Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press34410.36691/RJA344ArticlesСтатьиResearch ArticleACOUIRED IMMUNE DEFICIENCY SYNDROMEСиндром приобретенного иммунодефицитаKhaitovR MХаитовР М

Institute of Immunology

GudimaG OГудимаГеоргий Олегович

Institute of Immunology

goudima@mail.ruФГБУ «ГНЦ Институт иммунологии» ФМБА России15102016134-5NO4-5 (2016)№4-5 (2016)31910032020Copyright ©; 2016, Pharmarus Print MediaCopyright ©; 2016, Фармарус Принт Медиа2016Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/344

HIV/AIDS is one of the most important problems of world health care. Number of HIV infected individuals in the world are about 40 millions and continue rising. Fight against HIV/AIDS is one of United Nations’ «Millenium Goals». Efforts of many research institutions and unprecedented financial resources are mobilized for counteraction of the disease. Despite intensive investigations there are no radical treatment or effective preventive vaccine, which is able to protect vulnerable populations from HIV infection. The key steps of HIV/AIDS investigations, development of drugs and strategies of prevention and treatment of the disease, and also perspectives of epidemic control are reviewed.

Одной из важнейших проблем современного здравоохранения является ВИЧ-инфекция/СПИД. Количество ВИЧ-инфицированных в мире составляет около 40 млн человек, и это число продолжает расти. Борьба с распространением ВИЧ-инфекции/СПИДа обозначена ООН как одна из основных целей развития тысячелетия. На противодействие этому заболеванию направлены усилия многочисленных научных коллективов и мобилизованы значительные финансовые ресурсы. Несмотря на интенсивные исследования, ни радикальных средств лечения заболевания, ни эффективной вакцины, которая защищала бы уязвимые популяции от ВИЧ-инфекции, в мире пока не существует. В обзоре рассмотрены ключевые этапы исследований ВИЧ-инфекции/СПИДа, разработки средств и стратегий превенции и лечения этого заболевания, а также перспективы контроля эпидемии.

HIVAIDSantiretroviral therapyHIV/AIDS vaccineВИЧСПИДантиретровирусная терапияанти-ВИЧ/СПИД-вакциныGlobal AIDS Update. UNAIDS, 2016. http://www.unaids. org/sites/default/files/media_asset/global-AIDS-up-date-2016_en.pdf.ВИЧ-инфекция в Российской Федерации на 31 декабря 2014 г. Федеральный научно-методический центр по профилактике и борьбе со СПИДом, http://hivrussia. metodlab.ru/ files/ spravkaHIV2014.pdf.Декларация тысячелетия, 2000, ООН. http://www.un.org/ ru/ millenniumgoals/.Онищенко Г.Г., Хаитов Р.М. 26-я Специальная сессия Генеральной ассамблеи ООН по ВИЧ/СПИДу. Аллергия, астма и клин. иммунол. 2001, № 8, с. 3-7.Jiang A.P., Jiang J.F., Guo M.G. et al. Human Blood-Circulating Basophils Capture HIV-1 and Mediate Viral trans-Infection of CD4+ T-Cells. J. Virol. 2015, v. 89, p. 8050-8062.Jiang A.P., Jiang J.F., Wei J.F. et al. Human mucosal mast cells capture HIV-1 and mediate viral trans-infection of CD4+ T-cells. J. Virol. 2015, v. 90, p. 2928-2937.Stremlau M., Owens С.М., Perron M.J. et al. The cytoplasmic body component TRIM5alpha restricts HIV-1 infection in Old World monkeys. Nature. 2004, v. 427, p. 848-853.Cicala C., Arthos J., Fauci A.S. HIV-1 envelope, integrins and co-receptor use in mucosal transmission of HIV. J. Transl. Med. 2011, v. 9, p. 2.Nawaz F., Cicala C., Van Ryk D. et al. The genotype of early-transmitting HIV gp120s promotes a (4) ß(7)-reactivity, revealing a (4) ß(7) +/CD4+ T-cells as key targets in mucosal transmission. PLoS Pathog. 