % of women were hereditary tainted with oncological diseases. 79.6 % of men and women are non-smokers. 10.5 % of men and 11.6 % of women had sedentary lifestyle; 65.8 of men and 66.7 % had mixed lifestyle; and 23.7 % and 21.7 % of men and women, respectively, had active lifestyle.
Conclusions: One risk factor was determined in 16 people aged from 21 to 40 y.o. Two risk factors were determined in 25.5 % respondents. A combination of three factors was recorded in 23.5 % of cases. 17.3 % of respondents had a combination of four, 11.2 % had five, and 1 % had six risk factors. A combination of seven risk factors is defined in 2.1 % of cases. The main risk factors for non-communicable diseases at the age of 21–60 years old include: overweight, poor nutrition, physical inactivity, smoking, drinking alcohol, hypercholesterolemia, hereditary burden, hypertension and obesity. More than 2/3 of the patients had an impact on the body of more than three risk factors.

Objective is to organize data on malaria incidence in the world and in Primorskiy Territory and on characteristics of epidemiological process within the program of malaria elimination and success of regional initiative on control of imported and territorial epidemiological blocks.
Methods: The study has been done on the basis of epidemiological research methods. We used data of the epidemiological survey, results of epidemiological examination of blocks using materials of epidemiological records, materials of WHO reports on a new plan to control malaria.
Results: Imported malaria cases among the population of Primorskiy Territory have been registered annually since 1997. 52 cases of malaria were registered in total from 1996 to 2016 including 20 cases of tropical malaria and 32 cases tertian malaria. The highest incidence rate was registered in 1997, 1999, 2000 and 2002. Mosquitos Anopheles hyrconus have an epidemiological value in formation of endemic foci in Primorskiy territory the population of water bodies whose larvae in the meadow biotopes of Primorye is 27.3 %.
Conclusions: Effort to eliminate malaria in the world requires constant assessment of malaria potential of different regions of Primorskiy Territory, improvement of epidemiological control and efficiency in implementing preventive and anti-epidemic measures at a local level.

Objective is to describe a radiation semiotics of brain lesions depending on immunosuppression state caused by HIV-infection and HIV replication activity.
Methods: We analyzed results of a complex X-Ray examination of 300 HIV-infected adult patients who underwent magnetic resonance imaging (MRI) of the brain. All patients were divided into groups depending on status of antiretroviral therapy (ARVT), amount of CD4-lymphocytes in the blood, and on detected brain lesions. Patients with the immune reconstitution inflammatory syndrome (IRIS) were placed in a separate group.
Results: Symptoms of HIV-encephalopathy were detected in more than a half of patients. We identified a wide range of coinfections and opportunistic diseases with brain damage. With development of immunosuppression we recorded the increase in number of focal and diffuse central nervous system. At IRIS new lesions appeared and old lesions increased in size in the brain; the confluent pattern of changes was recorded up to generalization. IRIS was associated either with beginning of ARVT or with its resumption after a break, and symptoms of abnormal progressive multifocal leukoencephalopathy were significantly more frequently visualized.
Conclusions: Atrophic changes, focal and diffuse brain lesions were detected in most patients with HIV-infection. Large foci were more common in cases without ARVT, perifocal edema and contrast uptake in the area of changes of central nervous system were detected, changes increased with the progression of immunosuppression. The main distinguishing radiation symptom of brain damage in IRIS was acute inflammatory demyelination. It is rationale to expand indications and conditions to conduct radiological examination of the brain in cases of suspected pathological process or in primary symptoms of cognitive or neuropsychological disorders in patients with HIV-infection.

