Latent tuberculosis infection (LTBI) represents a major global health concern as it constitutes the principal reservoir for future tuberculosis (TB) disease. Its identification is particularly important in Bacille Calmette–Guérin (BCG)-vaccinated populations, where cross-reactivity of purified protein derivative limits the specificity of the tuberculin skin test and hampers targeted preventive therapy. Early Mycobacterium tuberculosis antigens encoded within the RD1 region, especially ESAT-6, CFP-10 and TB7.7, have enabled the development of antigen-specific interferon-gamma release assays (IGRAs) and recombinant skin tests with improved BCG-independent specificity. This narrative review integrates and critically appraises current evidence on the immunobiological properties of early and latency-associated antigens, the cellular mechanisms underlying T-cell-dependent immune reactivity, and the diagnostic performance of IGRAs and ESAT-6/CFP-10-based skin tests, rather than merely summarizing individual studies. Although these platforms rely on different assay principles (in vitro cytokine release versus in vivo delayed-type hypersensitivity), both measure antigen-specific T-cell memory and do not define the biological stage of infection or reliably distinguish latent from incipient or active TB. Across most adult populations, IGRAs demonstrate high specificity and acceptable sensitivity, whereas reduced sensitivity and higher rates of indeterminate results are observed in young children and immunocompromised individuals. ESAT-6/CFP-10-based skin tests show diagnostic accuracy comparable to IGRAs and may offer operational advantages in resource-limited settings. Latency-associated antigens and host biomarkers such as IP-10, together with multi-analyte immune signatures, represent promising avenues for improving diagnostic sensitivity and prognostic stratification but currently lack sufficient validation for routine clinical use. Overall, RD1-encoded antigens remain central to LTBI immunodiagnosis, while future research should focus on developing stage-resolving and prognostic biomarkers, optimized antigen panels, and standardized interpretive frameworks.

Background: Poor adherence to antihypertensive therapy is a major barrier to effective blood pressure control, particularly in countries with a high burden of non-communicable diseases. In Kazakhstan, improving adherence is a key objective of the “Densaulyk” State Health Program (2020–2025). Objective: To assess medication adherence among patients with arterial hypertension in Kazakhstan and identify associated socio-demographic and clinical factors. Methods: A cross-sectional survey was conducted among outpatient hypertensive patients at a major urban medical center. Adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Socio-demographic characteristics, disease duration, and the number of prescribed medications were analyzed in relation to adherence levels. Results: Adherence was significantly associated with age, ethnicity, education, marital and financial status, disease duration, and treatment complexity. A notable share of participants demonstrated low to moderate adherence. The use of self-reported data may have introduced bias. Conclusions: Medication adherence in Kazakhstan is influenced by multiple interrelated factors. Targeted and culturally appropriate interventions—such as simplified regimens, digital tools, and broader access to subsidized drugs—are essential to improve long-term outcomes in hypertension management.

Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major global health burden due to latent infection, multidrug resistance, and the limite

Tuberculosis (TB) remains a major global health concern, with the transition from latent to active TB still poorly understood. Therefore, enhancing clinical management and prevention strategies for TB is essential. High-throughput sequencing data of genes and miRNAs from individuals at different TB stages were obtained from NCBI. Differential expression analysis was performed using the R package limma, alongside GO and KEGG analyses. The central regulatory network of miRNAs was visualized with Cytoscape, and relevant genes were validated using ROC analysis. The predicted key genes involved in the transition from latent to active TB, including PLEKHG1, CLPB, DOK4, IL1β, and TLR3, are primarily associated with multicellular organism processes, stimulus-response, GPCR ligand binding, and immune functions. Finally, we screened Celastrol and Cefaclor Anhydrous targeting IL1β as potent anti-inflammatory drug to reduce the inflammation due to TB. These findings were further validated with Molecular dynamic simulation MM-GBSA and PCA analysis. Our study advances the understanding of latent tuberculosis and identifies genes and microRNAs as potential biomarkers for diagnosis, monitoring, and treatment, with broader implications for complex disease research.

