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Background. A significant role in the pathogenesis, resistance to treatment and progression of many types of lymphomas, including diffuse large B-cell lymphoma, is assigned to the TP53 gene. Literature data on the prognostic significance of the expression of its product, the p53 protein, and its association with aberrations at the 17p13 locus are ambiguous. Aim. To assess the relationship of p53 protein expression with the presence of a 17p13 locus deletion of the TP53 gene and the survival of patients with diffuse large B-cell lymphoma. Material and methods. The study included 75 patients with newly diagnosed diffuse large B-cell lymphoma who received R-CHOP therapy. The calculation of the relative content of tumor cells expressing p53 was carried out using immunohistochemical and morphometric methods on biopsy samples of lymph nodes. The 17p13/TP53 deletion was determined by fluorescent in situ hybridization. The threshold level of p53-positive tumor cells, corresponding to 43%, was calculated by ROC analysis. The association between p53 protein expression and the presence of a 17p13 deletion was assessed using Fisher's (F) and Pearson's 2 tests. The correlation dependence was evaluated by the Cramer method (V). Five-year overall and progression-free survival was calculated using the KaplanMeier method. Differences between the indicators were considered statistically significant at p 0.05. Results. The frequency of 17p13/TP53 deletion was higher in patients with high expression of p53 (43%) compared to the group of patients with low expression: 87.5 and 12.5%, respectively (p=0.018). A direct correlation between a high level of p53 expression (43%) and the presence of a 17p13/TP53 deletion was found (p=0.018). Five-year overall and progression-free survival in patients with a proportion of p53-positive cells 43% was significantly lower than in patients with its subthreshold value: 54.5 versus 81.0% (p=0.014) and 45.5 versus 66.7% (p=0.022), respectively. Conclusion. High expression of the p53 protein is associated with the presence of a 17p13 locus deletion and a low five-year survival rate in patients with diffuse large B-cell lymphoma.

BACKGROUND: During pregnancy and childbirth, anemia and thrombocytopenia are twice as common among HIV-positive women as in the general population. It has not been yet clear to what extent HIV affects the incidence of cytopenias, therefore, the correlation between the incidence and the HIV RNA level and CD4 count in HIV-positive pregnant women, as well as the role of antiretroviral therapy, requires further study. AIM: The aim of this study was to assess the effect of the HIV RNA level and CD4 count on the frequency of anemia and thrombocytopenia in HIV-positive pregnant women. MATERIALS AND METHODS: In this study, we analyzed social and demographic features, epidemiological personal history data, the frequency of pregnancy and delivery complications, and the timing of the initiation of antiretroviral therapy in 303 HIV-positive pregnant women, as well as the data of screening for HIV infection of their children. The study included 27 mother-child pairs with perinatal HIV transmission and 276 mother-child pairs without mother-to-child transmission of HIV. All pregnant women were divided into groups depending on the CD4 count and HIV RNA level. A comparative analysis of anemia and thrombocytopenia frequencies was carried out in the study groups. RESULTS: A direct correlation was revealed between the frequency of anemia and thrombocytopenia in HIV-positive pregnant women and markers of HIV infection: severe immunodeficiency (CD4 200 cells/l, p 0.01) and high HIV RNA levels (more than 100,000 copies / ml, p 0.01) in peripheral blood. CONCLUSIONS: We confirmed the high frequency of cytopenias in HIV-positive pregnant women, which exceeds the general population level. In addition, we demonstrated the effectiveness of prescribing antiretroviral therapy among women of reproductive age who planned to become pregnant or did not exclude the possibility of pregnancy (who did not use the effective methods of contraception), as a means of anemia and thrombocytopenia prevention during pregnancy.

HIV-infected women have a higher risk of complications during pregnancy and delivery (chronic placental insufficiency, anemia, placental abruption, preterm birth) compared with HIV-negative women, especially in case of opportunistic infections, immunodeficiency and a high viral load in the blood. The obstetrical pathologies are hard to study in these women because the above conditions are associated with a range of confounding factors that are not directly related to HIV infection but are often present, such as drug addiction, weight deficit, and chronic viral hepatitis coinfection. The literature review provides data from domestic and international studies on the correlation between HIV infection and the frequency of complications during pregnancy, delivery and the postpartum period, as well as the effect of the infection on the condition of newborns. The article cites current recommendations on the choice of delivery types for HIV-infected women.

Despite the success in reducing mother-to-child HIV transmission rate worldwide, the problem of perinatal HIV transmission is still relevant. Sexual activity nowadays is the predominant way of transmission, therefore the number of HIV cases among women growths. This leads to an increased number of pregnancies and childbirth in HIV-infected women. Better preventive treatment has decreased the transmission risk to 1% or less. Despite this, the Russian Federation is still not among the countries where the elimination of mother-to-child transmission has been recorded. This review article focuses on the main stages of mother-to-child transmission prevention from the time that no antiretroviral therapy was available to the current stage, when highly active antiretroviral therapy is used during pregnancy, childbirth and for the treatment of newborns. The research provides a comparative analysis of modern national and international clinical recommendations for the prevention of mother-to-child HIV transmission.

Assessing the timing and delivery methods, clinical and laboratory indicators of HIV-infected pregnant women is important for organizing effective care for this group of patients and further reducing the frequency of perinatal transmission of HIV infection. In 20142017, in Saint Petersburg, there were 2,524 childbirths in HIV-infected women, who were observed during pregnancy mainly in the Center for the Prevention and Control of AIDS and Infectious Diseases (AIDS Center). The average frequency of perinatal HIV transmission in the city over the study period was 1.3%, which is lower than the average for Russia (2.5%). A retrospective and prospective analysis of 1,858 medical records of HIV-infected women observed during pregnancy at the AIDS Center in 20142017 was performed. An annual decrease in the proportion of chronic viral hepatitis C coinfection was found, which was proportional to a decrease in parenteral HIV transmission in the study group. Due to the increase in HIV testing coverage, the frequency of detection of infections in pregnant women in antenatal clinics during registration was reduced. This allows conducting a thorough examination, counseling and a timely initiation of antiretroviral therapy (ART) during pregnancy planning. The vast majority of HIV-infected women are committed to follow-up in medical facilities during pregnancy, to receive antiretroviral prophylaxis (ARP) and, as a result, to give birth to a healthy child. The rate of preterm birth among HIV-infected women is higher than in HIV-seronegative women. This determines the timely initiation of ARP/ART during pregnancy for prevention of preterm delivery. The proportion of births through the birth canal increases annually, but the operative delivery rate remains above the population.

Iron deficiency anemia (IDA) is a very common pathological condition during pregnancy and the postpartum period. In the structure of hematological diseases in pregnant women, anemias account for about 90% and in most cases are iron deficient [3, 17, 19]. In the third trimester of pregnancy and in the early postpartum period, almost every woman has a latent iron deficiency, and 3040% develop IDA [4, 15, 16, 20, 26]. According to the Ministry of Health of the Russian Federation, the frequency of IDA in Russia has increased 6.3 times over the past ten years, and in St. Petersburg - almost 2 times. The development of anemia during pregnancy is due to an imbalance of iron in the body and is associated with its increased costs for creating a fetoplacental complex, an increase in iron metabolism and a redistribution of this trace element in favor of the fetus. Iron deficiency in the body of pregnant women and women in childbirth is associated with inadequate replacement of losses due to alimentary and mobilized iron.