Резюме Цель: оценка иммуногенности вакцинации от гриппа ВИЧ-инфицированных взрослых, исходно серонегативных к вирусу гриппа. Материалы и методы: вакцинировали от гриппа 175 ВИЧ-инфицированных и 50 здоровых добровольцев на базе Республиканского центра по профилактике и борьбе со СПИД г. Уфы в ноябре 2016 г. Определяли титр гемагглютинирующих антител к антигенам вируса гриппа А (H1N1), А (H3N2) и В в стандартной реакции торможения гемагглютинации до вакцинации (0 день), на 21-й и 150-й дни после вакцинации. Анализ поствакцинальной динамики антител к вирусу гриппа провели у 12 больных ВИЧинфекцией (7%) и 13 человек из контрольной группы (26%) с титром антител ниже протективного значения (1/40) согласно критериям иммуногенности противогриппозных вакцин для всех субтипов антигенов вакцины. Результаты: от 2 до 7% ВИЧ-инфицированных и от 12 до 24% здоровых лиц были исходно серонегативны к антигенам трех вирусов гриппа. Коэффициент сероконверсии варьировал от 1,6 до 2,3; показатель сероконверсии составил от 0 до 25%; показатель серопротекции от 67% к антигену А (H1N1) до 100% к антигенам А (H3N2) и В. Титр антител, выработанный к 21-му дню, у всех привитых не снижался до 150-го дня после вакцинации. Анализ у ВИЧ-инфицированных с разным количеством CD4-лимфоцитов показал, что большинство привитых вырабатывают минимальное протективное количество антител (1/40); при уровне CD4-лимфоцитов более 350 кл/мкл наблюдали четырехкратный и более рост титра в динамике. Заключение: однократная иммунизация ВИЧинфицированных стандартной вакциной для сезонной профилактики гриппа недостаточна для формирования полноценного иммунного ответа. Малая выборка исследования не позволяет экстраполировать результаты исследования на большие когорты больных ВИЧинфекцией. Для разработки рекомендаций по вакцинопрофилактике гриппа у больных ВИЧ-инфекцией требуются дальнейшие исследования.

Purpose: to estimate the content of platelets and sP-selectin in patients with different severity of Hemorrhagic Feverwith Renal Syndrome. Materials and methods: we have conducted the clinical and laboratory examination of 220 patients with Hemorrhagic Fever with Renal Syndrome, including mild (52), moderate (112) and severe (56) forms. The quantitative content of sPselectin in blood serum was determined by enzyme immunoassay in 90 patients (30 people from each group). Results: during first days of admission to the hospital thrombocytopenia in patients with mild form of HFRS was moderate. For moderate and severe forms of HFRS during the initial period the average value of the platelet was less than 100u109/l; correlation analysis between platelet countand creatinine level revealed an inverse relationship between the platelet count during the initial period and the level of creatinine during the oliguric period (r=-0,526; p=0,029). The difference in the content of sP-selectin are statistically significant not only with the control group, but also between groups of patients depending on the severity of the disease, a correlation between the content of platelets and sP-selectin was revealed in all groups of patients. Conclusion: the activity of sP-selectin and the degree of thrombocytopenia are closely interrelated and characterize the severity of the disease.

Objective. To analyze T cell-mediated immunity (subpopulations of CD3+, CD4+, and CD8+ lymphocytes) in HIV-infected patients with helminthiasis receiving or not receiving antiretroviral therapy (ART). Patients and methods. This study included 159 individuals; 100 of them had subclinical stage 3 HIV infection and helminthiasis (caused by different helminths) and were divided into two experimental groups depending on whether they received ART or not. The control group 1 comprised 29 HIV-positive people without helminthiasis not receiving ART, whereas the control group 2 included 30 HIV-negative people with helminthiasis. Patients in the experimental groups and control group 2 were followed up during the study and received anthelmintic treatment. The assessment of the immune status using monoclonal antibodies against specific antigens of subpopulations of T-lymphocytes (CD3+, CD4+ cells, cytotoxic T-cells-suppressors-CD8+ and CD4+/CD8+ ratio) was performed in the laboratory of the Republican Center for the Prevention and Control of AIDS and Infectious Diseases, Ufa, Russian Federation. Results. In this study, we evaluated the relative count of CD3+, CD4+, and CD8+ T cells in HIV-infected patients with helminthiasis at different time-pints during 6 months. We observed significant differences in the CD3+, CD3+CD4+, and CD3+CD8+ cell count between HIV-infected patients with helminthiasis on ART and without ART. Patients in the experimental group on ART demonstrated a significantly lower CD3+ cell count compared to patients in the experimental group not on ART (2.3 times lower; p < 0.01), as well as lower CD3+CD4+ cell count (1.5 times lower; p < 0.05) and CD4+CD8+ cell count (1.9 times lower; p < 0.05). Our findings suggest that HIV-infected people with helminthiasis on ART are more likely to have their CD3+, CD4+, and CD8+ Т-cell count normalized than those not receiving ART. Conclusion. The assessment of the immune status (T-cell medicated immunity) in the study groups demonstrated that HIVinfected patients with helminthiasis on ART presented with a gradual increase of the relative CD3+ cell count throughout the study (62.5 ± 5.6 %), whereas HIV-infected patients with helminthiasis receiving no ART presented with a gradual decrease of the relative CD3+ cell count (28.0 ± 4%). HIV-infected patients without helminthiasis and receiving no ART (control group 1) also demonstrated a decrease of the relative CD3+ cell count (28.1 ± 3.5%). We also observed a clear trend towards the normalization of relative CD3+CD4+ T-cell count (41.4 ± 8.2%) in HIV-infected patients with helminthiasis on ART, while patients from other groups (including HIV-infected patients with helminthiasis without ART and individuals in both control groups) demonstrated a tendency to a steady decline in the relative CD3+CD4+ cell count at all time-points. We also found that HIV-infected patients with helminthiasis on ART had their CD4+/CD8+ ratio back to almost normal by month 6 (45.7 ± 3.7%), whereas HIV-infected patients with helminthiasis without ART and patients from the control group 1 had their mean CD4+CD8+ ratio gradually decreasing throughout the study (27.5 ± 4.9% and 30.5 ± 7.1% respectively). The parameters of T-cell mediated immunity (subpopulations of CD3+, CD4+, and CD8+ lymphocytes) showed a more pronounced tendency to normalization in HIV-infected patients with helminthiasis who received ART. Our findings suggest that in HIV-infected patients with helminthiasis on ART, compensatory mechanisms of T-lymphocytes predominate, in contrast to HIV-infected patients with helminthiasis receiving no ART and the control group of HIV-infected patients receiving no ART, in whom we observed immunodeficiency of different grades. Key words: HIV infection, helminthiasis, T-cell immunity

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