2011, v. 7, p. e1001301.Becker Y. HIV-1 gp120 binding to dendritic cell receptors mobilize the virus to the lymph nodes, but the induced IL-4 synthesis by FcepsilonRI+ hematopoietic cells damages the adaptive immunity - a review, hypothesis, and implications. Virus Genes. 2004, v 29, p. 147-165.Becker Y. HIV-1 induced AIDS is an allergy and the allergen is the shed gp120 - a review, hypothesis, and implications. Virus Genes. 2004, v. 28, p. 319-331.Becker Y. The changes in the T-helper 1 (Th1) and T-helper 2 (Th2) cytokine balance during HIV-1 infection are indicative of an allergic response to viral proteins that may be reversed by Th2 cytokine inhibitors and immune response modifiers - a review and hypothesis. Virus Genes. 2004, v 28, p. 5-18.Veazey R., Lackner A. The mucosal immune system and HIV-1 infection. AIDS Rev 2003, v. 5, p. 245-252.Acar M., Sutcu M., Umur O. et al. Acquired Immune Deficiency Syndrome in Differential Diagnosis of Hyper-IgE-Immunoglobulinemia. Pediatric Case Report. J. Trop. Pediatr. 2016, p. 1-3.Bowser C.S., Kaye J., Joks R.O. et al. IgE and atopy in perinatally HIV-infected children. Pediatr. Allergy Immunol. 2007, v. 18, p. 298-303.Burastero S.E., Paolucci C., Breda D. et al. Immunological basis for IgE hyper-production in enfuvirtide-treated HIV-positive patients. J. Clin. Immunol. 2006, v. 26, p. 168-176.Da Silva L., Kweku Sagoe Amoah S., Da Silva J. Relationship between atopy, allergic diseases and total serum IgE levels among HIV-infected children. Eur. Ann. Allergy. Clin. Immunol. 2013, v. 45, p. 155-159.Thawabi M., Habib M., Shaaban H., Shamoon F. Acute Eosinophilic Myocarditis and Hyper IgE in HIV Infection: A Case Report. N. Am. J. Med. Sci. 2014, v 6, p. 338-341.AIDS Vaccine Blueprint 2008. Global HIV Vaccine Enter-prize - IAVI, 2008.Greene W.C. A history of AIDS: looking back to see ahead. Eur. J. Immunol. 2007, v. 37, p. 94-102.HIV/AIDS Media Guide. IFJ media guide and research report on the media’s reporting of HIV/AIDS. International Federation of Journalists, 2006.UNAIDS World AIDS Day report 2012: results. Geneva: UNAIDS; 2012 (http://www.unaids. org/ sites/ default/ files/ media_asset/ JC2434_WorldAIDSday_results_en_1.pdf).UNAIDS Report 2015. Executive summary. How AIDS changed everything. MDG 6: 15 years, 15 lessons of hope from the AIDS response. http: //www.unaids.org/ sites/ default/ files/ media_asset/ MDG6_ExecutiveSummary_en.pdfCDC. MMWR. 1981, v 30, p. 305-308.Gottlieb M.S., Schroff R., Schanker H. et al. Pneumocystis carinii pneumonia amd mucosal candidiasis in previously healthy homosexual men. New Engl. J. Med. 1981, v 305, p. 1425-1430.Mazur H., Michelis M.A., Greene J.B. et al. An outbreak of community-acquired pneumocytosis carinii pneumonia. New Engl. J. Med. 1981, v. 305, p. 1431-1438.Покровский В.В. Эпидемиология и профилактика ВИЧ-инфекции. М., «Медицина». 1996, 275 с.Хаитов Р.М., Игнатьева Г.А. СПИД. М., «Народная академия культуры и общечеловеческих ценностей». 1992, 352 с.Kerina D., Stray-Pedersen B., Muller F. HIV Diversity and Classification, Role in Transmission. Advances in Infectious Diseases. 2013, v. 3, p. 146-156.Korber В., Muldoon M., Theiler J. et al. Timing the ancestor of the HIV-1 pandemic strains. Science. 2000, v. 288, p. 1789-1796.Gallo R.C., Montagnier L. AIDS in 1988. Sci. Am. 1988, v. 259, p. 41-48.Barre-Sinoussi F., Chermann J.C., Rey F. et al. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. 