Speed center schedule. Moscow City Center for Prevention and Control of AIDS. Republic of North Ossetia-Alania
Moscow City Center for Prevention and Control of AIDS
Address
125275, Moscow, 8th st. Sokolinaya Gora, 15, bldg. 5Help Desk Phone
(495) 366-62-38Metro
Elektrozavodskaya, Semenovskaya, Highway EntuziastovDirections
metro station "Elektrozavodskaya", Bus: 86, Minibus: 32, "Sokolinaya Gora Hospital" - final stop;M. "Semyonovskaya", Buses: 83, 36, 141, Minibus: 83, Stop "8th Street Sokolinaya Gora" - 7th from the metro;
M. "Highway Enthusiasts", Buses: 83, 36, 141, Minibus: 83, Stop "8th Street Sokolinaya Gora" - 4th from the metro.
Email address
[email protected]reference Information
Head of the centerMazus Alexey Izrailevich
Hotline number(495)
366-62-38
The Moscow City Center for the Prevention and Control of AIDS of the Moscow Healthcare Department (MGC AIDS) is the leading institution in Moscow providing comprehensive assistance to patients with HIV and AIDS.
Analytical report
"HIV/AIDS in Russia: trends, problems, countermeasures.
Own website:http://www.spid.ru
Treatment
Any Muscovite can contact the Center and receive the necessary advice. This is especially important for people with a laboratory diagnosis of HIV infection. Contacting the Center makes it possible to receive timely medical care and psychological support to maintain a normal lifestyle, work and relationships with others. Regular examination allows you to prescribe specific antiviral therapy in a timely manner. In addition, constant monitoring allows timely detection and treatment of opportunistic infections, which not only significantly improves the patient’s quality of life, but also prolongs its duration.
Most patients undergo examination and treatment on an outpatient basis, regularly visiting the Center's clinic. Today, the vast majority of HIV-infected people who are registered at the Center and regularly visit a doctor continue to lead an active lifestyle without stopping their studies and work. If indicated, patients can be hospitalized in the Center’s hospital, where they receive the most modern treatment.
Currently, more and more HIV-infected women decide to give birth to children, and, thanks to the use of modern special preventive programs at the Center, the probability of having an HIV-infected child has now decreased by more than six times, and is no more than 4%. However, if desired, an HIV-infected woman can artificially terminate her pregnancy.
Clinical and epidemiological studies are conducted at the Center, and the center’s staff gives lectures and conducts training seminars in other medical institutions in Moscow.
The center also participates in scientific research, tests and implements new methods for diagnosing and treating HIV infection.
The center coordinates the work of all medical institutions in Moscow on issues of AIDS prevention, and also controls the quality of laboratory diagnostics of HIV infection carried out in medical institutions in Moscow.
Branches
The MGC AIDS includes an outpatient department, a hospital, a laboratory, a clinical epidemiology department, as well as a prevention department and an organizational and methodological department.
Outpatient department
The outpatient department provides constant medical supervision of HIV-infected people. Regular examination allows you not to miss the moment when the need for antiretroviral treatment occurs. Thanks to early diagnosis, opportunistic infections are detected in a timely manner, which greatly facilitates their treatment.
Hospital
The AIDS Center hospital has beds for both adults and children. There are 110 beds for adults, of which 70 are for patients with HIV, and another 40 for patients with HIV and hepatitis. The children's department includes 45 beds.
Patients with a laboratory-confirmed diagnosis of HIV infection are admitted to the hospital by referral from other treatment and prevention institutions or by ambulance. There are clear indications for hospitalization; the question of hospitalization is decided by the doctor.
Most patients are treated on an outpatient basis, that is, not in a hospital, but regularly visiting a clinic. Thus, they can lead a full, active life without stopping treatment.
Strict confidentiality is maintained during the examination and treatment of patients.
Laboratory
Laboratory tests are the basis for both diagnosis and treatment of HIV-infected people. The result of laboratory testing significantly influences the timing of initiation of antiretroviral treatment. Constant examination of patients makes it possible to monitor the effectiveness of treatment, identify concomitant diseases, and monitor the development of side effects.
Department of Clinical Epidemiology
The department works in two directions: studying the epidemiological situation on HIV and AIDS in Moscow, as well as counseling and training for HIV-infected people.