Objective: to assess drug addiction epidemic influence on the incidence of HIV-infection among women in Tatarstan Republic.
Methods: We analyzed characteristics of HIV-infection epidemic and drug addiction in Tatarstan Republic from 1987 to 2018. To identify risk factors of contamination we did an anonymous survey
of 208 HIV-infected women.
Results: Direct correlation of incidence rates of HIV-infection and drug addiction was established in 1987–2006 within the Republic (r = 0,73), reverse correlation for 2006–2018 (r = –0,8). From 1996 to 2018 incidence rate of HIV-infection among women increased by 7.6 times. Till 2002 blood-borne route of infection prevailed, from 2003 – through sexual contact. We presented increase in heterosexual transmission of infection from 23.7 % in 2001 to 82.8 % in 2016. According to the survey most women (76.9 %) were infected through heterosexual contacts, nevertheless 49 % of cases HIV-infection was direct or indirect consequence of drug addiction epidemic. Moreover, the number of women infected through sexual contacts with injection drug users exceeded the number of those who were infected using drugs. Cases of physical assault associated with partner’s drug addiction contributed to contamination.
Conclusions: Till 2002 the most part of women in Tatarstan Republic were infected with HIV-infection using drugs. Nowadays sexual transmission prevails; however, the source of infection are men who are injection drug users.

Objective: to analyze incidence rate of genetic variations of human immunodeficiency virus 1 and mutation of resistance to protease inhibitors (PI), to Nucleoside and Non-Nucleoside Reverse Transcriptase Inhibitors (NRTI and NNRTI) in Primorskiy Territory.
Methods: We presented results of examinations of 124 batches of patients with HIV-infection having lived in Primorskiy Territory and having observed in Regional Center for Prevention and Control of AIDS and Infectious Diseases in 2013–2019. Blood plasma taken during the period of therapy served as the material for molecular genetic studies. To isolate nucleic acids, the reverse transcription reaction, the polymerase chain reaction, and the cyclic sequencing reaction, the HIV-1 Genotyping System v. 2.0 test system was used (Celera Diagnostics, Abbott, USA). The gene encoding the protease of the pathogen (1–99 codons) and two thirds of the gene encoding the reverse transcriptase (1–335 codons) were subjected to investigation. The AB 3500 genetic analyzer (Applied Biosystems, USA) was used to determine the sequences by capillary electrophoresis method.
Results: The most frequently registered resistance simultaneously to NRTIs and NNRTIs (23.4 %). At the same time, drug resistance to drugs of one of the groups of reverse transcriptase inhibitors was quite common (9.7 %). The number of patients in whom drug resistance was caused by mutations of resistance to NRTI and NNRTI (54.9 %), both in isolation and in combination with PI mutations, turned out to be large. The level of resistance to PI was low (4.8 %). Drug resistance to drugs of the three groups was detected in 10 cases (8.1 %).
Conclusions: Among examined patients with virological and immunological failure of antiretroviral therapy residing in the territory of Primorskiy Territory, the subtype B of human immunodeficiency virus type 1 is the most common. The pathogen had mutations of drug resistance in more than half of the cases. It creates an unfavorable situation with the spread of mutations in the population and the formation of primary resistance. Of course, methods of molecular genetic analysis are of great importance both in studying the epidemiological distribution of variants of human immunodeficiency virus type 1, and in the selection and correction of antiretroviral therapy in cases of its ineffectiveness.

Objective to analyze the effectiveness of therapy with the use of genetically engineered biologic drugs (GEBD) in patients with moderate and severe forms of ulcerative colitis (UC) and Crohn’s disease (CD).
Methods: The study was done based on gastroenterological department of PRCH No. 1. The effectiveness of treatment was assessed with retrospective analysis of 29 case records. The severity of the disease was evaluated according to the Mayo Score and the Harvey–Bradshaw index. Following biologic therapy drugs were used: anti-tumor necrosis factor α agent and integrin blocking agent ‘Vedolizumab’. Clinical response and endoscopic dynamics were included. Data was processed with software Statistica 10.
Results: 20 patients were diagnosed with CD, 9 patients – with UC. Mean age of patients is 37.2 y.o. Initially all patients received standard immunomodulatory therapy. Development of resistance to steroids and steroid-dependence, and also ineffectiveness of immunosuppressive drugs became an indication to use GEBD. Positive clinical response was observed right after the first infusion in 24 patients. After 10-14 weeks of treatment positive clinical response was recorded in 58.6 % of cases. After 24–28 weeks of treatment clinical remission rate with endoscopic view improvement was in 24.1 %, and total clinical endoscopic remission rate was 17.2 %. Therapy improvement was required in 17.2 % of cases.
Conclusions: The use of GEBD has advantages in clinical and endoscopic remission in treatment of patients with refractory types of UC and CD.