1983, v. 220, p. 868-871.Temin H.M. Genetics of retroviruses. Ann. NY Acad. Sci. 1995, v. 30, p. 161-165.Temin H.M., Mizutani S. RNA-dependent DNA polymerase in virions of Rous sarcoma virus. 1970. Biotechnology. 1992, v. 24, p. 51-56.Gallo R.C., Yang S.S., Ting R.C. RNA dependent DNA polymerase of human acute leukaemic cells. Nature. 1970, v. 228, p. 927-929.Morgan D.A., Ruscetti F.W., Gallo R. Selective in vitro growth of T-lymphocytes from normal human bone marrows. Science. 1976, v. 193, p. 1007-1008.Poiesz B.J., Ruscetti F.W., Reitz M.S. et al. Isolation of new type С retrovirus (HTLV) in primary uncultured cells of a patient with Sezary T-cell leukaemia. Nature. 1981, v. 294, p. 268-271.Duesberg P. Does HIV cause AIDS? J. AIDS. 1989, v. 2, p. 514-515.Krause R.M. Koch’s postulates and the search for the AIDS agent. Public Health Rep. 1984, v. 99, p. 291-299.Smith D.W Koch’s postulates and the Koch phenomenon, an update. Indian J. Chest. Dis. Allied. Sci. 1982, v. 24, p. 95-100.Moss A.R., Bacchetti P., Osmond D. et al. Seropositivity for HIV and the development of AIDS or ARC: three years follow up of the San Francisco General hospital cohort. BMJ. 1988, v. 296, p. 745-750.Dagenais-Lussier X., Mouna A., Routy J.P. et al. Current topics in HIV-1 pathogenesis: The emergence of deregulated immuno-metabolism in HIV-infected subjects. Cytokine Growth Factor Rev. 2015, v. 26, p. 603-613.Polis M.A., Masur H. Predicting the progression to AIDS. Amer. J. Med. 1990, v. 89, p. 701-705.Anderson R.W. Mathematical models of HIV pathogenesis. Nat. Med. 1997, v. 3, p. 936-937.Lemp G.F., Payne S.F., Rutherford G.W. et al. Projections of AIDS morbidity and mortality in San Francisco. JAMA. 1990, v. 263, p. 1497-1501.Gallo R.C., Sarin P.S, Gelmann E.P. et al. Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS). Science. 1983, v. 220, p. 865-867.Dalgleish A.G., Beverley P.C., Clapham P.R. et al. The CD4 (T4) antigen is an essential component of the receptor for the AIDS retrovirus. Nature. 1984, v. 312, p. 763-767.Fuller T.C., Trevithick J.E., Fuller A.A. et al. Antigenic polymorphism of the T4 differentiation antigen expressed on human T-helper/inducer lymphocytes. Human Immunilogy. 1984, v. 9, p. 89-102.Gallo R.C., Wong-Staal F., Montagnier L. et al. HIV/HTLV gene nomenclature. Nature. 1988, v. 333, p. 504.Хаитов Р.М. Синдром приобретенного иммунодефицита. Патол. физиол. 1986, № 1, c. 77-84.Khaitov R.M. Search of AIDS in immunodeficiency patients in the USSR. I Intern. Confer, on AIDS, Atlanta. 1985, 36 р.Игнатьева Г. А., Сидорович И.Г., Нестерчук С.Л., Баринский И.Ф. Эффект усиления вирусной инфекции HIV моноклональными антителами. ДАН СССР 1989, № 5, c. 1272-1275.Игнатьева Г.А., Фукс Б.Б., Сидорович И.Г. Антиидиотипические моноклональные антитела в изучении механизмов инфекции HIV в культуре чувствительных клеток. Журнал ВХО им. Д.И. Менделеева. 1988, № 5, c. 567-570.Sundstrom J.B., Hair G.A., Ansari A.A. et al. IgE-FcepsilonRI interactions determine HIV coreceptor usage and susceptibility to infection during ontogeny of mast cells. J. Immunol. 2009, v. 182, p. 6401-6409.Resolution A/res/65/277. Political declaration on HIV and AIDS: intensifying our efforts to eliminate HIV and AIDS-annex. New York: United Nations General Assembly. 2011.Петров Р.В., Хаитов P.M., Иванов В.Т. и соавт. Выявление антител против HIV-1 и HIV-2 с помощью синтетических антигенных детерминант. Иммунология. 1990, № 2, c. 21-25.Петров Р.В., Хаитов Р.М., Сидорович И.Г. и соавт. Пути расширения диагностических возможностей синтетических детерминант белков HIV. Иммунология. 