Epidemiological studies make it possible to identify the scale and characteristics of the spread of HIV in Moscow. As a result, the AIDS Center creates certain recommendations for preventing the spread of HIV infection.
Counseling and education for people living with HIV includes pre- and post-test counseling, as well as training in behavior that reduces the risk of transmitting HIV to a sexual partner.
In addition, counseling is provided for pregnant women infected with HIV. First of all, they are told how to prevent infection of the fetus at all stages of its development. Pregnancy and HIV raise a number of moral and legal issues that the AIDS Center staff help resolve.
Contacts
Anonymous examination room on Sokolinaya Gora. Anonymous HIV testing room:
Free HIV diagnosis
Pre- and post-test counseling
Free counseling on HIV/AIDS issues
Schedule:
Tue, Wed, Fri 16.00 - 20.00
Thu 10.00 - 14.00
Sat. 10.00 - 13.00
Address: Moscow, 8th st. Sokolinaya Gora, house 15, building 3.
Directions: metro station "Elektrozavodskaya". Bus N 86 to the final stop "Sokolinaya Gora Hospital"
Phone: 366-26-70, 365-06-01
Anonymous HIV testing room (Central Administrative District, 4th city clinic)
Anonymous free diagnostics for HIV, hepatitis B and C, syphilis.
Schedule:
Mon 14.00 - 19.00 (consultations and tests),
Tue - Fri 9.00 - 14.00 (consultations) 9.00 - 10.15 (tests).
All services are free.
Address: Moscow, st. Rabochaya, building 34, floor 1. Entrance from the back of the building.
Directions: metro station "Ilyich Square".
Phone: 278-52-87
Office of HIV prevention and psychosocial counseling (Southern Administrative Okrug, clinic N 211)
Anonymous free diagnosis of HIV, hepatitis B and C, syphilis.
A certificate of test results is issued only if you have a passport and medical insurance.
Schedule:
Taking tests:
Mon 10.00 - 13.00
Tue, Thu 15.00 - 19.00
Wed 14.00 - 17.00
Fri 8.00 - 9.30
Issuance of certificates:
Mon 10.00 - 13.00
Tue 15.00 - 19.00
Fri 8.30 - 9.30
All services are free.
Address: Moscow, Varshavskoe highway, building 148, building 1, floor 1, room 127.
Directions: metro station "Prazhskaya". Bus 682 to the "Furniture Store" stop. Buses 797, 145, 147 to the “3rd Road Passage” stop.
Phone: 389-60-18
HIV prevention room (Southeastern Administrative District, clinic N55)
Anonymous free diagnosis of HIV, hepatitis B and C, biochemical tests.
Pre- and post-test counseling.
Schedule:
Mon, Wed, Fri 9.00 - 14.00
Tue - Thu 14.00 - 19.00
All services are free.
A medical insurance policy is required for hepatitis tests and biochemical tests.
Address: Moscow, st. Mikhailova, house 33, building 2, room 103.
Directions: metro station "Ryazansky Prospekt". Bus 51 to the stop "Polyclinic N 55".
Phone: 171-12-93
Testing room (South-Western Administrative District, clinic N 134)
Anonymous free diagnostics for HIV, hepatitis, syphilis. Psychologist consultations.
Operating mode:
Mon, Wed 14.00 - 18.00
Tue, Thu, Fri 9.00 - 14.00
All services are free.
Address: Moscow, Novoyasenevsky prospect, building 24, building 2, room 111.
Directions: metro station "Yasenevo".
Phone: 472-66-01 (extension 23)
Anonymous HIV testing room (SAO, clinic N113)
Anonymous free diagnostics for HIV, hepatitis, syphilis.
Pre- and post-test counseling.
Schedule:
Mon, Wed 14.00 - 20.00
Tue, Thu, Fri 8.30 - 14.00
For area residents all services are free. It is advisable to have a policy. To obtain a certificate, a policy is required.
Address: Moscow, st. Kuusinen, building 8, floor 4, rooms 415 - 416.
Directions: metro station "Polezhaevskaya", two stops on any transport; metro station "Sokol", trolleybuses 43, 86, 35 to the stop "Kuusinen St., 13".
Phone: 195-47-86
HIV prevention room (North-Eastern Administrative District, clinic N31)
Anonymous free HIV diagnosis.