The use of mathematical model based on assumption of heterogeneity of population in epidemiological studies of infectious diseases cause grave mistakes in assessment of transmission rate of infection and average incidence rate. For an accurate assessment of morbidity, we need models that take into account the structure of risk groups. In this case, the duration of cycles of multi-year oscillations for homogeneous and heterogeneous models is close, so it can be used to estimate the value of the contact number. In addition, models that do not take into account the finiteness of the population give an incorrect description of the dynamics of the incidence – in such models the incidence tends to a constant value. The reason for this lies in the fact that even for multimillion populations the dynamics of the number of infected people has a strong stochasticity, and to reproduce the actual dynamics of the epidemic process, it is necessary to use not deterministic but stochastic models.

Objective: is to analyze main epidemical trends of HIV-infection distribution in different territorial subjects of Far Eastern Federal District (FEFD).
Methods: We have analyzed data from reports of Centers for the prevention and control of AIDS according to the letter of the Ministry of Health of the Russian Federation dated July 12, 2018. 
Results: Nowadays FEFD is a territory with the moderate level of HIV-infection prevalence. The number of infected population exceeds 25,000 people and accounts for 2.5 % of total cohort of people with HIV in the Russian Federation. The incidence rate calculated for 100,000 of people is 2.2 times lower in FEFD than in Russia in general. Primorskiy Territory is a top district by the absolute number of people with HIV and by the number of newly infected with HIV. The incidence rate of new cases in 2018 in district in general was 107 % (in Russia – 97 %) compared with 2017. The maximal growth rate was demonstrated by low population areas: Jewish Autonomous Region (162 %), Chukotka Autonomous Region (147.6 %) and Kamchatka Territory (124 %). According to the data obtained from the most Centers sexual transmission of infection prevailed in the FEFD; the group most involved in the epidemic process is men of 25–45 years old. In 2018, the district achieved the targets of the State Strategy on HIV Testing for the population – 25 % (2.1 million people) and the provision of antiretroviral therapy – 60 % of those under medical examination or 55.6 % of the entire cohort living with HIV in the district (in the Russian Federation – 55 %).
Conclusions: Far East was always at the bottom of Federal rating on HIV prevalence; a well-built policy of preventive measures helped to achieve such results. Modern diagnostic, therapeutic and preventive technologies are constantly being introduced into the practice of the service for the prevention and control of AIDS. All Anti-AIDS Center conducts traditional preventive measures, including free, voluntary, including anonymous HIV testing with mandatory pre- and post-test specialised medical consultation. The level of population awareness in FEFD on HIV infection was 87.2 % in 2018 that equals the performance of State Strategy. 

Objective is to determine features of development and applicability of database of clinical signs of an infection associated with medical care in general hospitals.
Methods: We used data on 1560 patients with malignant neoplasms in departments of an oncology center; we determined 28 descriptors designating data on infections and 45 risk factors.
Results: We built a functional model and defined two data arrays: clinical features and medical risk factors for seven medical care divisions.
Conclusions: Singularity of a created database is its creation on the basis of specific clinical signs typical for each particular patient and treatment taking into account functional and logical consistency of collected data.

Clinical observation of inflammatory bowel disease in 25 y.o. woman is represented. During two years clinical data, endoscopic view and results of histologic examination of intestinal mucosa did not enable to differentiate Crohn’s disease from ulcerative colitis. Infectious diseases, amyloidosis were excluded. Only with computed tomography enterography pathognomonic changes in the small intestine and the abdominal cavity were identified as pathognomonic for Crohn’s disease. Obtained data allowed us to correct the treatment and reasonably refuse surgery required for ulcerative colitis.

The article describes a clinical case of pneumocystic pneumonia when pulmonary involvement was the first manifestation of HIV-infection. It is hard to diagnose a pneumocystic pneumonia in HIV-infected patients that caused by absence of pathognomonic clinical symptoms and frequent combined course of several opportunistic diseases at the advanced stage of HIV-infection. We have organized and showed data on etiology and pathogenesis, clinical features of the disease, diagnostics and treatment of pneumocystic pneumoniain HIV-infected patients.