1988, № 4, с. 20-23.Петров Р.В., Хаитов P.M., Фонина Л.А., Андреев С.М. Синтетические пептиды Env и Gag распознаются антителами к LAV/HTLV-III. Иммунология. 1986, № 5, с. 80-81.Петров Р.В., Хаитов P.M., Фонина Л.А. и соавт. Синтетические пептидные антигены HIV при изучении СПИД. Иммунология. 1988, № 3, с. 21-25.Хаитов P.M. Синтетические антигены в иммунодиагностике. Успехи соврем. биол. 1989, т. 108, вып. 3 (б), с. 429-445.Хаитов P.M. Синтетические антигены: использование в диагностике инфекционных болезней. Иммунология. 1989, № 4, с. 5-10.Хаитов P.M., Сидорович И.Г., Павликов С.П. Использование синтетических пептидов в диагностике ВИЧ-инфекции. Иммунология. 1990, № 2, с. 15-20.Arnov R., Brown F., Khaitov R.M. The use of synthetic antigens for diagnosis of infections diseases. Rep. of the WHO Sci. Group, Geneva. 1989, р. 3-74.Duncan J., Simon F., Ho Do. et al. Synthetic peptides in HIV diagnosis and AIDS-related research. AIDS. 1991, v. 5, p. 1-9.Khaitov R.M. The synthetic peptides in AIDS research. 1 Israel-Soviet Seminar on peptides and proteins. Rehovot, The Weizmann Inst. Sci. 1990, 23 р.Khaitov R.M., Andreev S.M. Prospects for the use of synthetic antigens in immunodiagnosis. Biomed. Sci. 1990, v. 1, p. 553-564.Khaitov R.M., Sidorovitch I.G., Fonina L.A., Liozner A.L. Env and gag peptides interacting with HIV antibodies. Immune deficiencies and Allergologies, Moscow. 1986, v. 212, p. 551.Petrov R.V., Khaitov R.M., Sidorovitch I.G. et al. The use of synthetic peptides in the diagnosis of HIV infection. Biomedical Science. 1990, v. 1, p. 239-244.Сидорович И.Г., Николаева И.А., Павликов С.П. и соавт. Пути совершенствования серодиагностики СПИД. Опыт применения тест-системы «Пептоскрин-2» на контингентах с высокой серопозитивной прослойкой (р. Уганда). Матер. Первого всесоюзного иммунологического съезда, Москва, СССР 1989, т. 2, с. 276.Biryahwaho B., Nikolaeva I., Sidorovich I., Androsov V. Application of a synthetic peptide-based enzime immunoassay in the detection of HIV infection in Uganda, Materials of III International Conference on AIDS and Associated Cancers in Africa, 1988, Dar es Salaam, Tanzania.Сидорович И.Г., Павликов С.П., Николаева И.А. и соавт. Использование синтетических пептидных антигенов для выявления антител к ВИЧ методом пассивной агглютинации латекса. Иммунология. 1990, № 4, с. 29-31.Khaitov R.M. Acquired immunodeficiency syndrome. Harwood Acad. Publishers, London. 1989, 93 p.Salk J. Prospects for the control of AIDS by immunizing seropositive individuals. Nature. 1987, v. 327, p. 473-476.Andreev S.M., Meshcheryakova D.V., Khaitov R.M. et al. Fine analysis of the immunodominant region from HIV transmembrane protein by chemical modification of the synthetic peptides. VII Int. Conf. on AIDS, Florence, June 1991 (Abstr.), M.A. 1141, p. 127. 7 5. Andreev S.M., Meshcheryakova D.V., Vafina M.G. et al. Analysis of the fine structure of the antigenic determinants of the tin protei of the HIV coat with chemically modified synthetic peptides. Biomed. Sci. 1991, v. 2, p. 271-278.Andreev S.M. CD4-derived peptides in studies of HIV-cell interactions. VIII Int.Conf.AIDS/STD, Amsterdam, 19-24 July, 1992, PoA2000.Khaitov R.M., Chuvirov G.N., Trubcheninova L.P et al. HIV-like structure detection in people with indeterminate immunobloting results. J. AIDS. 1991, v. 4, p. 444-446.Khaitov R.M., Trubcheninova L.P., Glushenko M.V. et. al. HIV-infection and some more persistent viruses. VIII Int. Congr. Virol., Berlin. 