Certificates are issued only to residents of North-Eastern Administrative District.
Operating mode:
Mon - Fri 8.30 - 12.00
All services are free.
Address: Moscow, st. Snezhnaya, house 20.
Directions: metro station "Sviblovo".
Phone: 180-75-52
Anonymous HIV testing room (North-West Administrative District, branch of clinic N151)
Anonymous free diagnosis of HIV, hepatitis B and C, syphilis.
Operating mode:
Mon, Tue, Wed 9.00 - 14.00
Thu 11.00 - 16.00
Fri 9.00 - 11.00
For tests for hepatitis and syphilis, as well as to obtain a certificate of the result of an HIV test, a medical insurance is required.
Address: Moscow, Donelaitisa proezd, building 21.
Directions: metro station "Skhodnenskaya", buses 199, 678, fourth stop - "Proezd Donelaitisa, 38". First floor of a 12-storey residential building, sign "Branch of clinic N 151".
Phone: 497-79-76
HIV prevention room (JSC, polyclinic No. 40)
Anonymous free HIV diagnosis.
Operating mode:
Mon, Wed, Fri 10.00 - 12.00
Test results are issued upon presentation of a passport.
Address: Moscow, st. Kremenchugskaya, building 7, building 1, floor 1.
Directions: metro station "Filyovsky Park". Bus 104, to the "Policlinic" stop.
HIV prevention room (VAO, clinic N 175)
Chelyabinskaya street, 16 a,
tel. 300-72-20,
Time of receipt:
Mon-Fri from 8.00 to 10.00.
HIV prevention room (Zelenograd Autonomous District, clinic N 152)
The Moscow City Center for the Prevention and Control of AIDS of the Moscow Health Department (MGC AIDS) is the main link in the city service for the prevention of HIV infection and the provision of medical care to HIV-infected and AIDS-infected residents of Moscow.
The center was created on the basis of the department of Infectious Clinical Hospital No. 2, which, in 1985, began to receive the first HIV-infected and AIDS patients identified on the territory of the Soviet Union.
The specialists who provided medical care to the first HIV-infected and AIDS patients formed the core of the MGC AIDS team. Today the Center employs more than 200 people and consists of 7 structural divisions.
Patients of medical institutions are referred to the MGC AIDS to confirm the diagnosis of HIV infection and subsequent registration, or with a questionable result of an HIV antibody test.
The Center provides all types of specialized medical care to HIV-infected and AIDS patients. Patients and their family members also have the opportunity to receive advisory, methodological and psychological assistance.
Regular examination allows you to timely prescribe specific highly active antiretroviral therapy (HAART). In addition, constant monitoring allows timely detection and treatment of opportunistic infections, which not only significantly improves the patient’s quality of life, but also prolongs its duration.
Most patients undergo examination and treatment on an outpatient basis, regularly visiting the Center's clinic. All those in need of specialized treatment receive HAART.
Today, the majority of HIV-infected people who are registered at a dispensary and regularly visit a doctor continue to lead an active lifestyle without stopping their studies and work. If indicated, patients are hospitalized in the hospital of the Moscow AIDS Center, where they receive modern treatment that meets international standards.
An important achievement of the Center is the introduction in medical institutions of Moscow of a program to reduce the risk of a child becoming infected with an HIV-infected mother during pregnancy and childbirth. This is especially true today, when more and more HIV-infected women decide to have children. Thanks to the use of modern special prevention programs, the probability of having an HIV-infected child has now decreased by more than six times and does not exceed 3%.
The MGC AIDS has organized a round-the-clock operation of the “AIDS Hotline” telephone, which receives more than 50 calls per day not only from Moscow, but also from other regions of Russia. The website www.spid.ru is operational. Clinical and epidemiological research is conducted on the basis of the AIDS Medical Center; Center staff give lectures and conduct training seminars in other medical institutions in Moscow.
The center participates in scientific research, tests and puts into practice new methods of diagnosing and treating HIV infection. MGC AIDS coordinates the work of all medical institutions in Moscow on the prevention of HIV infection, and also controls the quality of laboratory diagnostics of HIV infection in medical institutions in Moscow.
