Introduction: In recent years, the frequency of human immunodeficiency virus (HIV) and hepatitis C (HCV) co-infection has increased, which is due to their common routes of transmission. HIV/chronic HCV co-infection aggravates the development of fibrosis and increases the risk of cirrhosis. The aim of the study was to evaluate the results of liver elastometry in patients of different ethnic groups with HIV/chronic HCV co-infection. Methodology: The study involved 49 Kazakh and 46 Russian patients with HIV/chronic HCV co-infection. The stage of liver fibrosis was assessed by the results of indirect ultrasonic liver elastometry according to the METAVIR scale using FibroScan 502. As an indirect marker of liver fibrosis, level of alanine aminotransferase and aspartate aminotransferase, as well as platelet counts, were determined. Results: Analysis of the results with the evaluation of the dynamics of fibrotic process in 36 months revealed a prevalence of patients with advanced liver fibrosis (F3, F4) among Kazakh compared with Russian patients, accompanied by a significant increase of liver elasticity indices in Kazakhs and Russians (p < 0.05). Significant differences in the indices of transaminases in the patients with later stages of liver fibrosis (F3, F4) were found (p < 0.05). Conclusions: The study of patients with HIV/chronic HCV co-infection revealed differences in the progression of liver fibrosis depending on ethnicity. Results of elastometry and indirect markers of liver fibrosis were used in the comprehensive assessment at different stages of liver fibrosis.

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The article analyzes the data in the literature the most common opportunistic infections in HIV-infected patients. The results of analysis of outpatients patients with HIV-infection are at a dispensary in the SI "Karaganda regional center for the prevention and control of AIDS". Analyzed the prevalence of HIV-infection in the Republic of Kazakhstan, including Karaganda region for 2012-2013. The statistical data of deaths among people with AIDS in the Republic of Kazakhstan, mortality from tuberculosis HIV-infected patients in the Karaganda region.Keywords: HIV-infection; AIDS-defining illnesses; immunodeficit; opportunist infections; tuberculosis; cytomegalovirus infection; toxoplasmosis; clinical signs; organ lesions; Karaganda region. ВведениеОппортунистические инфекции, наблюдающиеся в стадии вторичных заболеваний развиваются на фоне уже выраженного иммунодефицита. Эти инфекции являются маркерами иммунологического неблагополучия, развивающегося у ВИЧ-инфицированных вследствие прогрессивного течения заболевания. СПИД-индикаторные заболевания приводят к тяжелому поражению клеточного иммунитета, что еще больше усугубляет иммунодефицит на фоне ВИЧ-инфекции. Такие инфекции имеют протозойную, грибковую, бактериальную и вирусную природу. В настоящее время ведущими вторичными поражениями выступают туберкулез, ЦМВИ, церебральный токсоплазмоз, пневмоцистная пневмония, тяжелые проявления кандидозной инфекции, рецидивирующие бактериальные пневмонии. По мере прогрессирования разрушения иммунной системы при ВИЧ-инфекции растет число суперинфекций, тяжесть их течения [1, 2, 3].Клиническая диагностика оппортунистических инфекций у ВИЧ-инфицированных больных затруднена, так как их основные проявления: астенический синдром, лихорадка, лимфаденопатия, гепатоспленомегалия -зачастую расцениваются как проявления прогрессирования основного заболевания. Широкий диапазон клинических проявлений и преобладание инаппарантных форм болезни определяют специфику диагностики этой группы инфекций, выдвигая на первый план лабораторные методы и определение ведущих диагностических критериев [4][5][6][7][8].Из бактериальных инфекций наибольшее значение на сегодняшний день имеет туберкулез, который на поздних стадиях ВИЧ-инфекции приобретает все черты тяжелого

The article features literature data for treatment of patients with HIV infections as well as factors for prescription the antiretroviral drugs. The analysis of the VAART use between 1012-13 in Karaganda region was conducted. The data of in-and outpatients with HIV infections are presented. The reasons for treatment cessation and the data of ARV of HIV patients' tuberculosis are shown.

AimTo evaluate immunological indices in HIV-infected patients with chronic hepatitis C (CHC) who are injecting drug users.Materials and methodsThe study examined 38 patients coinfected with HIV and CHC who were injecting drug users and 36 patients with HIV/CHC who were not injecting drug users. In the study of immune status, the relative and absolute numbers of CD3+, CD4+, CD8+, CD16+, and CD20+ cells were determined by means of flow cytofluorometry of “FACSCount” using monoclonal antibodies of the company Becton Dickinson. The level of circulating immune complexes in blood serum was determined by means of precipitation in polyethylene glycol solution.ResultsIt was found that T-cell immunodeficiency was developing in patients coinfected with HIV and CHC. T-cell immunodeficiency was characterized by a decrease in the number of T-helpers, mainly for injecting drug users. At the same time, patients coinfected with HIV and CHC experienced markedly elevated levels of circulating immune complexes, mainly among injecting drug users. The evaluation of immunogram indices in injecting drug users coinfected with HIV and CHC, depending on the stage of HIV infection, revealed a greater degree of immune-suppression of T-helper cells in clinical stage III.ConclusionOur comprehensive immunological study of patients coinfected with HIV and CHC revealed a pronounced dysfunction of the immune system. The comparison of the immune system indices in patients with HIV/CHC showed a more pronounced T-cell suppression in injecting drug users than in patients with HIV/CHC but who were not injecting drug users.