1990, v. 33, p. 009.Khaitov R.M. Functional properties of HIV envelope and CD4-derived synthetic peptides from putative HIV-cell intersction fragments.VIII Int. Conf. AIDS/STD, Amsterdam, 19-24 July, 1992, p. РОА2011.Daniel M.D., Kirchhoff F., Czajak S.C. et al. Protective effects of a live attenuated SIV vaccine with a deletion in the nef gene. Science. 1992, v. 258, p. 1938-1941.Moore J.P., Trkola A., Korber B. et al. A human monoclonal antibody to a complex epitope in the V3 region of gp120 of human immunodeficiency virus type 1 has broad reactivity within and outside clade B. J. Virol. 1995, v. 69, p. 122-130.Trkola A., Pomales A.B., Yuan H. et al. Cross-clade neutralization of primary isolates of human immunodeficiency virus type 1 by human monoclonal antibodies and tetrameric CD4-IgG. J. Virol. 1995, v. 69, p. 6609-6617.Mangeat В., Turelli P, Caron G. et al. Broad antiretroviral defence by human APOBEC3G through lethal editing of nascent reverse transcripts. Nature. 2003, v. 424, p. 99-103.New data on male circumcision and HIV prevention: policy and programme implications. Montreux: World Health Organization and UNAIDS; 2007 (http://www.who.int/hiv/pub/ malecircumcision/ research_implications/en/.HIV gp120 Vaccine - VaxGen: AIDSVAX trade mark, AIDSVAX trade mark B/B, AIDSVAX trade mark B/E, HIV gp120 Vaccine - Genentech, HIV gp120 Vaccine AIDSVAX - VaxGen, HIV Vaccine AIDSVAX - VaxGen. Drugs R.D. 2003, v. 4, p. 249-253.Johnston R. AIDSVAX results: an answer, or just more questions? AIDS Patient Care STDs. 2003, v. 17, p. 47-51.Klausner R.D., Fauci A.S., Corey L.N. et al. Medicine. The need for a global HIV vaccine enterprise. Science. 2003, v. 300, p. 2036-2039.Guadalupe M., Reay E., Sankaran S. et al. Severe CD4+ T-cell depletion in gut lymphoid tissue during primary human immunodeficiency virus type 1 infection and substantial delay in restoration following highly active antiretroviral therapy. J. Virol. 2003, v. 77, p. 1708-1717.Khaitov R.M., Liozner A.L. Antipeptide antibodies recognized HIV-1 core antigens. IV Int. Confer. AIDS, Stockholm. 1988, p. 1197.Khaitov R.M., Meshcheryakova D.V., Andreev S.M. et al. Immunoreactivity of selected peptides from HIV-1 gpl20 PND and CD4-binding region. VII Int.Confer. on AIDS, Florence. 1991, v. I, Abstr. NMA 1142, р.127.Гудима Г.О., Коробова С.В., Николаева И.А. и соавт. Клинические испытания первой отечественной анти-ВИЧ/ СПИД-вакцины «ВИЧРЕПОЛ» - итоги и перспективы. Рос. Аллергол. Журн. 2010, № 1, с. 229-230.Хаитов РМ., Решетников А.В., Сидорович И.Г. и соавт. Клинические испытания первой отечественной анти-ВИЧ/СПИД-вакцины. М., «ГЭОТАР-Медиа». 2009, 671 с.Gudima G., Korobova S., Nikolaeva I. et al. First clinical trials of HIV/AIDS vaccine in Russia - transition to phase II. Medimond International Proceedings. 2009, p. 465-468.Gudima G.O., Nikolaeva I.A., Sidorovich I.G. Clinical trials of HIV/AIDS vaccine started in Russian Federation. Allergy and Clinical Immunology International. 2005, v. 1, p. 131.Gudima G., Sidorovich I., Karamov E., Khaitov R. First clinical trials of HIV/AIDS vaccine in Russia, phase 2. Eur. J. Immunol. 2009, v. 39, p. 256.Nikolaeva I., Korobova S., Chevalier A. et al. HIV Epidemic Profile in Russia and Preparing for Clinical Trials of the First Russian HIV Vaccine «VICHREPOL». XV International AIDS Conference (July 11-16, 2004, Bangkok, Thailand). Medimond International Proceedings. 2004, v. 3, p. 157-160.Ongoing trials of Preventive AIDS Vaccines, 2005. IAVI Report. 