The content of the article
Acquired immunodeficiency syndrome - AIDS(acquired immune deficiency syndrome, HIV infection) is an infectious disease from the group of slow infections caused by the human immunodeficiency virus (HIV) and is transmitted predominantly sexually, as well as parenterally; is characterized by a profound violation of cellular immunity, resulting in the addition of various secondary infections (including those caused by opportunistic flora) and malignant neoplasms. AIDS is the only slow infection capable of epidemic spread.Historical AIDS data
AIDS- a relatively new infectious disease. The first report of AIDS appeared in 1981 in the United States. Since 1979, strange group diseases of Pneumocystis pneumonia and Kaposi's sarcoma have been observed in the United States - rare diseases that occur against the background of immunodeficiency. The rapid spread of the disease indicated its infectious nature. At first, the disease was associated with herpes viruses, hepatitis B, cytomegalovirus, and Epstein-Barr virus. However, these assumptions were not confirmed. Researchers' attention was drawn to the ability of retroviruses to cause cell metaplasia and immunodeficiency. The search in this direction justified itself, and already in 1983 in France, L. Montagnier et al. and in 1984 in the USA R. Gallo et al. The causative agent of AIDS was discovered.Etiology of AIDS
The causative agent of the disease is human immunodeficiency virus (HIV)- belongs to the family Retroviridae. The name retrovirus is due to the presence in the virus of a unique enzyme - reverse transcriptase, with the help of which genetic information is read from RNA to DNA. HIV has a tropism for helper T lymphocytes (T4). T4 cell cultures were tested to cultivate HIV. However, unlike other retroviruses, which only cause cell malignancy, infection with HIV led to their death. Only obtaining a clone of leukemic T4 cells resistant to HIV made culturing the virus possible. HIV is genetically heterogeneous and has a high degree of variability. The virus is sensitive to heat, ether, ethanol, beta-propiolactone, and is inactivated quite quickly under the influence of conventional disinfectants, as well as at a temperature of 56 ° C.Epidemiology of AIDS
The source of infection is a sick person and virus carriers. The ways of spread are almost the same as hepatitis B - natural and artificial. The natural route of infection is the sexual (main) route of infection. Homosexuals and bisexual men are more often infected. “Vertical” transmission of infection from a pregnant woman to the fetus - transplacental infection - also plays a great role in the spread of HIV. The artificial route includes infections associated with the use of unsterile medical instruments, through the transfusion of blood and its preparations. Patients with hemophilia are especially often infected, due to repeated administration of blood clotting factors. Although HIV is found in the urine, sweat, and saliva of a patient, it is not transmitted through normal contact. Infection at home is possible when sharing a toothbrush, knife, scissors, etc. with a virus carrier or a sick person.According to the routes of infection, the following groups are identified at increased risk of contracting HIV:
1) homosexual and bisexual men;
2) prostitutes;
3) persons, regardless of gender, with a disordered sex life;
4) patients who are frequently administered blood products, especially patients with hemophilia;
5) drug addicts who use drugs parenterally;
6) children who are born from mothers who carry the virus or have AIDS.
Seasonality is not typical. Young people and children are more often affected by artificial parenteral spread of HIV - regardless of age. Susceptibility to infection has not been sufficiently studied. The disease manifests itself in most countries of the world in the form of isolated cases and cluster outbreaks. Most common in the USA and some African countries.
Pathogenesis and pathomorphology of AIDS
The pathogenesis of AIDS has been developed primarily at the level of hypotheses. The leading link in pathogenesis is the damage to lymphocytes - T-helper cells (T4). HIV enters cells through receptors on their outer membrane. With the help of reverse transcriptase, the RNA of the HIV genome enters the genome of the target cell, where it represents a provirus. This creates a latent infection.A latent infection can turn into an active one, which leads to illness. HIV also infects macrophages and other cells that have receptors in common with T4. The virus can persist in macrophages for a long time. With macrophages crossing the blood-brain barrier, HIV enters the spinal cord and brain, causing their damage.
Due to the destruction of T4, the helper/suppressor ratio changes - the T4/T8 ratio decreases significantly and does not exceed 0.6-0.5 (the norm is 1.8-2). The defeat of T4 is accompanied by an increase in T8 activity, which is characteristic of immunodeficiency. At the same time, this causes activation of B-lymphocytes, an increase in the number of immune complexes and other profound changes in almost the entire system of immunological homeostasis with a predominant disruption of its cellular component. Deep damage to the immune system leads to opportunistic infections caused by opportunistic flora. They aggravate the course of AIDS and often cause the death of patients.
