Clinical experience of using Polysorb in complex pathogenetic therapy of chronic hepatitis C with severe liver fibrosis

Abstract

Introduction. Violation of metabolic processes in the gastrointestinal tract in patients with chronic hepatitis C (HCV) leads to the accumulation of toxic metabolic products in the intestine, negatively affecting both the balance of the microbiota and the functional state of hepatocytes. The sorption of toxins released by opportunistic anaerobic bacteria contributes to the restoration of the population of bifidobacteria and lactobacilli, which has a beneficial effect on the functional state of the liver.Aim. To evaluate the clinical and laboratory efficacy and safety of Polysorb as part of complex pathogenetic therapy in patients with HCV with severe liver fibrosis.Materials and methods. The study included 62 patients with HCV in the stage of severe liver fibrosis (F3 according to METAVIR) of both sexes aged 18 to 65 years who were not receiving antiviral therapy. In the study group, pathogenetic therapy was supplemented with Polysorb. Clinical and laboratory parameters were evaluated before and after the course of treatment. The study of the intestinal microbiota was carried out by determining the concentration of volatile fatty acids (VFA) in the intestinal contents: acetic, propionic, butyric, the total content of isoC4 + isoC5 + isoC6 and the value of the anaerobic index by gas-liquid chromatography (chromatograph “Tsvet 100”, Russia).Results and discussion. Complex pathogenetic therapy of patients with HCV (F3), including the enterosorbent Polysorb, increases the effectiveness of treatment for clinical syndromes: right hypochondrium by 35.8%, asthenovegetative – by 13.6%, dyspeptic – from 8 to 22.5% (according to individual symptoms), cholestatic – by 8%, and also improves the biochemical parameters of liver function: p = 0.060; GGTP, p = 0.014 and it helps to stabilize the composition of the microbiota, increasing the total level of LVH (p < 0.05), mainly due to normalization of acetic acid values, improvement of the anaerobic index: before treatment -0.858 ± 0.152, after -0.601 ± 0.163 (p < 0.05).Conclusion. The inclusion of Polysorb in the pathogenetic therapy of patients with HCV (F3) helps to stabilize the composition of the microbiota, while no side effects or adverse events have been recorded.