The case of chronic hepatitis C 1b genotype with grade 3 fibrosis according to Metavir, complicated by the development  of mixed  type  III  cryoglobulinemia,  cryoglobulinemic vasculitis with damage to the skin vessels of the skin (hemorrhagic vasculitis), and the liver (alternatively proliferative vasculitis) is demonstrated. The introduction of daclatasvir + asunaprevir was virologically unsuccessful: mutations D168E and L31V were detected against  the background of a  virological breakthrough. A repeated course of antiviral therapy with the combination of Grazoprevir + Elbasvir in combination with sofosbuvir led to a stable virologic response, partial immunological and clinical remission.

The purpose statement is to analyze the socio-demographic, clinical, epidemiological, and behavioral characteristics of patients with only HIV infection and those co-infected with HIV and Tr. pallidum, which are under supervision in St. Petersburg GBUZ «Center for the Prevention and Control of AIDS and Infectious Diseases».Material and methods. The data of outpatient cards of 588 patients who were registered in the dispensary at the St. Petersburg Central Clinical Center in the period from 2018 to 2020 were studied, and the data of the cards of males (435 people) were selected. Patients were divided into two groups: with HIV monoinfection (198 people) and with a combination of HIV infection and syphilis (237 people).Results. Patients co-infected compared with HIV-only patients were less likely to have higher education, were less likely to be married, were diagnosed with HIV infection more often at self-report and during routine examination, there were more men who hade sex with men (homosexual), and bisexual men. Co-infected patients were less likely to have used drugs in the present or in the past and were primarily infected with HIV through sexual contact. They were diagnosed mainly with early forms of syphilis. In patients with coinfection, concomitant diseases of the kidneys, cardiovascular, endocrine systems were often detected, and a high comorbidity with chronic hepatitis B was also noted.Conclusion. The identified socio-demographic, clinical, epidemiological and behavioral characteristics of men with HIV + syphilis coinfection indicate the need for more active work aimed at popularizing barrier contraception among men, especially MSM and prone to bisexual contacts; when syphilis is detected in HIV-infected patients, conduct a thorough examination of all organs and systems, extraordinary for the presence of viral hepatitis.