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Purpose. Analyze and identify the features of the course of the new coronavirus infection (COVID-19) in HIV-infected patients.Materials and methods. An analysis of the course of coronavirus infection (COVID-19) was carried out in 16 patients with HIV infection who were hospitalized at the St. Petersburg State Budgetary Healthcare Institution Center for the Prevention and Control of AIDS and Infectious Diseases from April to October 2020. All patients underwent a study of biological material from the oropharynx and nasopharynx for COVID-19 and diagnosed based on a positive PCR result.Results. In HIV-infected patients with diagnosed coronavirus infection caused by COVID-19, signs of progression of HIV infection, clinical, immunological, virological (75%), opportunistic diseases and comorbidities (chronic viral hepatitis in the cirrhotic decompensated stage, cardiovascular diseases and others) (94%). A small sample of patients did not allow to determine with reliable accuracy the mutual influence of existing diseases and pathologies, but, of course, multiple comorbid pathologies play a role in the development of severe conditions and unfavorable outcomes. A clinical case is presented.Conclusion. The provoking factors have been identified that play a role in the development of infection and more severe forms of coronavirus infection caused by COVID-19 in HIV-infected patients (injecting drug use, alcohol abuse, late stage of HIV infection (4B, 4C) and progression of earlier stages (4A ), a low number of CD4 lymphocytes (less than 200 cells / μl), multiple comorbid pathology (HIV infection, opportunistic diseases, comorbidities, especially chronic liver damage in the stage of decompensated cirrhosis), absence, interrupted antiretroviral therapy, multiple changes of regimens, absence prevention of opportunistic diseases). A patient with HIV infection at ART. 4B with multiple comorbidity, the possibility of long-term persistence of the COVID-19 virus coronavirus with positive and negative results for more than 2 months and later development of lung damage caused by COVID-19 was established.

The article presents the experience of the mobile team as an integral component of palliative care for patients with HIV infection.Objective: To analyze the effectiveness of the mobile team as a key component of palliative care for patients with advanced stages of HIV infection and comorbid conditions.Materials and methods: In 2018, a joint project of the St. Petersburg AIDS Center and the BF (charity foundation) «Humanitarian Action» created a mobile team to provide onsite medical and social assistance to patients with HIV infection. The article presents the results of the project for 2018–2019. We studied the composition of patients, their needs for various types of support, as well as assessing the problems in providing this type of service to patients with HIV infection. The analysis of the work of the mobile team for 2018–2019. The composition of patients in need of medical and social assistance was studied. Results. In the supervision of the mobile team were 79 patients with HIV. The main tasks of the mobile team were to identify patients with HIV infection who suffered from severe opportunistic diseases, for various reasons they could not come to the doctor’s center for antiretroviral therapy, and also monitor the effectiveness of treatment and psychological support for sedentary and hard-to-reach groups of patients.Conclusion: Given the increase in the number of patients with advanced HIV infection and comorbid conditions, the creation of mobile teams that are part of palliative care is an essential part of comprehensive medical and social care.

Objective: to characterize the clinical and laboratory parameters of patients with HIV infection with newly diagnosed Kaposi’s sarcoma.Materials and methods. The analysis of clinical and laboratory data of 25 HIV-infected patients with newly diagnosed Kaposi’s sarcoma who were treated in the in-patient department of St. Petersburg Center for the Prevention and Control of AIDS and Infectious Diseases in 2009-2017Results. Ninety-two (n=23) patients were men. The median age at detecting HIV infection is 36 years. The manifestation age of Kaposi’s sarcoma is a median of 37 years. Elements of Kaposi’s sarcoma were located mainly on the skin of the lower and upper extremities, trunk, face and oral mucosa. Manifest CMV infection was registered in one patient, candidiasis of various localizations was found in 19 patients (76%), 2 of them also had one case of tuberculosis and toxoplasmosis. The viral load of HIV in the serum of patients upon admission to the hospital ranged from 26 159 to 2 755,549 copies/ml. The number of CD4 lymphocytes in the serum of patients is from 4 to 674 cells/μl. First-line antiretroviral drugs were prescribed to 20 (80%) patients, while the positive dynamics of sarcoma was observed in 8 patients. Four (16%) patients received antitumor treatment. The duration of hospitalization of patients ranged from 8 to 85 days (median 29). Twenty-one patients were discharged from the hospital, death was registered in 4 patients (16%).Conclusion. Characteristics of patients with HIV infection with newly diagnosed Kaposi’s sarcoma are: the predominance of males aged 30-39 years; skin lesions of the limbs and trunk in the debut of the clinical picture of sarcoma; laboratory signs of pronounced immunodeficiency (in 75% of patients, CD4 lymphocytes in the serum are less than 200 cells/μl); high viral load of HIV in serum (in 88% of patients more than 100 000 copies/ml); frequent combination with other opportunistic diseases.

The one of leading HIV infection manifestations is trophological insufficiency developing due to violation of digestion processes and leading to disease progress, development of multiple organ failure and lethal outcomes.The objective of research was to reveal the clinical and laboratory characteristics of patients with advanced stages of HIV infection and malnutrition, as well as the efficiency of nutritional support for this category of patients.Materials and methods. The study included 42 patients on the stage 4A-B HIV infection and underweight. All patients were on inpatient treatment in the department of palliative medicine of the St. Petersburg AIDS Center. Clinical-laboratory and instrumental measures were analyzed, the trophic status was estimated before the beginning of antiretroviral therapy (ART). The patients were divided in two groups. The first group received medical enteral nutrition (liquid mixture “Impact oral”). The second group received a regular balanced diet. At the same time, patients in both groups were prescribed ART in accordance with clinical guidelines.Results. A month after the start of treatment it was possible to analyze the results in the 1st group in 23 people and in 11 in the 2nd group. Comparative analysis showed that in the 1st group the distribution of the patients significantly changed according to the level of CD4 lymphocytes, BMI and nutritional status, with a markedly positive dynamics of these indicators. Also, patients of this group coped better with ART. Despite the fact that the analysis was conducted at the initial stages of the work, the obtained data demonstrate a high perspective of nutritional-metabolic therapy in the context of optimizing the HIV treatment in patients with a marked failure of the trophic status.

Objective. To study the clinical manifestations of CNS lesions caused by different factors in patients with HIV disease progression.Materials and methods. The study involved 128 ART naïve HIV patients with CD4 cell counts

The clinical case of mycobacteriosis caused by drug resistant strains of M. avium (subspecies of hominissuis), was observed in the patient su}ering from HIV at the stage of AIDS. The severity of immune deficiency and the absence of opportunity for antibacterial and antiviral therapy promoted the rapid progression of mycobacteriosis, early lymphogeneous generalization and the lethal outcome in 16 months from the start of the disease. Mycobacteriosis in this clinical case was specifically characterized by the massive bacterial semination, the absence of specific granulomatous changes in parenchymal organs, massive lesion of lymph nodes with extensive necrosis and the presence of para-specific changes. It highlights the similarity of mycobacteriosis pathogenesis with pathogenesis of primary tuberculosis.

A comparative investigation has been applied to 100 HIV infected patients with CD4 lymphocytes rate