The work is devoted to increasing the effectiveness of treatment of patients with chronic hepatitis C (HCV) combined with intestinal dysbiosis (IB) by studying the relationships between the clinic, biochemical indicators, the nature of liver lesions, cytokine imbalance and the degree of dysbiotic changes in these patients. The dissertation resolves an important and topical issue of modern gastroenterology and infectious disease, which concerns the study of the influence of intestinal dysbiosis on the course of CHC and the improvement of treatment measures in patients with comorbid pathology.
To achieve the goal, a number of tasks were performed, namely: the clinical and laboratory features of intestinal microbiocenosis in patients with CHC were analyzed, the features of the clinical course of CHC were studied, the relationships between the nature of liver lesions and intestinal dysbiosis in these patients were established, and the cytokine link of the immune system was investigated. The influence of intestinal dysbiosis on indicators of psychological status and quality of life of patients with CHC was also studied, and the effectiveness of complex therapy with the use of probiotics in combination with UDCA was substantiated.
Standard examinations according to current clinical protocols and special methods, such as molecular genetic and non-invasive methods of diagnosing liver fibrosis - FibroMax, were used to implement the tasks.
As a result of the conducted studies, it was established that the severity of clinical manifestations of both intestinal DB and hepatobiliary dysfunction in patients with CHC directly depend on the degree of aggression of DB.
Cholestasis syndrome combined with DB is more often registered in patients with CHC, the negative influence of intestinal DB on lipid metabolism, dysfunction of the cytokine link of the immune system, and a decrease in all components of the quality of life is also determined.
The paper substantiates the expediency of prescribing a complex treatment that includes a probiotic in combination with UDCA against the background of standard therapy, as it has a positive effect not only on the course of DB, but also improves the functional state of the liver in patients with CHC, reduces the manifestations of asthenovegetative and dyspeptic syndromes, cholestasis syndrome , and also contributes to the elimination of cytokine imbalance and reduces the severity of depression and anxiety on the hospital scale, which improves the quality of life of these patients. Also, combined therapy using a probiotic in combination with UDFC is an effective method for correcting not only dysbiotic changes in the colon, but also leads to normalization of the blood lipid profile in patients with CHC and intestinal DB.
Key words: chronic hepatitis C, intestinal dysbiosis, inflammation, cytokines, steatosis, non-alcoholic fatty liver disease, dyslipidaemia, non-invasive diagnostics, probiotic, UDCA.
