Epidemiological dynamics of nephropathia epidemica in the Republic of Tatarstan, Russia, during the period of 1997-2013.

This report summarizes epidemiological data on nephropathia epidemica (NE) in the Republic of Tatarstan, Russia. NE cases identified in the period 1997-2013 were investigated in parallel with the hantavirus antigen prevalence in small rodents in the study area. A total of 13 930 NE cases were documented in all but one district of Tatarstan, with most cases located in the central and southeastern districts. The NE annual incidence rate exhibited a cyclical pattern, with the highest numbers of cases being registered once in every 3-5 years. The numbers of NE cases rose gradually from July to November, with the highest morbidity in adult males. The highest annual disease incidence rate, 64·4 cases/100 000 population, was observed in 1997, with a total of 2431 NE cases registered. NE cases were mostly associated with visiting forests and agricultural activities. The analysis revealed that the bank vole Myodes glareolus not only comprises the majority of the small rodent communities in the region, but also consistently displays the highest hantavirus prevalence compared to other small rodent species.

[The diagnostic value of enzyme-linked immunosorbent assay technique in detection of anti-tuberculosis antibodies in groups of patients with HIV-positive and HIV-negative reaction].

The article analyzes the results of evaluation of diagnostic value of enzyme-linked immunosorbent assay for detection of antituberculosis antibodies with purpose to diagnose tuberculosis of lungs separately in groups of both HIV-positive and HIV-negative persons. A moderate diagnostic value of enzyme-linked immunosorbent assay is established under screening for tuberculosis of lungs in HIV-negative patients. The evidence of reliability of results depended mainly of actual form of tuberculosis of lungs. In view of many positive results in detection of anti-tuberculosis antibodies in control group of patients with HIV-infection the data testified the low diagnostic significance of enzyme-linked immunosorbent assay in group of patients with HIV-infection. The drawbacks of enzyme-linked immunosorbent assay technique of diagnostic of tuberculosis of lungs in common group of HIV-infected patients partially compensated by possibility of its application at late stages of development of HIV-infection.

[Clinical and immunological features of concomitant HIV/tuberculosis infection and HIV infection without tuberculosis].

The clinical and hematological manifestations and functional state of the immune system were comparatively evaluated in patients with concomitant HIV/tuberculosis (TB) infection (n = 84) and in those with HIV infection without tuberculosis (n = 106). The course of concomitant HIV-TB infection was ascertained to differ from HIV monoinfection in a diversity of additional exposures that aggravated the patients' general condition. These included: the parameters of a long proceeding inflammatory process, which were accompanied by the signs of the infection-toxic syndrome, inflammatory changes in the hemogram, by a sharp stimulation of the nonspecific link of immunity. So the comparative analysis of the trend in HIV infection in combination with active tuberculosis and HIV monoinfection revealed a prompter progression of the disease in the former case.

[Antituberculosis humoral immunity in patients with tuberculosis, HIV infection concurrent with tuberculoses].

Enzyme immunoassay (EIA) was used to study the diagnostic value of PTAT circulating in the free and attached state as part of serum circulating immune complexes (CIC) in 34 patients with tuberculosis (TB), 38 with concomitant HIV/TB infection, and 92 with HIV infection without active tuberculosis. A humoral immunological response as circulating PTAT and PTAT conjugated in specific CIC depends on both the form and degree of pulmonary tuberculosis and may be employed to diagnose a disease running as both an independent entity and in the concomitant HIV/TB infection. The use of specific CIC yields additional information on the presence and circulation of mycobacterial antigenic components, which should be borne in mind at the early stages of the disease. EIA diagnosis of pulmonary tuberculosis from the significant titer of PTAT is relatively effective at the stages with infiltration and it ascertains destructive changes before their detection on X-ray and tomographic films.

[The specific features of formation of a humoral immune response in patients with tuberculosis].

The paper presents the results of studying the time course of changes in tuberculosis antibodies by enzyme immunoassay (EIA) and immune blotting (IB) in 34 patients with pulmonary tuberculosis. In 76.5% of cases, EIA were established to reveal tuberculosis antibodies whose concentration is most pronounced in lung tissue destruction. The detection rate of specific antibodies to Mycobacterium tuberculosis (MBT) structural components by IB was 100%, which was 23.6% greater than that by EIA. The MBT structural components with a molecular weight of 11-20, 21-30, and 101-160 kDa were found to have high immunogenic properties, as suggested by the maximum levels of antibodies and by the marked antigenic proteins of proteins with a molecular weight of 11-20, 21-30, and 41-50 kDa, which showed itself as the generation of the maximum levels of circulating immune complexes with antigens of this specificity.

[Clinical and immunological features of the course of tuberculosis concurrent with HIV infection].

The clinical and immunological features of the course of tuberculosis concurrent with HIV infection were studied in 109 patients. Thirty-eight patients were found to have active tuberculosis to HIV infection; 22 patients were diagnosed to have HIV infection and tuberculosis, and 49 patients developed tuberculosis in the presence of HIV infection. The most acute course of the disease with severe infection-toxic and asthenovegetative syndromes was observed in patients with simultaneous detection of HIV infection and tuberculosis, and, when tuberculosis joins as a secondary disease in the presence of HIV infection, the bronchopulmonary syndrome, body weight loss, lymphoadenopathy, and skin lesion were pronounced at most. The most severe clinical forms of tuberculosis were observed in a group where tuberculosis manifested itself as an opportunistic disease in the presence of moderate and severe immunodeficiency.