Type of enterovirus was detected in 2753 cases when examining 4122 patients with various clinical forms of enterovirus infection (EVI) during the 2017-2018 period. We identified viruses of 42 types belonging to Enterovirus A-B-С species. The ratio of EV-A: EV-B: EV-C species was 51.29 percent: 47.06 percent: 1.65 percent. In 413 environment samples 29 non-polio enteroviruses were identified, three of which, CA14, EVA76 and ECHO25, were not detected in the period in patients with EVI. The Coxsackie A6 virus, which caused a drastic increase in the morbidity of exanthema forms was the dominant agent in the etiological structure of EVI in 2017 in most areas; the leading etiological agents of enteroviral meningitis (ECM) were the ECHO30, ECHO9, ECHO18 viruses. There was a decrease in the morbidity of both all forms of EVI and computers due to a decrease in the activity of the circulation of epidemic variants of the Coxsackie A6 and ECHO30 viruses as a whole in Russia in 2018. The computer epidemic process in 2018 was supported by the become active or remained active viruses of ECHO6, Coxsacke B5, ECHO9, ECHO18 and other viruses of the Enterovirus B species. The remaining relatively high morbidity of exanthema forms of EVI in addition to the Koksaki A6 virus was supported by the activated viruses Koksaki A16, Koksaki A5 and other viruses of the Enterovirus A species. The results of phylogenetic analysis of genome sequences that dominated etiological agents of EVI indicate that in 2018 there was a multiple importation of enterovirus epidemic variants into the territory of the Russian Federation, which supported the EVI / computer epidemiological process in the Russian Federation as a whole and caused a complication of the epidemiological situation in a number of subjects. It is possible that these events contributed to the arrival of a large number of fans at the 2018 FIFA World Cup and visa-free entry into the territory of the Russian Federation for this category of tourists until the end of the year.

Surveillance for acute flaccid paralysis syndrome (AFP) in children under 15 is the backbone of the Global Polio Eradication Initiative. Laboratory examination of stool samples from AFP cases allows the detection of, along with polioviruses, a variety of non-polio enteroviruses (NPEV). The etiological significance of these viruses in the occurrence of AFP cases has been definitively established only for enteroviruses A71 and D68. Enterovirus Coxsackie A2 (CVA2) is most often associated with vesicular pharyngitis and hand, foot and mouth disease. Among 7280 AFP cases registered in Russia over 20 years (2001–2020), CVA2 was isolated only from five cases. However, these included three children aged 3 to 4 years, without overt immune deficiency, immunized with 4–5 doses of poliovirus vaccine in accordance with the National Vaccination Schedule. The disease resulted in persistent residual paralysis. Clinical and laboratory data corresponded to poliomyelitis developing during poliovirus infection. These findings are compatible with CVA2 being the cause of AFP. Molecular analysis of CVA2 from these patients and a number of AFP cases in other countries did not reveal association with a specific phylogenetic group, suggesting that virus genetics is unlikely to explain the pathogenic profile. The overall results highlight the value of AFP surveillance not just for polio control but for studies of uncommon AFP agents.

Hand-foot-and-mouth disease (HFMD) is the most common enteroviral infection in South-East Asia. When evaluating the role of enterovirus 71 (EVA71) as an etiological agent of infectious disease in South Vietnam, we revealed a high proportion of EVA71 among identified species A enteroviruses found in 3542 samples from HFMD cases; 125 samples from cases of enteroviral meningitis; and 130 samples from acute flaccid paralysis (AFP) cases. These represent 50%, 54.8%, and 51.5%, respectively. According to molecular analysis, 90% of EVA71 were attributed to genotype C4 and 10% were attributed to genotype B5. The predominance of EVA71 circulation among the population proves the need to strengthen surveillance (with monitoring of enterovirus circulation for facilitation of HFMD outbreak prediction) and to increase the effectiveness of preventative measures by the implementation of vaccination against EVA71-associated infections. A phase III trial of a Taiwanese vaccine (EV71vac) in Taiwan and South Vietnam showed its safety, tolerability, and efficacy in children aged 2–71 months. This B4 genotype-based vaccine, which features cross-protection against B5 and C4 genotypes, and other existing EV71 vaccines can serve as a good approach to solving the HFMD problem, which is so important for Vietnam.