Malignant neoplasms characteristic of AIDS arise due to the oncogenic effect of the virus, which causes the transformation of latent cancer genes of normal cells (pro-oncogenes) into oncogenes. The development of malignant neoplasms is also due to a profound disruption of immunological homeostasis. This is what is associated with the frequent occurrence of Kaposi's sarcoma in AIDS. There are hypotheses that explain the high susceptibility of homosexual men to HIV. According to one of them, alloimmunization of homosexuals with sperm contributes to the production of antibodies against spermatozoons, which cross-react with T-lymphocytes and negatively affect their functional activity. Thus, it is believed that increased susceptibility to HIV is also due to autoimmune processes. In addition, sperm can contribute to the development of immunosuppression due to the activity of transglutaminase and the action of polyamines (spermine, spermazine). Drugs and medications that suppress the immune system can affect susceptibility to HIV.
In recent years, a hypothesis has been put forward that sensitivity to HIV is genetically determined. This assumption was made on the basis that in patients with AIDS, a unique soluble immunosuppressive factor produced by peripheral blood mononuclear cells was identified. It is believed that under the influence of HIV, the production of this factor increases and this contributes to the development of the disease. The study of the pathogenesis of AIDS continues.
In people who died of AIDS, multiple inflammatory foci are found in almost all internal organs. It is typical that AIDS patients lose the ability to localize the infectious process and to form granulomas. Atypicality of many cells and an increase in the number of immature lymphoreticulocytes are observed. Various other changes occur, due to the characteristics of secondary infections or the nature of malignant neoplasms.
AIDS clinic
AIDS, like other slow infections, is characterized by a long incubation period - from 6 months to 5 years or more and a slow development of the disease. There are various forms of HIV infection - from asymptomatic to very severe clinical forms with layers of secondary infections and malignant neoplasms.Conventionally, 4 stages of the disease can be distinguished:
1) mononucleosis-like syndrome - acute infection;
2) generalized lymphadenopathy;
3) pre-AIDS;
4) stage of a developed clinic.
Separately, we should highlight the asymptomatic form of HIV infection, which can only be detected using specific research methods.
The initial (prodromal) period of AIDS lasts for a year, sometimes longer.
Usually the disease begins with fever, excessive sweating, and general weakness. A significant proportion of patients experience manifestations of mononucleosis-like syndrome (polyadenopathy), which, unlike other clinical signs of the disease, can develop within 2-3 weeks after infection. It begins acutely, the fever lasts 1-3 weeks, is characterized by various forms of sore throat, symmetrical enlargement of the cervical, occipital, axillary and inguinal lymph nodes (painless, mobile, the skin over them is not changed). The liver and spleen enlarge. For mononucleosis-like syndrome, an uncharacteristic decrease in the number of lymphocytes in the peripheral blood. Sometimes the onset of the disease can be flu-like.
The disease gradually enters a latent stage. Signs of mononucleosis-like syndrome disappear, leaving only generalized lymphadenopathy, which persists for a long time (for months). Generalized lymphadenopathy is characterized by an increase in at least two groups of lymph nodes. Most often these are axillary, posterior cervical, submandibular, supraclavicular. They can increase significantly, sometimes forming conglomerates, and pain may occur.
In the initial period of AIDS, skin lesions (seborrheic dermatitis, folliculitis, psoriasis), nails, often oral herpes, herpes zoster are possible.
Weight loss begins, which does not yet exceed 10% of body weight. The initial period of the disease is also characterized by recurrent respiratory infections.
Gradually the disease progresses, its next stage is pre-AIDS. The term "pre-AIDS" was proposed by the US Center for Infectious Diseases to refer to a Plexu eye symptom that resembles AIDS and gradually develops to a full clinical picture of the disease. The term is used to designate the transitional stage of the disease - from initial to clinically advanced (conditionally transitional period). Pre-AIDS is characterized by prolonged intermittent fever, often with increases in the afternoon, significant sweating with profuse night sweats, and severe general weakness. Loss of body weight during this period exceeds 10%. Quite often, severe long-term debilitating diarrhea and intoxication develop, and sometimes there may be mucus and blood in the stool. Many patients experience oral candidiasis, which tends to spread to the esophagus with the formation of erosions and ulcers (esophagitis). Herpetic lesions of the oral cavity also intensify, sometimes of the esophagus, trachea, bronchi, and lesions of the genital organs and areas of otkhodniks often occur. During this period, the development of Pneumocystis pneumonia is possible, although this is more typical for the full picture of AIDS.
