To evaluate the molecular-epidemiological structure and pharmacoresistant HIV variants in HIV-infected individuals in Ho Chi Minh City (Socialist Republic of Vietnam), nucleotide sequences of the polymerase gene fragment (pol) HIV were analyzed in 42 patients (4 people with newly diagnosed HIV infection and 38 with virologic failure of antiretroviral therapy).Results. In the examined group, HIV circulating recombinant form CRF01_AE (92,2%) prevailed compared to genotype B (5,3%), CRF08_BC was detected in one patient (2,6%). Among people with newly diagnosed HIV infection, 75% were genotype CRF01_AE and 25% were genotype B. The drug resistance mutations to any drugs in 76,2% of patients were detected. Among isolates with identified pharmacoresistance, 43.75% had single mutations. Mutations to IR were more common (84,8%) than mutations to PI (15,2%). The most common mutations were NNRTIs — 47,8%, followed by NRTIs (37%) and PI (15,2%). Isolates with pharmacoresistance only to NRTIs amounted to 9,4% (7,1% of the general group), only to NNRTIs 28,1% (21,4% of the general group), only to PI 12,5% (9,5% from the general group), simultaneously to PI and NRTI 6,25% (4,8% of the general group), to PI and NNRTI 3,1% (2,4% of the general group), to NRTI and NNRTI 37,5% (28,6% of the general group), isolates with drugs resistance mutations to all three groups simultaneously were not detected. The drug resistance mutations occurrence and the occurring number naturally polymorphic variants in patients with two / three ARV regimens were significantly higher than those in patients with one regimen, regardless of the treatment duration. A pharmacoresistance mutation was detected in an ART-naive patient. Based on the foregoing, it seems necessary to monitor the HIV drug resistance in Vietnam to both those receiving ART and those who are ART-naive. K
Introduction. The problem of transfusion safety in relation to parenteral viral hepatitis still remains relevant. Viral hepatitis B (HB) remains the most common viral infection transmitted through transfusion procedures. One of the natural phases of chronic hepatitis B (CHB) is occult hepatitis B infection (OBI), characterized by an undetectable HBsAg (regardless of the other serological markers content) in the presence of hepatitis B virus (HBV) DNA in the liver tissue and an extremely low, up to undetectable, level of viral load in the blood. In the Republic of Guinea, as in most countries on the continent, the prevention of HBV transmission through transfusion is still based on HBsAg serological testing of donors only. In this connection, OBI remains as a potential threat to blood transfusion safety. Detection of HBV DNA is a reliable preventive measure against transmission of the virus from donors with HBsAg-negative HBV infection, especially in highly endemic regions. In this regard, the study was conducted to substantiate recommendations for improving blood safety against the background of significant HBV prevalence in the Republic of Guinea.The aim of the work was the evaluation of serological and molecular markers of HBV infection in blood donors in the Republic of Guinea.Material and methods. We examined 250 blood samples obtained from donors living in Conakry, Republic of Guinea. Samples were tested for the presence of serological (surface antigen, HBsAg; antibodies (ABs) to surface (anti-HBs IgG) and core (anti-HBc IgG) antigens) and molecular (DNA) markers of HBV infection.Results and discussion. The overall detection rate of hepatitis B markers was 83.2%; HBsAg was detected in 16.4% of all individuals. The high incidence of HBsAg in men (19.55%) compared to women (8.45%) was shown, the relative risk of HBV infection with the formation of HBsAg-positive chronic hepatitis B in males was also significantly higher. The prevalence of the HBV DNA in the study group was 30.4%, the OBI cases accounted for 15.6%. The prevalence of this form of the disease was shown in donors aged 30–49 years (24.78%), in the group of people younger than 30 years, the incidence was lower (8.73%), and at the age of over 50 years, OBI was not detected. Based on the phylogenetic analysis of 76 virus isolates, it was shown that genotype E prevails in the examined group (85.53%).Cases of pathogen DNA detection occurred in HBsAg-negative blood donors in the presence of anti-HBs IgG (n = 4), as well as in the simultaneous presence of ABs anti-HBs IgG and anti-HBc IgG (n = 7). The viral load exceeded 200 IU/ml in OBI samples. Escape mutations were detected by sequencing in each OBI sample, contributing to the virus escaping from diagnostic based on screening for HBsAg.Conclusion. Assessment of the prevalence viral hepatitis B markers in blood donors, determination of genotypes and clinically significant mutations of virus variants are necessary to ensure safe medical manipulations, control and prevention of the spread of this infectious agent.
