Microbicides for Topical HIV Immunoprophylaxis: Current Status and Future Prospects Yury V. Zhernov, Vladislava O. Petrova, Mark Y. Simanduyev, Denis V. Shcherbakov, Roman V. Polibin, Oleg V. Mitrokhin, Artem A. Basov, Nadezhda N. Zabroda, Sonya O. Vysochanskaya, Ezzulddin Al-khaleefa, Kamilla R. Pashayeva, Narmina Yu. Feyziyeva Pharmaceuticals, 2024 Microbicides, which are classified as topical antiseptic agents, are a revolutionary advancement in HIV prevention aimed to prevent the entry of infectious agents into the human body, thus stopping the sexual transmission of HIV and other sexually transmitted diseases. Microbicides represent the promise of a new age in preventive measures against one of the world’s most pressing health challenges. In addition to their direct antiviral effects during HIV transmission, microbicides also influence vaginal mucosal immunity. This article reviews microbicides by presenting different drug classifications and highlighting significant representatives from each group. It also explains their mechanisms of action and presents information about vaginal mucosal immune responses, emphasizing the critical role they play in responding to HIV during sexual transmission. The article discusses the following groups of microbicides: surfactants or membrane disruptors, vaginal milieu protectors, anionic polymers, dendrimers, carbohydrate-binding proteins, HIV replication inhibitors (reverse transcriptase inhibitors), and multi-purpose prevention technologies, which combine protection against HIV, other sexually transmitted diseases, and contraception. For each chemical compound, the article provides a brief overview of relevant preclinical and clinical research, emphasizing their potential as microbicides. The article offers insights into the multifaceted impact of microbicides, which signify a pivotal step forward in the pursuit of effective and accessible pre-exposure prophylaxis (PrEP).
Chorioamnionitis: clinical, anamnestic and molecular-genetic parallels I. V. Ignatko, A. D. Megrabyan, V. M. Anokhina, A. A. Churganova, T. V. Rasskazova, O. V. Zavyalov, V. A. Titov, V. O. Petrova Obstetrics Gynecology and Reproduction, 2024 Aim: to determine clinical, anamnestic and molecular-genetic parallels in emergence of clinical chorioamnionitis (CA) and severe forms of intrauterine infections (IUI) in high-risk pregnant women.Materials and Methods. A single-center prospective cohort comparative case-control study was conducted by examining 58 pregnant female patients aged 18 to 42 years with a verified CA diagnosis during pregnancy and childbirth at different gestation stages (main group), and 35 age-matched pregnant women with uncomplicated pregnancy and no significant extragenital pathology, aggravated factors of obstetric and gynecological history and risk factors for developing CA (control group), observed and performed a delivery in Yudin City Clinical Hospital. All women underwent clinical, anamnestic, laboratory, instrumental and molecular-genetic examitation. We studied the polymorphism of genes FCGR2A (Fc fragment of immunoglobulin G receptor IIa), IFN-γ (interferon gamma), IL-10 (interleukin-10), IL-6 (interleukin-6) and MBL2 (mannose binding lectin 2) to determine their role in assessing a risk of maternal and neonatal infection.Results. Among the patients with developed clinical CA vs. control subjects, more of them had a history of abortion and miscarriages (17.24 %), comorbid with chronic arterial hypertension (13.79 %), previous surgical interventions (27.59 %), as well as chronic inflammatory diseases (chronic tonsillitis, bronchitis, pyelonephritis, sinusitis; 27.59 % vs. 17.14 %). In addition to risk factors directly related to the infectious and inflammatory unfavorable background, they also had a significantly higher rate of obstetric complications: moderate preeclampsia - 6 (10.34 %) cases, threat of miscarriage or premature birth - 14 (24.14 %) cases vs. 1 (2.86 %) case in control group (p = 0.007), polyhydramnions - 4 (6.9 %) cases, placental insufficiency - 6 (10.34 %) cases. The frequency of premature rupture of membranes was 31.03 % in women with CA. Questionable cardiotocography (CTG) type was found in 24 (41.38 %) women with CA vs. 4 (11.4 3%) women without CA (p = 0.003), the pathological CTG type was observed only in women with CA. In the group with clinical CA and neonatal IUI, the combination of genotypes AG rs1801274 FCGR2A, TT rs2430561 (IFN-γ)+874, GC rs1800795 (IL-6)-174 occurs in 80.65 % (25/31), whereas in women without severe neonatal IUI - in 37.04 % (10/27) (odds ratio (OR) = 7.08; 95 % confidence interval (CI) = 2.166-23.166). In addition, the combination of alleles TT rs2430561 (IFN-γ)+874, GC+CC rs1800795 (IL-6)-174, AA rs1800450 MBL2 codon 54 was detected in 90.32 % (28/31) vs. 44.44 % (12/27) in main and control group (OR = 11.667; 95 % CI = 2.842-47.886), respectively.Conclusion. The study data evidence about importance of identifying genes for developing CA and neonatal septic complications to optimize and personalize management of high-risk patients (premature birth, infections during pregnancy, premature rupture of membranes).
