The article presents a review of the recent hypothesis that the national policy of BCG-vaccination affects the spread of COVID-19 in different countries. It contains the information from 70 publications with epidemiological indicators, providing pros and cons of this hypothesis, with the description of possible mechanisms of non-specific antiviral action of BCG vaccine. It is concluded that there are not enough data to verify or refute the hypothesis, and at the moment the use of BCG vaccine to prevent the spread of the infection even in high-risk groups would be unreasonable.

The article presents a review of 60 publications from international and Russian databases (PubMed, Web of Science, and Elsevier) from 1960 to 2018 with the keywords "sarcoidosis," "autoimmune reactions," "antibodies," and "HLA-genotype" characterizing sarcoidosis as an autoimmune disease. The information is divided into sections: the role of triggers, clinical manifestations and combination with autoimmune diseases, immunogenetic predisposition, features of cellular immune response, humoral immune response, and immunosuppressive therapy.

In Russia starting from 2014, adults from risk groups are vaccinated against pneumococcal infection in accordance with the vaccination calendar based on epidemic indications. However, data collected by the Epidemiological Surveillance for Vaccine Prevention do not allow to judge about the protection of adult population against pneumococcal disease, as there is no information on the coverage of risk groups.

The objective: to analyze the coverage of adult population from risk groups with vaccination against pneumococcal infection.

Subjects and methods. The number and groups of adults vaccinated against pneumococcal infection were provided by the executive authorities in charge of health care in the Russian Federation. Data for 4 years were collected (2015-2018). The information was received from 79 regions of the Russian Federation. Descriptive statistics methods were used to analyze the coverage in age and occupational risk groups and people with chronic diseases.

Results. The main groups of adults vaccinated against pneumococcal infection were the following: patients with chronic diseases (55%, including 27.5% of patients with chronic lung disease), conscripts (30%), various occupational risk groups (11%). The remaining risk groups accounted for less than 5% of vaccinations. The maximum coverage was achieved among adults with chronic lung disease (15.1%). Among patients with chronic non-pulmonary diseases, coverage was the following: patients with liver diseases – 4%, cardiovascular diseases – 3.8%, endocrine system – 2.8%, immunodeficiencies – 1%. In other groups of chronic patients, coverage was even lower. Among adults with occupational risk factors and staying in special conditions, the maximum vaccination coverage was achieved among conscripts (67.4%). Vaccination in other categories of occupational risk was performed in a small number of people; among health workers, it was 4.9%, among employees of educational organizations of open type (schools, kindergartens, etc.) it made 3.1%.

The objective: to study efficacy and safety of metabolically favorable antiretroviral therapy regimens (ART), their effect on HIV RNA levels, levels of CD4, CD8 T lymphocytes, and the ratio of CD4/CD8 in HIV patients who had no previous treatment.

Subjects and methods. The study included 80 patients with HIV infection who no received ART previously, 67 of them – without clinical manifestations of HIV infection, 13 – with HIV associated diseases. The virological and immunological efficacy of three ART regimens was evaluated: rilpivirine + emtricitabine + tenofovir (RPV + FTC + TDF); dolutegravir, emtricitabine, tenofovir (DTG, FTC, TDF); raltegravir, etravirine, lamivudine (RAL, ETR, 3TC) during the first 6 months of treatment.

Results. By the end of the 6th month of ART, the rate of decrease of viral load compared to the initial level increased in the series RPV + FTS + TDF < RAL, ETR, 3TC < DTG, FTC, TDF. The number of CD4 T-lymphocytes and the ratio of CD4/CD8 increased in all three ART regimens; the number of CD8 T-lymphocytes varied depending on the treatment regimen, the presence or absence of clinical manifestations. The assessment of ART efficacy should be based on the clinical signs of HIV infection. To assess treatment efficacy, it is necessary to control the viral load and three immunological parameters: the number of CD4, CD8 T-lymphocytes, and the ratio of CD4/CD8.

The objective: to study the structure of Beijing genotype family of Mycobacterium tuberculosis in Omsk Region, Western Siberia.

