Хронический бактериальный простатит снижает репродуктивную функцию мужчин и ухудшает качество жизни. Нарушение иммунной системы при хроническом бактериальном простатите требует иммунокоррекции и обуславливает применение дополнительной иммуномодулирующей терапии. Целью настоящего многоцентрового двойного слепого рандомизированного плацебо-контролируемого клинического исследования было доказать эффективность и безопасность препарата рекомбинантного интерферона альфа-2b и высокоактивных антиоксидантов (витамины Е и С) в комплексной терапии хронического бактериального простатита. Мужчин в возрасте от 18 до 50 лет с диагнозом «хронический бактериальный простатит» категории II или IIIA (n = 140) рандомизировали в две группы. Пациенты основной группы (n = 70) получали интерферон альфа-2b, суппозитории ректальные, 1 000 000 МЕ (2 раза в сутки, 20 дней), группы сравнения (n = 70) – плацебо в том же режиме применения. Одновременно в качестве антибактериальной терапии пациенты в обеих группах получали левофлоксацин (500 мг/сут, 28 дней). Эффективность лечения оценивали по клиническим опросникам, бактериологическому и микроскопическому анализам, частоте рецидивов хронического бактериального простатита в течение 6 мес с начала лечения, ультразвуковому исследованию, урофлоуметрии. Оценку эффективности проводили после окончания дополнительной терапии, завершения антибактериальной терапии и через полгода после начала лечения. Клиническая симптоматика хронического бактериального простатита снижалась в обеих группах терапии уже в течение 20 дней после начала лечения. При этом дополнительная терапия препаратом интерферона альфа-2b с антиоксидантами способствовала снижению среднего числа лейкоцитов в секрете предстательной железы/третьей порции мочи в 2,6 раза (95% ДИ 1,6-4,4) после окончания интерферонотерапии, в 4,2 раза (95% ДИ 2,4-7,2) – после завершения антибактериальной терапии и в 5,4 раза (95% ДИ 3,4-8,3) – к концу наблюдения по сравнению с плацебо (p < 0,001). Доля пациентов с микрофлорой, обнаруженной в секрете предстательной железы, по завершении интерферонотерапии была на 20% ниже, чем в группе плацебо (p = 0,013). Таким образом, дополнительная иммунотерапия препаратом интерферона альфа-2b облегчала течение хронического бактериального простатита за счет ускорения элиминации бактериальной микрофлоры и снижения воспалительно-пролиферативных процессов в простате. Препарат интерферона альфа-2b не вызывал опасений по безопасности и хорошо переносился пациентами. Chronic bacterial prostatitis reduces the reproductive function of men and worsens the quality of life. Impairment of the immune system in chronic bacterial prostatitis requires immunocorrection and use of additional immunomodulatory therapy. The objective of this multicenter, double-blind, randomized, placebo-controlled clinical trial was to prove the efficacy and safety of the recombinant interferon alpha-2b preparation and highly active antioxidants (vitamins E and C) in complex therapy in patients with chronic bacterial prostatitis. Men aged 18 to 50 years with a diagnosis of chronic bacterial prostatitis of category II or IIIA (N = 140) were randomized into two groups. Patients in the main group (N = 70) received interferon alpha-2b, rectal suppositories 1,000,000 IU (20 days bid), and patients in the comparison group (N = 70) received placebo as described above. All patients received levofloxacin (500 mg/day, 28 days) as antibiotic therapy. The efficacy of treatment was assessed by clinical questionnaires, bacteriological and microscopic analyses, frequency of chronic bacterial prostatitis relapses within 6 months from the start of treatment, and by ultrasound and urodynamic testing. The efficacy was evaluated at the end of additional therapy, at the end of antibiotic therapy and six months after the start of treatment. Clinical symptoms of chronic bacterial prostatitis decreased in both groups within 20 days after the start of treatment. However, interferon alpha-2b therapy reduced the average number of leukocytes in the prostate secretion/third urine specimen by 2.6 (95% CI: 1.6-4.4) times by the end of interferon therapy, by 4.2 (95% CI: 2.4-7.2) times by the end of antibiotic therapy and by 5.4 (95% CI: 3.4-8.3) times by the end of follow-up period compared to placebo (p < 0.001). The proportion of patients with prostate secretion microbiota was 20% lower in interferon alpha-2b compared to Placebo group (p = 0.013). Thus, complex interferon alpha-2b therapy improved chronic bacterial prostatitis resolution by accelerating the elimination of bacteria and reducing inflammatory and proliferative processes in the prostate. Interferon alpha-2b had no safety concerns and was well tolerated by patients.

Anogenital warts are caused by the human papillomavirus (most commonly types 6 and 11, giant condylomas ― types 16 and 18) and are exophytic and endophytic growths on the skin and mucous membranes of the genital and perianal areas. There is no generally accepted classification, but based on clinical manifestations, there are: acute condylomas, papular, patchy, hyperkeratotic, and giant condyloma acuminatum (BuschkeLowenstein tumor). Anogenital warts can be the result of infection through sexual contact, which is indicated by the synonym venereal warts. Anogenital warts is a separate nosology (International Classification of Diseases of the Tenth Revision: A63.0), but can also be part of the symptom complex of immunodeficiency conditions (in particular acquired immunodeficiency syndrome) and neoplasias (squamous cell carcinoma and erythroplasia of Queyrat). We offer the publication of a photogallery on this problem.

The article presents a clinical case of pustular psoriasis and arthropathy in a patient with HIV infection. The diagnosis of psoriasis was confirmed by morphological examination. Signs of arthropathy were confirmed by X-Ray: presence of oligoarthritis of the distal interphalangeal joints of the fingers and feet was seen. Dactylitis severity ― 23 points, the Ritchie index ― 2, DLQI ― 28. The clinical course of psoriasis and its treatment in HIV-infected patients was considered after taking into account the data from literature and the patients current condition and observation. The above observation of a combination of several clinical forms of psoriasis (vulgar, pustular and arthropathy) in patients with HIV infection is an illustration of the features of the course and comorbidity of chronic dermatosis and AIDS, due to the influence of the infectious process, immunosuppression and ART. The development of pustular form and arthropathy creates the additional challenge of prescribing basic systemic treatment for severe and complicated psoriasis in an HIV-infected patient due to the presence of contraindications due to comorbidity. The glucocorticosteriod selected by the committee was effective on the skin and joint pathological processes, without having any negative impact on the course and treatment of the HIV infection. Such cases require further study and development of methods for the treatment of patients with comorbidity and their inclusion in an additional section in the clinical recommendations for the diagnosis and treatment of psoriasis.