Короткий опис (реферат):
Introduction: The use of modern drugs with direct antiviral effect allows achieving a
stable virologic response (SVR) in patients with chronic hepatitis C (CHC). However, in most
cases, after the elimination of HCV infection, the progression of fibrosis continues with the
development of its terminal stages and adverse outcomes for patients. The presence of nonalcoholic fatty liver disease (NAFLD) in these patients significantly increases the rate of
progression of fibrosis and its complications, even after reaching SVR. Therefore, the search
and development of new non-drug treatment technologies for this category of patients is
relevant. Aim: to study the effectiveness of mineral water intake (with a high content of
bicarbonates, sodium, potassium, and silicon compounds) in the new mode of use in the
complex treatment of patients with chronic hepatitis C with concomitant NAFLD. Methods:
anamnestic, clinical, general clinical, biochemical (indicators of lipid metabolism, HOMA
index), serological (markers of viral hepatitis C, HCV RNA PCR, qualitative and quantitative
determination, genotyping), ultrasonographic studies of the digestive system and statistical
methods. Results: Patients with chronic hepatitis C (genotype 1b in the phase of replication,
minimal and moderate activity) with concomitant NAFLD, which had been divided into two groups, were examined. Patients of group I (control group) received a standard complex of
treatment (diet therapy that corresponded to the Mediterranean diet, dosed exercise regimen,
antiviral therapy - sofosbuvir (400 mg) and ledipasvir (90 mg) - 3 months). Patients of group
II (the main group) additionally received an internal course intake of mineral water (MW)
according to our methodology: 3 ml per kg of patient’s body weight 30-40-60 min before
meals, depending on the acidity in the stomach, and the same dose after food intake, three
times a day (course - 2 months, a break - 2 months, a second course - 2 months). Evaluation
of the effectiveness of treatment was carried out after six months from the start of treatment.
Conclusion: The results prove the feasibility and effectiveness of using MW in a doubled
dosage regimen in the complex treatment of patients with chronic hepatitis C with chronic
concomitant NAFLD, which was determined by improving lipid metabolism, reducing signs
of insulin resistance, improving ultrasonographic signs and preventing the development of
fibrotic changes in the liver.
