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Research Objectives: the analysis of a specific and strains drift of Candida in HIV/AIDS patients with oropharyngeal candidiasis and the analysis of Candida sensitivity dynamics to reference antimycotic drugs. The study comprised 49 HIV-infected patients aged 20-69 years. The study revealed candidiasis treatment provides specific and strains drift of Candida. Eradication of fluconazole sensitive C. albicans leads to growth of more resistant strains (C. glabratae, krusei, tropicalis) thus lowering antimycotic therapy efficacy. The efficacy improvement requires selective approach to candidiasis treatment with azol agents.

To the article a brief historical review and modern data are driven about the state of HIV-infection in the Odessa area, morbidity of HIV is analysed--the infected patients, passing treatment in stationary section of the Odessa regional centre from a prophylaxis and fight against AIDS during the last six year, drawn conclusion about efficiency of introduction of potent antiretroviral therapy.

The causes of hospitalization of HIV-infected patients during of medical treatment in a multidisciplinary health care setting (Military Medical Academy) are analyzed. Leading causes of death in medical institutions among patients with HIV are diseases, which are not associated with HIV infection: burns, combined injuries, toxic substances poisoning. It was found that HIV infection worsens prognosis for patients hospitalized with respiratory diseases and leads to earlier development of nosocomial infections, exacerbation of bronchopulmonary diseases and short-term mortality.

The article analyses the results of questionnaire survey, of patients with tuberculosis associated with HIV-infection. The insufficient awareness about of issues of clinical course, treatment and prevention of tuberculosis was established. The distinctive feature of this category of patients is a lower medical activity and ignorance of characteristics of clinical manifestations of tuberculosis when associated with HIV-infection. This situation creates serious obstacles for timely detection of tuberculosis. Yet another negative factor also is lower readiness of health institutions to provide medical care to patients with HIV-infection.

The FTA technology was applied for sampling, archiving, and molecular analysis of the DNA isolated from stool samples to diagnose and identify microsporidia, the intracellular opportunistic parasites which induce malabsortion syndrome in immunosuppressed humans, particularly in patients with AIDS. Microsporidia DNA was successfully amplified in 6 of 50 stool samples of HIV-positive patients of the S. P. Botkin Memorial Infectious Disease Hospital (St. Petersburg) applied to FTA cards (FTA-Cars, Whatman Inc. Florham Park, NJ, USA). Amplicons (the fragments of rDNA) were directly sequenced, and microsporidia species--Encephalitozoon intestinalis, E. cuniculi, E. hellem, and Enterocytozoon bieneusi--were identified in Genbank by NCBI BLAST program. The FTA method of DNA immobilization is especially promising for epidemiological and field population studies which involve genotyping of microsporidia species and isolates.

The analysis of urological care for HIV infected patients treated in Moscow city clinical hospital N 47 covers 12-year trends in hospitalization of HIV-infected urological patients, their nosological distribution, statistics of surgical outcomes. The highest efficacy of empiric antibacterial therapy of acute pyelonephritis in HIV-infected patients was seen in combined administration of fluorofloxacin of the second generation (ofloxacin) and nitroimidasol (metronidasol). Specific features of pharmacokinetics and interaction of antiretroviral drugs with medicines used in urological practice are analysed.

Aim: To define the incidence and features of brain lesion (BL) in HIV-infected inpatients., Subjects and Methods: Four hundred and fifty-eight patients with Stage 4B HIV infection (AIDS) and central nervous system (CNS) lesion admitted to Infectious Diseases Hospital Two, Moscow, were followed up in 2003-2009. The authors used cerebrospinal fluid (CSF) microscopic and bacteriological assays for DNA of T. gondii, M. tuberculosis, herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), HSV type 6, and varicella-zoster virus, Cr. neoformans, C. albicans, C. glabrata, and C. krusei. Blood and CSF were tested for IgM and IgG T. gondii antibodies; brain magnetic resonance imaging was carried out., Results: In patients with late-stage HIV infection, the principal cause of neurological diseases was cerebral toxoplasmosis (34.7% of BL cases) and a generalized process involving the brain, lung, heart, liver, and eyes in 11.5%. There was commonly cerebral toxoplasmosis concurrent with CMV infection with clinical manifestations. 16-32% of the inpatients developed tuberculosis meningoencephalitis that was a manifestation of hematogenous disseminated tuberculosis involving the lung. There was a rise in the incidence of cancers (brain lymphomas, astrocytomas) running with CNS lesion. Mental disorders progressing to dementia were a distinctive property of CMV ventriculoencephalitis, one of the leading factors in the development of AIDS dementia complex. Molecular diagnostic techniques are needed to ascertain the etiology of BL in HIV infection., Conclusion: The CSF test for DNA of causative agents is a specific and most sensitive method for diagnosing a relevant CNS lesion.

Two cases of generalized cryptococcosis in patients who died of HIV infection are described. The course of the disease was masked by other diseases and final diagnosis was established after necropsy. Leukemia was a clinical "mask" in one case and generalized tuberculosis in the other. Numerous cryptococci were found in different organs histologically with positive Shiff-reaction. Ultrastructurally, cryptococci were of variable forms this probably reflecting different stages of interaction between microorganisms and the host.

Cryptococcosis was detected in 17% of examines with AIDS. The disease was caused by fungus Cryptococcus neoformans. Most frequently cryptococcosis affected CNS (meningitis and encephalitis). The symptoms were scare and nonspecific, e.g. positive meningitis indicators occurred only in 9% of the patients. Cryptococcosis tends to hematogenic spread with severe dissemination. The diagnosis was made primarily basing on the results of mycological investigations of the biosubstrates, i.e. discovery of Cryptococcus neoformans.

A new antifungal drug of systemic action diflucan (Pfizer, USA) has been tried in 10 patients (mean age 35.9 + (-)3.7 years) with various disseminated mycoses. The drug was used in a daily dose 200 mg intravenously or orally for 23.6 + (-)3.3 days. The response was achieved in all the patients with disseminated mycoses caused by yeast fulgi. Side effects were not registered.

Mycotic complications were registered in 21 out of 37 HIV-infected subjects. Oropharyngeal candidiasis was most common. It occurred prior to or concurrently with esophageal and skin candidiasis, fungemia, meningoencephalitis and disseminated lesions. With immunodeficiency progression, the prevalence and severity of mycosis go up. The causing fungi vary in great range: Candida albicans, Candida krusei. Candida tropicalis, Candida pseudotropicalis, Candida parapsilosis. Cryptococcus neoformans, Rhodotorula rubra, Penicillium chrysogenum.

The main purpose of the present study is the investigation of relationships of Pneumocystis carinii with the organism of white rat Wistar, which is natural carrier of this parasite. The series of experiments has shown that the immunosuppressor Tricort-40 (corticosteroid of prolonged activity) in a short time reactivates the Pneumocystis infection. The parasites have been observed in a great number in the lungs and rarely in the liver. The reactivation and dissemination of the Pneumocystis infection have been achieved constantly and with great expression by the combined immunosuppression of rats, by the medicamentous immunosuppression (injection of T-40) and biological one (infection with amastigotes Leishmania infantum). The developing mixed-infection (with pneumocysts and leishmania) could be the basis for the parasitocenological relationships.