The advanced AIDS clinical stage is characterized by an extremely serious condition of the patient.
At this stage of AIDS, depending on the nature of the secondary lesions, three forms are distinguished:
1) AIDS with opportunistic diseases;
2) AIDS with Kaposi's sarcoma or other malignant neoplasms;
3) AIDS with opportunistic infections and malignant neoplasms.
Opportunistic diseases, more often observed in patients with AIDS, are divided into four large groups:
1) protozoal and helminthiases;
2) mycoses;
3) bacterial;
4) viral.
All secondary infections, as a rule, have a severe course, often generalized.
Protozoal diseases include, in particular, Pneumocystis pneumonia, which is caused by Pneumocystis (P. corinii), one of the most severe complications of AIDS. Pneumonia is characterized by a subacute course, bilateral lung damage. Clinically characterized by a dry cough, shortness of breath, severe intoxication, severe circulatory failure. Pneumocystis pneumonia causes almost 40% of the mortality in AIDS patients.
Tuberculosis in patients with AIDS becomes disseminated and quickly leads to death. It is the leading cause of death for AIDS patients in regions with a high incidence of tuberculosis. Cytomegalovirus disease, observed in approximately 10-12% of patients, affects the lungs, central nervous system, and digestive organs. It is accompanied by fever, granulocytopenia, and lymphocytopenia. Patients may develop toxoplasmosis, cryptococcosis, isosporidiosis, atypical mycobacteriosis, and extrapulmonary tuberculosis. Most patients experience various neurological lesions. Some of them are a consequence of immunosuppression, most are caused by infectious and tumor processes. Patients with AIDS experience meningitis, myelopathy, signs of peripheral neuropathy, dementia, etc.
The incidence of malignant tumors in AIDS patients is 40%. Kaposi's sarcoma, an idiopathic multiple sarcoma, is most often observed. Much less common are Burkitt's lymphoma, diffuse undifferentiated lymphoma, and immunoblastic sarcoma. Initial manifestations of Kaposi's sarcoma can appear in patients even before the full picture of AIDS. Kaposi's sarcoma in patients with AIDS differs significantly from those forms that occur in patients with immunodeficiency conditions of other origins. In the case of a “normal” course, Kaposi’s sarcoma is often localized on the legs, in patients with AIDS - also in the head, face, and torso. The formation of spots, plaques, and nodes with hemorrhages is characteristic. The size of the elements is 3-5 mm, they are red-bluish or red-brown in color, later darkening. The elements are clearly defined, painless on palpation. Gradually they enlarge, take on the shape of a ring, and become dense with a recess in the center. In patients with AIDS, tumors become necrotic, become covered with ulcers, and quickly metastasize, affecting internal organs and lymph nodes.
Due to the large number of secondary diseases associated with AIDS, there is no typical clinical picture of the disease. Conditionally, depending on the predominance of certain manifestations, The following types of disease progression can be distinguished: pulmonary, gastrointestinal, cerebral and generalized (disseminated).
All AIDS patients experience typical changes in the blood and characteristic immunological changes. The blood side is characterized by leukopenia, lymphocytopenia, thrombocytopenia. The decrease in the number of lymphocytes is mainly due to the destruction of T-helper cells, which are sometimes not detected at all in the blood. All cellular immune reactions are also disrupted. Functional disorders of the T-cell component of immunity are laboratory manifested by the absence of delayed-type hypersensitivity reactions - reactions of inhibition of leukocyte migration, a decrease in the blast transformation rate. In patients with tuberculosis, the Mantoux test is negative, as are other skin allergy tests. A decrease in the content of interferon and interleukin-2 in the blood is also characteristic. The appearance of antibodies against lymphocytes, spermatozoons and thymus cells (thymus gland) indicates significant autoimmune disorders. They can be divided into the following groups:
1) quantitative disorders in the T-lymphocyte system - a decrease in the number of helpers, a change in their ratio with suppressors,
2) functional disorders in the T-lymphocyte system—a decrease or absence of various cellular immune responses;
3) functional deficiency of B lymphocytes - an increase in the level of serum immunoglobulins and the number of circulating immune complexes;
4) functional disorders of monocytes - decreased chemotaxis, lack of response to interleukin-1 inducers, increased production of prostaglandins, etc.;
5) serological changes - the presence in the blood serum of immunosuppressive factors that suppress immune reactions, antibodies against lymphocytes and some other cells of the body, an increase in the level of alpha-1-thymosin and a decrease in the concentration of serum thymulin.