Acinetobacter baumannii has emerged as one of the most challenging opportunistic pathogens in modern healthcare due to its remarkable ability to acquire and disseminate antimicrobial resistance determinants. Carbapenem-resistant A. baumannii (CRAB) is now recognized by the World Health Organization as a critical priority pathogen, highlighting the urgent need for improved diagnostic, surveillance, and therapeutic strategies. This review synthesizes current evidence on the relationship between phenotypic antimicrobial susceptibility patterns and underlying genetic determinants of resistance in A. baumannii. A structured literature search was conducted across major biomedical databases (PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library), supplemented by citation tracking and relevant institutional sources, focusing on studies published between 2016 and 2026. The analysis integrates findings from studies examining phenotypic antimicrobial susceptibility testing (AST) with molecular and genomic investigations of resistance mechanisms, including carbapenemases, aminoglycoside-modifying enzymes, efflux pumps, and resistance-associated genomic islands. Particular attention is given to the complex and sometimes discordant relationship between genotype and phenotype, where the presence of resistance genes does not always translate directly into phenotypic resistance due to regulatory mechanisms, gene expression variability, and genomic context. The review further discusses methodological differences in AST standards and genomic prediction approaches that may contribute to variability across studies. Collectively, the evidence supports a multidimensional interpretation of antimicrobial resistance in A. baumannii, emphasizing the necessity of integrating phenotypic and genotypic data for accurate diagnostics, surveillance, and clinical decision-making. This integrated perspective may contribute to improved understanding of resistance evolution and support the development of more effective strategies for managing multidrug-resistant A. baumannii infections.

Введение. В настоящее время одним из перспективных противовирусных препаратом для лечения COVID-19 является Ремдесивир. Для окончательного решения вопроса о включении этого препарата в международные рекомендации для лечения COVID-19 необходимы дальнейшие исследования для оценки его эффективности и безопасности у пациентов с COVID-19. Цель исследования – изучить клиническую эффективность ремдесивира в комплексной терапии пациентов с коронавирусной инфекцией COVID-19 средней степени тяжести. Материалы и методы исследования. В исследовании проанализированы данные 80 медицинских карт стационарного больного со среднетяжелой формой коронавирусной инфекции COVID-19. Исследование проводилось по историям болезней пациентов в ГКП на ПХВ «Многопрофильный медицинский центр» акимата города Нур-Султан. Работа проводилась в соответствии с заданием МЗ РК в рамках исследования по изучению эффективности ремдесивира в комплексном лечении пациентов с коронавирусной инфекцией COVID-19 и является открытым ретроспективным исследованием (протокол ЛЭК № 10 от 26.11.2020). Опытную группу (основная группа) составили 40 пациентов со среднетяжелой формой КВИ, которым дополнительно к стандартной терапии в соответствии с Клиническим протоколом диагностики и лечения «Коронавирусная инфекция COVID-19 у взрослых» по решению консилиума назначался препарат ремдесивир в дозе 200 мг в/в в 1-й день, затем 100 мг в/в ежедневно, всего 5 – 7 дней. Группу сравнения (контрольная группа) составили 40 пациентов, получавших патогенетическую и симптоматическую терапию без ремдесивира в соответствии с клиническим протоколом. Статистическая обработка полученных данных проводилась методами описательной статистики, проведен сравнительный анализ методом Т-теста (Стьюдент), анализ частот, расчёты Хи-квадрат с помощью программы IBMSPSS Statistics 20.0 и Jamovi. Результаты и обсуждение. Настоящее исследование показало, что раннее начало противовирусной терапии Ремдесивиром по сравнению со стандартной терапией без противовирусного препарата пациентов со среднетяжелой формой COVID-19 ассоциировано со статистически значимым клиническим улучшением и большим процентом элиминации вируса со слизистых оболочек верхних дыхательных путей по данным молекулярно-генетического исследования. В группе пациентов, получавших ремдесивир, полная ремиссия заболевания с нормализацией температуры тела и отсутствием жалоб на 7 дней госпитализации в стационар отмечалось достоверно чаще, чем в группе сравнения. Противовирусная терапия ремдесивиром назначалась пациентам с сопутствующей патологией (сахарный диабет, ожирение, артериальная гипертензия), являющейся фактором риска тяжелого, неблагоприятного течения заболевания. Не было зарегистрировано ни одного случая с ухудшением состояния пациента за счет прогрессирования инфекционного процесса на фоне применения ремдесивира. Тогда как в контрольной группе у 10% пациентов наблюдалось прогрессирование заболевания с развитием осложнений. Все эти пациенты имели факторы риска развития тяжелого течения COVID-19. Выводы. Полученные результаты показали, что Ремдесивир является эффективным противовирусным препаратом в комплексном лечении коронавирусной инфекции COVID-19 средней степени тяжести. Раннее назначение препарата у пациентов со среднетяжелой формой болезни...