CORRECTION OF INTESTINAL DISBIOSIS IN PATIENTS WITH CHRONIC HEPATITIS C AGAINST THE BACKGROUND OF NON-ALCOHOLIC FATTY LIVER DISEASE.

Abstract

Liver pathologies such as non-alcoholic faty liver disease (NAFLD), cirrhosis, hepatocellular carcinoma are associated with changes in the compositon of the microbiome in the intestne. There is strong evidence that bowel dysbiosis is associated with the progression and complicaton of these pathologies. The purpose of the work was to study the effectveness of treatng intestnal dysbiosis in patents with chronic hepatts C against the background of non-alcoholic faty liver disease using a probiotc containing Lactobacillus acidophilus (LA-5) and Bifdobacterium animalis subsp. lacts BB-12 and a combinaton of ursodeoxycholic acid. 84 patents with CHC partcipated in the study. In all patents, determinaton of hepatts B and C markers was carried out by ELISA, followed by determinaton of HCV RNA, genotype and virus quantty by PCR. The degree of liver fbrosis and steatosis was determined using a non-invasive diagnostc method – FibroMax (BioPredictve, Paris) and an indirect liver elastometry method using a diagnostc device manufactured by France – Fibroscan 502 F01261 sensor M 7 7012. The conditon of gut microbiocinosis was determined by microbiological examinaton of stool. Two groups were formed depending on the prescribed treatment: 1 gr (n = 40) – patents who received – LA-5 and BB-12 1 gt. x TID and 2 g (n = 44) received LA-5 and BB-12 + UDCA 500 mg qhs for 1 month. As a result of the study, it was established that patents with CHC against the background of NAFLD as part of the therapy, for correcton of the intestnal microbiocenosis disorders in additon to probiotcs, the additonal prescripton of UDCA is indicated, which helps to restore the colon microbiocenosis, improves the course of CHC and NAFLD, regulates dysfuncton of the cytokine link of the immune system, and improves the quality of life of patents