2005, v. 3, No. 1.Snow B. Why We Need AIDS Vaccine Activism. AIDS Vaccine Handbook, 1995, NY.Coordinating Committee of the Global HIV/AIDS Vaccine Enterprise. The Global HIV/AIDS Vaccine Enterprise: Scientific Strategic Plan. PLoS Med. 2005, v. 2, p. e25.Hütter G., Nowak D., Mossner M. et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. N. Engl. J. Med. 2009, v. 360, p. 692-698.Guidance on provider-initiated HIV testing and counselling in health facilities: new recommendations aim for wider knowledge of HIV status and greatly increased access to HIV treatment and prevention. Geneva: World Health Organization and UNAIDS; 2007 (http://www. who.int/hiv/pub/vct/ pitc2007/en/).Esparza J. A new scientific paradigm may be needed to finally develop an HIV vaccine. Frontiers in Immunology. 2015, v. 6, p. 1-7.Rerks-Ngarm S., Pitisuttithum P., Nitayaphan S. et al. MOPH-TAVEG Investigators. N. Engl. J. Med. 2009, v. 361, p. 2209-2220.RV144 trial. U.S. Bethesda, MD: Military HIV Research Program (http://www.hivresearch.org/ research.php?ServiceID=13).Microbicides. Durban: Centre for the AIDS Programme of Research in South Africa (http:// www.caprisa.org/Pages/ Microbicides).Grant R., Lama J.R., Anderson P.L. et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N. Engl. J. Med. 2010, v. 363, p. 2587-2599.Cohen M.S., Chen Y.Q., McCauley M. et al. HPTN 052 Study Team. Prevention of HIV-1 infection with early antiretroviral therapy. N. Engl. J. Med. 2011, v. 365, p. 493-505.Guidance on couples HIV testing and counselling including antiretroviral therapy for treatment and prevention in serodiscordant couples. Geneva: World Health Organization; 2012 (http://apps.who.int/iris/ bitstre am/10665/44646/1/9789241501972_eng. pdf ?ua=1).Kesho Bora study: preventing mother-to-child transmission of HIV during breastfeeding. Geneva: World Health Organization; 2011.Ledford H. HIV rebound dashes hope of «Mississippi baby» cure. Nature. 10 July 2014 (http://www.nature. com/news/hiv-rebound- dashes-hope-of-mississippi-baby-cure-1.15535).Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach - 2010 revision. Geneva: World Health Organization; 2010 (http:// whqlibdoc. who.int/publications/2010/9789241599764_eng. pdf ?ua=1).Together we will end AIDS. Geneva: UNAIDS; 2012 (http:// www.unaids.org/ en/ resources/ campaigns/ togetherwewillendaids).Global update on HIV treatment 2013: results, impact and opportunities. Geneva: World Health Organization, United Nations Children’s Fund and UNAIDS; 2013 (http://www. unaids. org/sites/default/files/ media_asset/20130630_treat-ment_report_en_0.pdf).Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions. Geneva: World Health Organization, United Nations Population Fund, UNAIDS, Global Network of Sex Work Projects and World Bank; 2013 (http://www.who.int/hiv/ pub/sti/ sex_worker_implementation/en/).WHO, UNODC, UNAIDS technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users: 2012 revision. Geneva: World Health Organization, United Nations Office on Drugs and Crime and UNAIDS; 2012 (http://www.who. int/hiv/pub/ idu/targets_universal_access/en/).Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva: World Health Organization; 2014 (http:// www.who.int/hiv/pub/ guidelines/keypopulations/ en/).Государственная стратегия противодействия распространению ВИЧ-инфекции в Российской Федерации на период до 2020 года и дальнейшую перспективу. Распоряжение Правительства Российской Федерации от 20 октября 2016 г. № 2203-р. http://government.ru/ docs/24983/.