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Objective. To study the prevalence of pneumocystosis among heart recipients (persons awaiting heart transplantation), persons with heart transplantation (patients with orthotopic heart transplantation) and to determine the role of pneumocysts in the etiology of bronchopulmonary complications in them. Materials and Methods. The paper presents an analysis of the results of a study of 94 samples of blood sera of patients who were treated at the Shumakov Institute of Transplantation and Artificial Organs of the Ministry of Health of Russia (Moscow). As a comparison group, samples were taken from 90 donors aged 18 to 60 years. Results. The detection of various markers of pneumocystosis made possible to establish the total number of infected among the examined and determine the stage of the disease in them. Total antibodies were found in a significant number of examined patients (donors, heart recipients, patients with OTTS. They were 2.1 times more often detected in patients with OTT (53.5%) than in the comparison group (23.3%). The indicators of heart recipients did not differ much from those of blood donors, and amounted to 25.0%. Active pneumocystis infection was most often detected in patients with OTT, which in 27.9% of cases was due to primary acute infection, in 2.3% – reactivation and in 3.5% – convalescence. Active pneumocystosis was diagnosed 2.7 times less frequently in OTT recipients than in patients after heart transplantation. All cases of pneumocystosis in them are associated with primary acute infection. It should be noted that the incidence of pneumocystosis among donors is practically absent, active infection was 2.2%, all cases are due to primary acute infection. Conclusions. The identification of such a significant number of cases of active pneumocystosis in patients after heart transplantation gives grounds to carry out laboratory diagnostics on a regular basis, which will prevent the development of pneumocystis pneumonia.

Aim. To study the dependence of detection of markers of opportunistic infections from afherence to antiretroviral therapy in children born to HIV-infected mothers on the example of herpesvirus infectionsand pneumocystis. Materials and methods. Samples of biological materials (blood serum and blood cells) of 66 children with HIV infection aged 1 month to 15 years old were treated in Children’s Boxed Department of Children’s Hospital No. 2 with diagnoses «incomplete HIV test» (children from the age of one month to one and a half years) and «HIV infection». To determine IgM and IgG to herpesviruses and pneumocyst, the method of enzyme immunoassay was used; indirect immunofluorescence reaction for the detection of herpesviruses and their antigens in the blood, early antigens and virus reproduction were determined using a rapid culture method. Results. 56.0% of the surveyed children received complete antiretroviral therapy, in 16,7% of cases they were not complete, and 27,3% of children did not fully adhere to ARVT. Despite the fact that 100% of children with an incomplete diagnosis of HIV infection were covered by ARVT due to the use of chemotherapy drugs by their mothers during pregnancy, they still had markers of both active and latent forms of herpesvirus infections and pneumocystis. In children with confirmed HIV infection living both in social institutions and in families, the markers of opportunistic infections were more often diagnosed in patients receiving ARVT in full and not in full volume than in children who did not have it. Conclusion. Identification of markers of active forms of herpesvirus infections and pneumocystis in HIV-positive children not receiving ARV is the basis for its immediate appointment.

The aim – the study of latent relationships between indicators of the thickness of intima-media (CMM) and infectious, immune, inflammatory and metabolic factors in patients with varying degrees of severity of vascular changes in these multivariate methods of statistical analysis.Materials and methods. Study included 220 patients (mean age – 43,9 ± 0,5 years) who were divided into 3 groups. Group 1 consisted of thepatients with no risk factors of cardiovascular disease (CVD), the 2nd – the presence of the above factors, in third – with atherosclerotic plaques in the carotid artery. Every patient had conducted a comprehensive survey, which included an ultrasound of vessels on the apparatus Aloka 5000 with the measurement of the thickness of KIM, the study of lipid panel, the definition of C-reactive protein and cytokines – tumor necrosis factor-α, interferon-γ, interleukin-1, -8, -4, antibodies to cytomegalovirus immunoglobulin (CMV), herpes simplex virus type 1, C. pneumoniae, H. pylori and β-hemolytic streptococcus group A. The immune system status was assessed by indicators of innate and acquired immunity.Results. According to cluster analysis, all groups of patients revealed the presence of close relationships with linear thickness KIM, infectious, immune and metabolic markers, and in patients with atherosclerotic plaques in blood vessels links with indicators of inflammation are additionally found. Using factor analysis latent variables exist revealed, consisting of indices and thickness of the CMM, in group 1 – blood lipids, in the 2nd – infectious factors (CMV, C. pneumoniae) and immune parameters. In the 3rd group vascular wall was linked with infectious diseases, immune and inflammatory indices and blood lipids, and systolic and diastolic blood pressure.Conclusion. The closest relationship with vascular wall of the studied parameters was observed in patients with risk factors of cardiovasculardisease, and in the presence of atherosclerosis. To implement the pathological process in the vessel are important factors of acquired immunity depression, chronic intracellular infections, and possibly associated with it inflammatory process.