A new method of hysterosuspension in patients with cervical elongation A.I. Ishchenko, A.A. Ishchenko, I.D. Khokhlova, T.A. Dzhibladze, O. Yu. Gorbenko, et al. Voprosy Ginekologii Akusherstva I Perinatologii, 2024 Objective. To improve the efficacy and long-term outcomes of surgical treatment of grade II–III cervical elongation. Patients and methods. The study included 22 patients aged 30–74 years with grade II–III cervical elongation. All patients underwent surgical treatment based on the developed original technique with titanium implants (braid). Results. The results of the surgical intervention were evaluated on an outpatient basis at 1, 6, 12, and 24 months after surgery. A comparison of questionnaires before surgery and in the early and late postoperative periods showed improvement in the quality of life of patients, social and sexual activity. During the first postoperative month, 12 (54.5%) patients reported non-acute cramping pain in the perineum and/or inguinal/femoral region, 6 (27.3%) patients complained of frequent urination. A comprehensive clinical examination in the dynamics revealed the preservation of surgical correction, absence of pelvic organ prolapse in all patients in the early and last postoperative periods. Mesh-associated complications were not revealed during the follow-up period. Conclusion. The study demonstrated the efficacy and safety of the developed original technique of hysterosuspension using tape-like titanium (braid) mesh implants in patients with grade II–III cervical elongation of different age groups, as evidenced by a normal position of the uterus, absence of pelvic organ prolapse, and Mesh-associated complications during the follow‑up period. Key words: grade II–III cervical elongation, surgical correction, tape-like titanium mesh implants, hysterosuspension
Medical Care for Tuberculosis-HIV-Coinfected Patients in Russia with Respect to a Changeable Patients’ Structure Olga P. Frolova, Olga V. Butylchenko, Patimat G. Gadzhieva, Margarita Yu. Timofeeva, Valeria A. Basangova, Vladislava O. Petrova, Inna A. Fadeeva, Maria I. Kashutina, Nadezhda N. Zabroda, Artem A. Basov, Elena V. Belova, Yury V. Zhernov, Oleg V. Mitrokhin, Inga I. Enilenis, Lyudmila P. Severova Tropical Medicine and Infectious Disease, 2022 To date, tuberculosis (TB) remains the primary cause of mortality in human immunodeficiency virus (HIV) patients in Russia. Since the beginning of 2000, a sharp change in the HIV patients’ structure, to the main known risk factors for HIV infection has taken place in Russia. The transmission of HIV through injectable drug use has begun to decline significantly, giving way to the prevalence of sexual HIV transmission today. These changes may require adjustments to organizational approaches to anti-TB care and the treatment of HIV-positive patients. Our study is aimed at identifying changes in TB-HIV coinfection patients’ structures in 2019 compared to 2000. Based on the results obtained, our goal was to point out the parameters that need to be taken into account when developing approaches to improve the organization of TB control care for people with HIV infection. We have carried out a cross-sectional, retrospective, epidemiological study using government TB registry data from four regions in two federal districts of Russia in 2019. The case histories of 2265 patients from two regions with high HIV prevalence, which are part of the Siberian Federal District of Russia, and 89 patient histories from two regions of low HIV prevalence, which are part of the Central Federal District of Russia, were analyzed. We found that parenteral transmission (69.4%) remains the primary route of HIV transmission among the TB-HIV coinfected. The unemployed of working age without disability account for 80.2% of all coinfected people, while the formerly incarcerated account for 53.7% and the homeless account for 4.1%. Those with primary multidrug-resistant TB (MDR-TB) comprise 56.2% of HIV-TB patients. When comparing the incidence of coinfection with HIV among TB patients, statistically significant differences were obtained. Thus, the chances of coinfection increased by 4.33 times among people with active TB (95% CI: 2.31; 8.12), by 2.97 times among people with MDR-TB (95% CI: 1.66; 5.32), by 5.2 times in people with advanced processes in the lungs, including destruction, (95% CI: 2.78; 9.7), as well as by 10.3 times in the case of death within the first year after the TB diagnosis (95% CI: 2.99; 35.5). The absence of data for the presence of TB during preventive examination was accompanied by a decrease in the chances of detecting coinfection (OR 0.36; 95% CI: 0.2; 0.64). We have identified the probable causes of the high incidence of TB among HIV-infected: HIV-patient social maladaptation usually results in delayed medical care, leading to TB treatment regimen violations. Furthermore, self-administration of drugs triggers MDR-TB within this group. Healthcare providers should clearly explain to patients the critical importance of immediately seeking medical care when initial TB symptoms appear.
