Title : Interaction between infectious and non-communicable diseases: Contemporary challenges and trends
Abstract:
The morbidity rate in Russia is primarily driven by the increase in certain chronic non-communicable diseases (NCDs), including cardiovascular diseases (CVD) associated with atherosclerosis, cancers, endocrine and metabolic disorders. On the other hand, Russia ranks among the top in the European region in terms of the spread of the Human Immunodeficiency Virus (HIV). The total number of deaths from coronavirus infection in Russia is 400,023 people. Several non-communicable diseases are associated with an increased risk of death from infection. According to a number of studies, the most severe complications from viral infections develop in elderly individuals and in patients with NCDs. Infectious diseases and NCDs often share common determinants. Overall, social, behavioral, biological risk factors, as well as environmental factors, create a background for the development of both individual diseases and their comorbidity. There is a bidirectional relationship between infectious diseases and NCDs. The interaction between infectious diseases and NCDs is a two-way process in which chronic diseases (diabetes, CVD) worsen the course of infections, while infections (HIV, COVID-19, etc.) trigger or exacerbate NCDs. Possible mechanisms linking infectious diseases and NCDs among the adult population include chronic inflammation, infectious oncogenesis, metabolic and hormonal disorders, microbiome alterations, and epigenetic changes. Modern medicine is transitioning to the concept of a "syndemic" where two or more diseases interact in such a way that they cause greater harm together than separately. When developing preventive programs, the following key aspects of interaction must be considered: the impact of NCDs on infections, the impact of infections on NCDs, and the presence of shared risk factors. Integrated management of both groups of diseases is essential for reducing mortality and improving patient's quality of life.