Aim – to examine the relationship of arteries wall thickness with the indicators characterizing the infectious, immune, metabolic status inapparently healthy individuals.Materials and methods. The study included 342 patients (mean age 43.7 ± 0.5 years) that in the process of cluster analysis on the thicknessof the intima-media thickness (IMT) were divided into 3 groups. Group 1 consisted of patients with no risk factors of cardiovascular disease,2nd – patients with presence of these factors, 3rd – patients with atherosclerotic plaques in the carotid artery. All patients were examinedin complex: ultrasound of vessels measurement on the Aloka 5000 with IMT, evaluation of lipid profile, glucose level, determination of C-reactive protein (CRP) in blood plasma and cytokines – tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin (IL) -1, -8, -4, specific antibody immunoglobulin G (IgG) to cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1 ), C. pneumoniae, H. pylori and β-hemolytic streptococci group A. Immune system status was assessed by innate and acquired immunity factors.Results. In groups of examined patients by increasing IMT of the common carotid artery infectious viruses (CMV, HSV-1) burden increased,what was obligatory for all groups. In the 3rd group, in 45 % of patients C. pneumoniae was found. In the 2nd and 3rd groups weakening ofacquired immunity was found out – reducing the total number of lymphocytes and T-lymphocytes, the increase of CRP and proinflammatory cytokines (IL-1, -8, IFN-γ, TNF-α), it was indicating development of inflammatory process, and in the third group it took characters of the system inflammatory response. In cluster analysis it was revealed that the process of thickening of the vascular wall is influenced by complex factors – infectious, metabolic and immune.Conclusion. The presence of the close relationship between the thickness of vessel walls and infectious, metabolic (lipid) and immune parameterswas established. Infection factor has an effect on the vessel wall in the face of declining immune resistance of the organism and may be an inducer of latent inflammatory process.

The study was based on the examination of 100 children (71 boy and 29 girls) aged 3–18 years with bronchial asthma in remission. The routine allergological examination was followed up by the immunohistochemical test of deep pharyngeal mucosal cells samples scraped to verify the Chlamydia pneumoniae, Cytomegalovirus hominis, HSV-1, HSV-2, EBV as well as by the bacterioscopic examination of pharyngeal causative and opportunistic pathogens. The immunological examination included evaluation of lymphocyte subpopulation (CD 3+, CD3+CD(16+56+)+ TNK cells, T helpers (CD3+CD4+), double-positive cells (CD4+CD8+), CD3-CD(16+56)+NK cells by means of flow cytometry. Measurements of spontaneous and induced cytokine production (IFN α, IFN γ, IL 4) were taken using the immune assay. The level of specific antibodies (Ig M, Ig G) to the relevant infectious agents in the serum was measured as well. These examinations demonstrated that children with bronchial asthma and latent infection of the upper respiratory tract have higher rates of bronchial hyperreactivity (86%) as well as more frequent (74,7%) uncontrolled or partially controlled course of asthma. According to the examination results, in children with broncial asthma and latent infection of the upper respiratory tract α-interferon induction is oppressed (74,7%), the IL4 in the serum is increased along with a shift of the immune response towards Th2, cytotoxic response is increased, TNK cells are increased (75,5%) with simultaneous decrease of NK cells.

A report is presented of a rare case of B-cell non-Hodgkin"s lymphoma and severe exacerbation of cryoglobulinic vasculitis which developed in a female patient with chronic hepatitis C four years after achievement of a persistent virusological response to antivirus treatment. Causes of a specific course of the disease and development of the tumor in the absence of HCV in blood serum are discussed: latent HCV-infection in immune cells with persistent antigenic stimulation of B-lymphocytes, possibility of HCV-independent lymphoproliferation.

Research objective was assessment of a possibility of primary diagnosis of viruses Epstein-Burr, a cytomegalovirus, a virus of herpes of the 6th type in oral liquid and also influences of herpes infection on development and the clinical course of precancer diseases of the oral mucosa and the red border of lips (RBL). Profound clinic-immunological examination is conducted to 60 patients: the first group are have made 20 patients with an erosive and ulcer form of the lichen planus, the second - 20 people with an erosive form of a leukoplakia, a third - 20 people without diseases of the oral mucosa. As a result of work detection herpes infection is revealed high (90%). The combined infection with a virus Epstein-Burr and a virus of herpes of the 6th type was observed more than at a half of patients. The imbalance of factors of local immunity of the oral cavity in the form of increase in the IgG profile, decrease in concentration of IGA, lysozyme, and increase in an indicator of Ksb three times in comparison with norm and also substantial increase of level of pro-inflammatory cytokin IL 1β and FNO-α is found in patients with precancer diseases of the oral mucosa. Characteristic clinical feature of the precancer diseases associated with latent herpes infection is the long, recidivous current, persistent to traditional therapy. The research of oral liquid and blood on herpes viruses and consultation of the infectiologist is recommended to all patients with precancer diseases.