urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.5.29GTKQTDurmj-1969Research ArticleОригинальные статьи | Original articlesOriginal articlesКлинико-эпидемиологические и диагностические особенности сочетанной ВИЧ-CHB-инфекцииClinical, Epidemiological and Diagnostic Aspects of Combined HIV-CHB Infectionhttps://orcid.org/0009-0004-6663-7669СиразиевА. М.SirazievA. M.

Сиразиев Айрат Маратович — эпидемиолог эпидемиологического отдела, РЦПБ со СПИД и ИЗ МЗ РТ; преподаватель кафедры фундаментальной медицины, медицинский институт, МарГУ.

Казань; Йошкар-Ола

Airat M. Siraziev — Epidemiologist of the Epidemiological Department, Republican Center for AIDS and Infectious Diseases Prevention and Control of the Ministry of Health of the Republic of Tatarstan; Lecturer of the Department of Fundamental Medicine, Institute of Medicine, Mari State University.

Kazan; Yoshkar-Ola

sirazievair95@mail.ruhttps://orcid.org/0000-0003-2711-0624ЕремееваЖ. Г.EremeevaZ. G.

Еремеева Жанна Григорьевна — кандидат медицинских наук, эпидемиолог эпидемиологического отдела, РККВД МЗ РТ им. проф. А.Г. Ге; ассистент кафедры эпидемиологии и доказательной медицины, КГМУ.

Казань

Zhanna G. Eremeeva — Candidate of Sciences (Medicine), Epidemiologist of the Epidemiological Department, Professor A. G. Ge Republican Clinical Dermatology and Venereology Dispensary of the Ministry of Health of the Republic of Tatarstan; Assistant of the Department of Epidemiology and Evidence-Based Medicine, Kazan State Medical University.

Kazan

Z.Eremeeva@tatar.ruhttps://orcid.org/0000-0003-4333-6316ФазыловВ. Х.FazylovV. Kh.

Фазылов Вильдан Хайруллаевич — доктор медицинских наук, профессор, инфекционист поликлиники, РЦПБ со СПИД и ИЗ МЗ РТ; профессор кафедры внутренних болезней № 2, медицинский институт, МарГУ; профессор кафедры инфекционных болезней, КГМА, РМАНПО.

Йошкар-Ола; Казань

Vildan Kh. Fazylov — Doctor of Sciences (Medicine), Professor, Infectiologist of the Polyclinic, Republican Center for AIDS and Infectious Diseases Prevention and Control of the Ministry of Health of the Republic of Tatarstan; Professor of the Department of Internal Medicine No. 2, Institute of Medicine, Mari State University; Professor of the Department of Infectious Diseases, Kazan State Medical Academy, Russian Medical Academy of Continuing Professional Education.

Kazan; Yoshkar-Ola

fazylov47@inbox.ruРеспубликанский центр по профилактике и борьбе со СПИД и инфекционными заболеваниями Министерства здравоохранения Республики Татарстан; Марийский государственный университетРоссияRepublican Center for AIDS and Infectious Diseases Prevention and Control of the Ministry of Health of the Republic of Tatarstan; Mari State UniversityRussian FederationРеспубликанский клинический кожно-венерологический диспансер Министерства здравоохранения Республики Татарстан имени профессора А.Г. Ге; Казанский государственный медицинский университетРоссияProfessor A.G. Ge Republican Clinical Dermatology and Venereology Dispensary of the Ministry of Health of the Republic of Tatarstan; Kazan State Medical UniversityRussian FederationРеспубликанский центр по профилактике и борьбе со СПИД и инфекционными заболеваниями Министерства здравоохранения Республики Татарстан; Марийский государственный университет; Казанская государственная медицинская академия, Российская медицинская академия непрерывного профессионального образованияРоссияRepublican Center for AIDS and Infectious Diseases Prevention and Control of the Ministry of Health of the Republic of Tatarstan; Mari State University; Kazan State Medical Academy, Russian Medical Academy of Continuing Professional EducationRussian Federation20250211202524529–40Copyright © Сиразиев А.М., Еремеева Ж.Г., Фазылов В.Х., 20252025Сиразиев А.М., Еремеева Ж.Г., Фазылов В.Х.Siraziev A.M., Eremeeva Z.G., Fazylov V.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1969

Цель работы — представить эпидемиологические и клинико-диагностические особенности хронического гепатита B (CHB) при сочетанном течении с инфекцией вируса иммунодефицита человека (ВИЧ) в условиях реальной клинической практики.

