Survey objective: analysis of transmission routes of HIV infection, its course and treatment in children with the aim of determining the common problems and solutions. Materials and methods. Observation of 388 HIV-infected children at the age from month to 17 years was held for the purpose of analysis of common problems on the basis of Motherhood and Childhood Department of State Budgetary Healthcare Institution «St. Petersburg Center on Prevention and Control of AIDS and Infectious Diseases». Statistical processing of data was carried out using Statistica for Windows software (v. 8.0). Survey results. It was found that 363 of children were infected with HIV during perinatal period (93,6%), 23% (5,9%) were infected during childbirth and 2 children — through injected drugs (0,5%). Of the 16 children with perinatally acquired AIDS diagnosed in 2017, breastfeeding was reported in 6 (37,5%) cases that evaluates HIV-screening of sexual partners of pregnant women. 378 (97,4%) of children take ART when clinically, immunologically and virologically indicate. Of this number, first line ART regimen is used in 130 children (34,4%). 199 (80,2%) switched to second-line ART regimen due to adverse effects, 49 (19,8%) after virological failure. Prevailing adverse effects such as dyslipidemia (40,8%), polyneuropathy (22,6%) and anemia (12,6%) were a reason for switching to alternative regimen with combined medications. Presently, it is a great problem that parents or foster parents of a child — HIV-dissidents refuse of children care and treatment that led to lethal outcome in 18 cases. In light of this, pediatricians of Centers on Prevention and Control of AIDS have to protect children’s rights for health by making request and applications to the guardianship authorities, courts, prosecutors, law enforcement agencies. 57 appeals to these authorities have been made in total.

За годы наблюдения в Санкт-Петербурге ВИЧ-инфицированными женщинами рождено 9057 детей, 3241 из которых-за последние 5 лет. Количество родов у ВИЧ-инфицированных женщин в городе остается стабильным в течение нескольких последних лет. Несмотря на низкую частоту перинатальной передачи ВИЧ, анализ ситуации по оказанию помощи ВИЧинфицированным женщинам на этапе планирования беременности и в течение беременности позволит оптимизировать данную работу и в перспективе снизить вероятность перинатального инфицирования. Цель исследования-провести анализ оказания медицинской помощи серодискордантным парам и ВИЧ-инфицированным женщинам на этапе планирования беременности, в течение бе-ременности и родов для дальнейшего снижения частоты перинатальной передачи ВИЧ в Санкт-Петербурге. Материалы и методы Проведен проспективно-ретроспективный анализ медицинских карт 2442 беременных женщин, закончивших беременность родами в Санкт-Петербурге в 2014-2017 гг. В ходе проведения анализа оценены количество желанных беременностей в исследуемой группе, сроки постановки на диспансерный учет при беременности и начала профилактики перинатальной передачи ВИЧ, охват химиопрофилактикой при беременности, в родах и новорожденных. Статистическая обработка материала проводилась с использованием программ Exel, «Statistica 10».

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Work objective: justification and development of algorithm for observation of HIV-serodiscordant couples at the stage of planning parenthood, including using Assisted Reproductive Technologies (ART) in Sverdlovsk region territory. Materials and methods. Statistical data were obtained from the materials of personal registration of people living with AIDS in State Budgetary Healthcare Institution of Sverdlovsk region «Sverdlovsk Regional Center on Prevention and Control of AIDS». 27 thousands of women of reproductive age and 31 thousands of men diagnosed with HIV infection were revealed in the region as of the end of 2018. On the basis of infectious disease department of State Budgetary Healthcare Institution of Sverdlovsk region «Sverdlovsk Regional Center on Prevention and Control of AIDS» a retrospective chart review for HIV-serodiscordant couples planning parenthood was held with using ART or the natural way. Statistical processing of data was carried out using Statistica 6 software. Results and discussion. The results of the survey showed the necessity of observation of HIV-serodiscordant couples from the stage of planning parenthood. Characteristics of partners were described with account for age, epidemiological anamnesis, laboratory parameters and final outcomes of conception with using ART or the natural way. Conclusion. Necessity of development of algorithms for observation of HIV-serodiscordant couples at the stage of planning parenthood was shown as these algorithms allow to determine case follow-up approach with the involvement of infectious disease physician and obstetrician-gynaecologist.