The prognosis is unfavorable.
Most patients die in the first two years after the onset of clinical manifestations of AIDS. Only 20-25% of patients live longer than three years.
AIDS diagnosis
The main symptoms of the clinical diagnosis of AIDS are frequent infectious processes caused by opportunistic pathogens, in particular Pneumocystis pneumonia, recurrent respiratory infections, prolonged fever of unknown origin, weight loss of up to 10% or more, prolonged severe diarrhea, generalized lymphadenopathy, Kaposi's sarcoma, lymphomas CNS, prolonged unexplained lymphopenia. One of the nonspecific, but important laboratory indicators is a decrease in the number of T-helpers and their ratio with T-suppressors (T4/T8 0.6). The possibility of AIDS is indicated by the severe and long-term course of all diseases associated with immunodeficiency (for example, herpes zoster, candidiasis, etc.), as well as leukopenia, lymphopenia due to T-helper cells, thrombocytopenia. Thus, an important sign of AIDS can be all clinical and immunological manifestations indicating a violation of the immune system. Epidemiological history data are important.Patients with various infections and malignant neoplasms among groups at increased risk of AIDS are subject to mandatory screening for AIDS.
Specific diagnosis of AIDS. Isolation of HIV from blood, cerebrospinal fluid, saliva, semen and other material is important for the diagnosis of seronegative AIDS, i.e. in cases where it is not possible to detect antibodies against HIV in patients with an AIDS-like symptom complex. However, the complexity of the virological research method makes its widespread use impossible at present. In clinical practice, detection of antibodies to HIV using ELISA is common. There are a large number of domestic and foreign test systems, but they all quite often give false positive answers. A final answer about the presence of antibodies against HIV in the patient’s blood can be given only after checking a positive result using immunoblotting. This method detects the core and surface proteins of HIV.
Differential diagnosis carried out with all immunodeficiency conditions.
AIDS treatment
Etiotropic treatment has not been sufficiently developed. Most often, azidothymidine (Retrovir) is used, which suppresses the replication and cytopathic effect of the virus. In patients receiving azidothymidine, the clinical course of the disease and immunological parameters are slightly improved, but this effect is unstable. Interferons are used, which give a temporary stabilizing effect, as well as interleukin-2.In the treatment of AIDS patients, the fight against secondary infections plays an important role. For Pneumocystis infection, bactrim, metronidazole, pentamidine are used, against Cryptococcus and other fungi - amphotericin B, against various bacteria - appropriate antibiotics.
Immunomodulators (thymolin, levamisole, etc.) are also used, but their effectiveness is unconvincing. In general, immunomodulatory treatments for AIDS patients have not been developed. In autoimmune processes, cytotoxic drugs are sometimes prescribed, in particular cyclosporine A, but their effectiveness is low. Other medications are prescribed depending on the characteristics of the course of AIDS and concomitant diseases.
AIDS prevention
Patients and virus carriers are under constant monitoring. they are warned of criminal liability for knowingly spreading the disease in accordance with current legislation. The main effective means of preventing AIDS is health education aimed at informing the population about the ways of spreading and means of preventing AIDS. Using condoms prevents sexual transmission of HIV. To prevent blood transfusion infection, donors are screened for antibodies against HIV. Prevention of infection by parenteral routes in medical institutions involves the provision of disposable medical instruments and strict adherence to the sterilization regime.To actively identify patients and virus carriers, it is necessary to conduct preventive examinations in groups at high risk of infection, as well as among the sexual partners of patients and virus carriers. Anonymous examination rooms are important for identifying HIV carriers and patients. Specific prevention of AIDS has not been developed.