Материалы и методы

Материалы и методы. Проведено одноцентровое кросс-секционное исследование на базе Республиканского центра по профилактике и борьбе со СПИД и инфекционными заболеваниями (Казань). Проанализированы амбулаторные карты 117 пациентов, наблюдавшихся в 2021–2023 гг. с установленным диагнозом «ВИЧ-инфекция» и наличием маркеров HBV-инфекции, а также лабораторные показатели и данные эпидемиологических карт. Категориальные данные представлены в виде абсолютных и относительных значений.

Результаты и обсуждение

Результаты и обсуждение. На протяжении всего исследования у 95 (81,20 %) обследованных в сыворотке крови определялся HBsAg, у 22 (18,80 %) — только anti-HBc сумм., что свидетельствует о потере HBsAg. В выборке преобладали мужчины — 89 (76,07 %). Возраст исследуемых составил 45 [42; 48] лет. При постановке на учет по ВИЧ основная часть наблюдаемых находилась на стадиях IVА (65,72 %) и IVБ (23,93 %). Длительность диспансерного наблюдения составила 15 [10; 22] лет; получения антиретровирусной терапии (АРТ) — 8 [5; 12] лет (один пациент АРТ не получал). Основной путь передачи — инъекционное употребление наркотиков (68 (58,12 %)). У 85 (72,65 %) лиц выявлены anti-HCV, у 7 (5,98 %) пациентов — маркеры HDV.

Заключение

Заключение. Латентные формы HBV-инфекции у ВИЧ-положительных лиц требуют длительного диспансерного наблюдения с использованием расширенного комплекса лабораторных и инструментальных методов. Поддержание высокой приверженности к АРТ и грамотный выбор схемы лечения являются важными условиями снижения вирусной нагрузки HBV и предупреждения реактивации инфекции.

Objective is to characterize the epidemiological and clinical-diagnostic features of chronic hepatitis B (CHB) in the context of HIV coinfection in real-world clinical practice.

Materials and methods

Materials and methods. A single-center cross-sectional study was conducted at the Republican Center for AIDS and Infectious Diseases Prevention and Control in Kazan. Medical records of 117 patients with HIV infection and HBV markers who were under observation from 2021 to 2023 were analyzed. Laboratory findings and data from epidemiological investigation forms were reviewed. Categorical variables are presented as absolute values and percentages.

Results and discussion

Results and discussion. HBsAg was detected in 95 (81.20 %) patients, while 22 (18.80 %) had only anti-HBc, indicating loss of HBsAg. The majority were male (89 (76.07 %)), with an age of 45 [42; 48] years. Patients aged 40– 49 years accounted for 85/117 (72.65 %). At the time of HIV diagnosis, most patients were at stage IVА (65.72 %) or IVB (23.93 %). The median duration of clinical follow-up was 15 [10; 22] years, and median antiretroviral therapy (ART) duration was 8 [5; 12] years (one patient had not received ART). Injection drug use was the main transmission route (68 (58.12 %)). Anti-HCV antibodies were detected in 85 (72.65 %) patients, and HDV markers were found in 7 (5.98 %) cases.

Conclusion

Conclusion. The findings highlight the need for long-term monitoring of HIV-СHB coinfected patients. Comprehensive diagnostic approaches and individualized ART regimens are recommended to reduce the risk of HBV reactivation and disease progression.

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The authors declare that there are no conflicts of interest present.