Subjects and methods: 325 strains of M. tuberculosis were studied, all of them were isolated from tuberculosis patients in Omsk Region. Strains were tested to identify if they belonged to Beijing genotype, B0/W148 and 94-32. Locus NTF and region RD181 were assessed. Ancient Beijing strains were analyzed by spoligotyping and MIRU-VNTR-typed at 12 loci, and the obtained profiles were compared with the international database of SITVIT_WEB.

Results. Among 204 (62.7%) strains of M. tuberculosis from Beijing family, 176 (86.3%) of strains belonged to the modern sublineage of 94-32 (60.7%) and B0/W148 (25.0%) clusters. Inside 94-32 cluster, it was found that 13 (10.5%) strains belonged to CAO group. Strains of the ancient Beijing sublineages of RD181[+] and RD181[-] were detected in 3.4% (7/204) and 10.3% (21/204) cases, respectively. All of Beijing RD181[+] strains had SIT269 spoligoprofile. The majority of strains of the ancient sublineage were represented by the MIRU types – MIT135 and MIT642.

Conclusion. In Omsk Region of Western Siberia, strains of the modern sublineage prevail in the population of M. tuberculosis of Beijing family, the prevalence of ancient strains of this family is (13.7%). The high level of multiple drug resistance is typical of strains of the modern sublineage of B0/W148, 94-32 CAO clusters and strains of the ancient Beijing sublineage.

The objective: to study the quantity and variability of bacterial microbiota in lower gut, the prevalence of microorganisms resistant to antibacterial drugs among microorganisms isolated from the bronchi of pulmonary tuberculosis patients receiving chemotherapy.

Subjects and methods. Microorganisms of the bacterial microbiota from lower gastrointestinal tract isolated from respiratory tuberculosis patients were studied. 178 patients were examined retrospectively and 53 patients were examined prospectively. Diagnostic specimens obtained from the bronchi/lungs (sputum, bronchoalveolar lavage fluid, aspirate, etc.) of respiratory tuberculosis patients were tested. Bacteriological tests complying with current regulatory documents were used.

Results. It was found out that gut microbiota varied in tuberculosis patients of various age groups at different stages of treatment and in addition to that, the microbiota was characterized by certain pronounced manifestations of dysbiosis. In cases when clinically significant microorganisms were isolated from bronchi of respiratory tuberculosis patients, a relatively high prevalence of microorganisms resistant to the most important antibacterial drugs was detected.

The objective: to identify and rank the predictors of lethal outcome in patients with tuberculosis resistance to at least rifampicin and concurrent HIV infection (TB-R/HIV).

Subjects and methods. 130 cases TB-R/HIV notified in Rostov Region in 2017-2018 were included in an observational retrospective cohort study. Two cohorts were formed: cohort A consisted of 31 patients with a documented fatal outcome within 12 months after registration for treatment, cohort B included 99 patients didn't die at least during the first year after registration for treatment. At the first stage of the study, the statistical significance of differences of certain signs in patients of cohorts A and B was determined. The signs with confirmed statistical significance of differences were included in the second stage of the study, during which their sensitivity as predictors of lethal outcome was determined. For this, automated artificial neural networks were used.

Results. The following can be used as predictors of lethal outcome for TB-R/HIV patients (in decreasing order of significance): homelessness (people who have no place of residence), addiction to alcohol or drugs, interruption of anti-TB chemotherapy in the past, low body mass index, low hemoglobin level, including anemia (but not severe), low level of CD4 T-lymphocytes (the prognosis is especially unfavorable with less than 100 cells/μl). The level of total protein may also be a potential predictor, however, the selection criteria for this indicator require further clarification.

The article describes a clinical case of diagnosis and successful treatment of liver tuberculosis in a 55-year-old female patient who has disability status (Group 1) due to cancer (acute myeloblastic leukaemia and mastectomy due to cancer in the past). Liver tuberculosis was diagnosed as a result of liver biopsy after focal changes had been detected by MSCT.