[Outcomes of severe pandemic influenza A/H1N1/2009].

AIM: To study the outcomes of severe pandemic influenza A/H1N1/2009. SUBJECTS AND METHODS: The study enrolled 24 patients, including 8 males and 16 females (10 of whom were pregnant), aged 17 to 58 years, with a laboratorily verified diagnosis of pandemic influenza A/H1N1/2009, treated at the intensive care unit for the significant symptoms of acute respiratory failure (RF). Real-time RT-PCR was used to verify the diagnosis. Organs and tissues from deceased patients were histologically studied; chest computed tomography, body plethysmography, fibrobronchoscopy, breath test, and 6-minute walk test were performed in the late period. RESULTS: Within the first 30 days, a fatal outcome caused by therapy-resistant progressive RF was observed in 33% of the patients with pandemic influenza treated at the intensive care unit. Diffuse alveolar damage caused by influenza virus, which gives rise to hyaline membranes, underlies RF. Lung tissue fibrosis formed in recovered patients. CONCLUSION: The severity of pandemic influenza A/H1N1/2009 was determined by massive bilateral pneumonia, interstitial (alveolar) pulmonary edema, formation of diffuse bilateral lung fibrosis at the outcome of severe virus pneumonia (acute respiratory distress syndrome) with a decrease in vital and diffusing capacities, thereby generating a need to follow up this patient category and, possibly, to elaborate special rehabilitation programs.

[The etiological pattern of diseases in pregnant women with enhanced blood ALT and AST activities, admitted to the obstetric unit of infectious disease hospital].

AIM: to define a role of hepatotropic (HAV, HBV, HCV, and HDV) and opportunistic hepatotropic (HGV, CMV, EBV, HHV types 1, 2, and 6) viruses in the etiological pattern of diseases accompanied by enhanced blood AlAT and AsA T activities in pregnant women. SUBJECTS AND METHODS: Two hundred and eleven pregnant women, including 123 patients with chronic viral hepatitis, 74 with enhanced blood AlAT activity and no markers of viral hepatitis (EAlA T-NMVH), and 14 with acute viral hepatitis were examined. RESULTS: Most pregnant women with chronic HBV and HCV infections were found to have HBV DNA and HCV RNA in the blood in the presence of normal and enhanced activities of transaminases. In the EAlAT-NMVH group, there was none of the opportunistic hepatotropic viruses in more than 7% of cases. No genetic material of HAV, HBV, HCV, HDV, HGV, CMV, EBV, HHV types 1, 2, and 6 was found in the blood of all 10 patients with hepatitis of unspecified etiology. CONCLUSION: In the absence of serologic data supporting the presence of infectious pathology, blood testing using the polymerase chain reaction is of low informative value in detecting opportunistic hepatotropic viruses in pregnant women with hepatitis of unspecified etiology. However, by keeping in mind that the spectrum of opportunistic hepatotropic viruses is not confined to those included in this study, it is expedient to examine additionally pregnant women with enhanced blood AlAT and AsAT activity in order to identify TTV, B19V, HHV-8, SEN and NV-F in the blood.

[Perinatal transmission of hepatitis C virus].

The perinatal transmission of hepatitis C virus (HCV) is the major route of infection in infants. The understanding of the risk factors of perinatal infection and the continuation of studies in this area allow one to propose immunological algorithms of prediction and to work outa follow-up strategy of infected children. The authors have made virological and Immunological studies of infants born to mothers with HCV infection.

[Blood levels of HbsAg in patients with different variants of chronic HBV-infection].

AIM: To estimate HbsAg in patients with different variants of chronic HBV infection. MATERIAL AND METHODS: Assay of HbsAg (IU/ml) in blood serum was made in 156 patients with chronic HBV infection (70 males and 86 females, age 19 to 78 years) using the test-system HbsAg Architect Lot 59665LF00 (Abbott) on the automatic analyzer Architect with construction of 4-parameter logistic curve. RESULTS: There are significant differences in the levels of HbsAg depending on the course of chronic HBV-infection: inactive carriers of HBV (12,884.14 +/- 5,512.26 IU/ml) had much lower blood levels of HbsAg than patients with HbeAg-negative (66,992.28 +/- 25,908.74 IU/ml) and HbeAg-positive chronic VHB (135,039.3 +/- 48,127.06 IU/ml) patients with chronic mixed hepatitis (82,783.12 +/- 21,001.34 IU/ml) and cirrhosis of HBV-etiology (67,477.86 +/- 24,081.9 IU/ml). No significant differences were found between two subgroups of pregnant women with or without viremia by HbsAg concentration in the blood. Maximal mean content of blood HbsAg was registered in patients with HbeAg-positive chronic hepatitis B. CONCLUSION: Significant differences in blood serum levels of HbsAg exist between patients with chronic viral hepatitis B and inactive carriers of HBV.

[Detection of the circulation of Crimean-Congo hemorrhagic fever virus in the piedmont steppes of the North Caucasus].

The laboratory verified cases of Crimean-Congo hemorrhagic fever (CCHF) in the piedmont steppes of the North Caucasus (Malgobeksky District, Republic of Ingushetia) are first described. The source of the first infection was Ixodidae ticks; three subsequent sources were contacts with the bloody discharges from patients. CCHF virus genome was detected in the blood of the cattle from an epidemic focus and in the pools of the Ixodes ticks Haemaphysalis parva Neum., 1897 and Boophilus annulatus Say, 1821, taken from cattle. The problem of including the piedmont steppes of the North Caucasus into the CCHF nosological area is discussed.