We studied mutations of HIV resistance to antiretroviral drugs during the period of widely use of antiretroviral therapy and the characteristics of the circulation of virus subtypes in the subjects of the Volga Federal District (VFD) from 2016 to 2018 on the plasma samples of HIV-infected patients. Genotyping of resistance mutations to antiretroviral drugs and statistical analysis were carried out. The most common mutations determining the resistance in the reverse transcriptase gene, the most common and specific mutations were identified. An analysis of the prevalence level of mutations in the virus resistance to different groups of antiretroviral drugs allows us to develop approaches to prevent the further occurrence of resistant strains of HIV and minimize their negative impact on the patient’s body. With the development of the epidemic, there is an increasing diversity in the landscape of HIV-1 subtypes circulating on the territory of the Volga Federal District. Point mutation patterns associated with antiretroviral therapy failure in different subtypes vary.

Энтеровирусные инфекции человека — это группа инфекционных заболеваний, вызываемых вирусами видов Enterovirus A-D (рода Enterovirus семейства Picornaviridae). Энтеровирусные инфекции могут различаться по клиническим проявлениям и тяжести течения: от бессимптомной инфекции до серьезных мультисистемных заболеваний. В процессе эволюции энтеровирусов могут формироваться штаммы с повышенной нейровирулентностью или атипичной патогенностью, обладающие при этом эпидемическим потенциалом. В недавнем прошлом по всему миру регистрировались вспышки энтеровирусной инфекции с повышенной частотой неврологических проявлений, значительной долей тяжелых случаев и летальных исходов, обусловленные энтеровирусами EV-A71, EV-D68 и другими. Всемирная организация здравоохранения включила энтеровирусную инфекцию, вызываемую вирусами EV-A71 и EV-D68, вместе с некоторыми другими опасными заболеваниями вирусной природы, в качестве кандидата для внесения в «Список приоритетных заболеваний». В связи с этим систематический глобальный надзор за циркуляцией энтеровирусов имеет значение для слежения за формированием и распространением эпидемических вариантов энтеровирусов, прогнозирования развития эпидемической ситуации, своевременного проведения профилактических мероприятий и разработки средств вакцинопрофилактики. Развитие сотрудничества России и Вьетнама в различных сферах деятельности приводит к увеличению миграции населения в обоих направлениях, что актуализирует научное и практическое взаимодействие в сфере надзора и борьбы с распространением инфекционных заболеваний, включая энтеровирусную инфекцию. В настоящее время эпидемиологический надзор за энтеровирусной инфекцией во Вьетнаме основан на мониторинге заболеваемости энтеровирусной экзантемой полости рта и конечностей, лабораторной диагностике энтеровирусной инфекции и идентификации штаммов энтеровирусов, выявляемых преимущественно у больных с тяжелым течением заболевания. У больных в 2001–2016 гг. были выявлены неполиомиелитные вирусы 34 типов. Наибольшую долю среди возбудителей составили вирусы EV-A71, CVA6, CVA10, CVA16. Самая высокая заболеваемость энтеровирусной инфекцией и наибольшее количество летальных случаев были связаны с ростом активности вируса EV-A71. В разные временные периоды на территории Вьетнама была зафиксирована циркуляция EV-A71 генотипов С1, С4, С5 и В5. В последние годы доминирующим возбудителем энтеровирусной инфекции во Вьетнаме так же, как и в большинстве других стран, является вирус CVA6 нового пандемического генотипа. Результаты изучения филогенетических взаимоотношений штаммов вирусов EV-A71 и CVA6 из Вьетнама позволили установить факты множественных заносов эпидемических вариантов этих вирусов с сопредельных территорий. Последующее широкое распространение таких вариантов вирусов внутри страны обусловило развитие эпидемии энтеровирусной инфекции в 2011–2012 гг. и сохранение заболеваемости вирусной экзантемой полости рта и конечностей на высоком уровне до настоящего времени.