The article deals with the category of sustainable development and its application to business units' activities. The essential ideological basis of the article is the need to combine business interests in profit increment, aimed at increasing stability, through extensive use of balance sheet instruments as well. Financial stability still occupies a vital place, despite a growing priority of environmental and social components of sustainable business development. Its analysis requires the use of static and dynamic balance theories. Their practical application calls for an adequate perception of a current financial and economic situation in a specific place and time period. From this perspective, the authors consider it necessary to use a variety of different balance techniques, depending on specific goals, faced by users of accounting information flows. The researchers make a conclusion about the essential priority of business units functioning longer, even at the expense of short-term achievements of a high level of profitability. In this regard, frequent revaluation of assets should be considered ineffective. This makes it objectively necessary to use both static and dynamic balance theories.
Highly active antiretroviral therapy (HAART) is currently a combination of three (less frequently four) antiretroviral drugs; these target pathways involved in various stages of HIV replication in the body. Treatment failure is a problem facing doctors and patients using HAART. The most common cause of therapeutic failure is the development of HIV drug resistance. The emergence of resistance is associated with processes involving mutation occurring in the viral genome under the influence of evolutionary factors. Sequencing reactions were performed using the AmpliSens HIV Resist-Seq. Assembly of consensus sequences from fragments obtained during sequencing was carried out using Unipro UGENE softwar. Isolate genotyping was performed using the MEGA-X software with the Neighbor-joining algorithm. According to the analysis, 72.05% of patients had at least one significant mutation associated with drug resistance for the corresponding viral subtype. HIV-1 A6 remains the predominant HIV-1 genetic variant in Russia’s Northwestern Federal District. Among samples with drug resistance mutations, in all cases, mutations associated with pharmacological resistance to two or three drug groups were found. Given the high incidence of resistance mutations in patients on ineffective ART, surveillance of HIV-1 drug resistance, in both ART-receiving and ART-naive individuals, appears necessary. A lack of vigilance and control measures may lead to the spread of primary ART-resistant HIV strains.
There is concern that the widespread use of antiretroviral drugs (ARV) to treat human immunodeficiency virus 1 (HIV-1) infection may result in the emergence of transmission of drug-resistant virus among persons newly infected with HIV-1. Russia is one of a growing number of countries in the world where drug-resistant HIV is becoming a serious health problem because it has the potential to compromise the efficacy of antiretroviral therapy (ART) at the population level.Materials and methods. We performed a genetic analysis of the HIV-1 plasma derived pol gene among the newly diagnosed ART-naïve HIV-1 infected patients during the period from November 2018 to October 2019 in the St. Petersburg Clinical Infectious Diseases Hospital named after S.P. Botkin. We used reverse transcriptase polymerase chain reaction (RT-PCR) followed by direct sequencing of PCR products to determine the prevalence of primary drug resistance (PDR) conferring mutations. HIV-1 genotypes were determined by phylogenetic analysis.Results. The predominant HIV-1 subtype was A1 (87.2%), followed by B (11.8%) and CRF06_cpx (1%). The overall prevalence of PDR was 11%. Virus with known resistance-conferring mutations to any nucleoside reverse transcriptase inhibitors (NRTIs) was found in 8 individuals, to any non NRTIs in 5 subjects, and to any protease inhibitors in 1 case. Multidrug-resistant virus was identified in 2 individuals (2%).Conclusion. The distribution of HIV-1 genotypes in St. Petersburg, Russia is diverse. The emerging prevalence of PDR in ART-naïve patients demonstrates the significance of constant monitoring due to the challenges it presents towards treatment.
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