The aim: To assess the dynamics of serum levels of angiopoietin-2 and transforming growth factor-β1 in patients with chronic hepatitis C (CHC) with concomitant nonalcoholic fatty liver disease (NAFLD) after successful DAAs. Materials and methods: 82 patients with CHC were examined, of which 56 were diagnosed with NAFLD and increased body weight. Ang-2, TGF-β1, leptin, adiponectin, and the degree of liver fibrosis were determined for all participants. The patients were divided into groups: 1 gr. (n=23) – CHС + increased body weight + hepatic steatosis, 2 gr. (n=33) – СНС + increased body weight + nonalcoholic steatohepatitis, 3rd gr. (n=26) – CHC. All patients received DAAs for 12 weeks. Results: From 82 patients F3-4 had 31 people, F1-2 – 25, F0-1 – 11, F0 -15 patients. F3-4 and steatosis S2-3 (p<0.05) was more common in patients of 2 gr.. Serum Ang-2 levels were higher (p<0.05) in patients of 2 gr. with F3-4, than in patients with F0-2. Fibrosis regression occurred more often in patients with 1 and 3 gr. with F1-2 than in patients 2 gr. and F3-4 and was accompanied by a decrease in Ang-2 and TGF-β1 levels. Conclusions: High levels of Ang-2 and TGF-β1 are registered in patients with CHC+NAFLD, which correlate with the degree of liver fibrosis and significantly decrease after successful DAAs in patients with low initial stages of liver fibrosis and normal body weight.

The aim: To evaluate the content of trace elements Zn, Cu and Se in blood serum and their relationship with viral load and the degree of liver fibrosis according to the results of the FibroMax test in patients with CHC. Materials and methods: 62 outpatients with a verified diagnosis of CHC were under observation, in which serum Zn, Cu and Se levels, viral load and degree of liver fibrosis were determined according to the FibroMax test. Results: HCV 1b genotype was detected in all patients. The proportion of patients with a high viral load was 32%, with a low viral load – 68%. In 19% of patients, the level of Zn was below normal, and the levels of Cu and Se were within the reference values. The proportion of patients without fibrosis was 32%, 16% had minimal fibrosis, 40% had moderate fibrosis, 8% had progressive fibrosis, and 3% had severe fibrosis. 68% of patients had active inflammation of various degrees, liver steatosis – 65%, non-alcoholic steatohepatitis – 48%, inflammation caused by alcohol consumption was absent. No statistically significant difference was found in serum trace element levels and viral load (p>0.05). A weak negative correlation between the level of Zn and the degree of fibrosis (ρ=-0.340, p=0.007) and a negligible negative correlation between the level of Zn and inflammation activity (ρ=-0.286, p=0.024) were revealed. Patients with fibrosis grade ≥F2 had lower Zn levels compared to patients with fibrosis ≤F1 (0.607 (0.540, 0.691) mg/l vs. 0.716 (0.593, 0.875) mg/l, p=0.01), and when comparing there was no difference in Cu and Se levels (р>0.05). Conclusions: Thus, there is a relationship between the level of Zn in blood serum and the degree of liver damage in patients with CHC, which indicates the prospects for further research.

No abstract

Aim: To assess the effectiveness of the physiopharmacological treatment of GERD in persons who successfully completed a full course of CHC therapy with direct antiviral drugs no more than 6 months ago. Materials and Methods: 67 people with GERD who completed a course of CHC therapy with direct antiviral drugs no more than 6 months ago were under observation. The patients were divided into: 1 group (n=20) – received rabeprazole 20 mg in the morning 40 minutes before meals, 2 group (n=23) – rabeprazole 20 mg in combination with taking mineral water “Polyana Kvasova” according to the proposed scheme, group 3 (n=24 patients) – took rabeprazole 20 mg in combination with MV«Polyana Kvasova» for 24 days, and with a course of magnetic therapy procedures. Results: Under the influence of treatment, on the 24 th day of observation, all 100% of patients in the 3rd group had positive dynamics: the elimination of heartburn (p<0.001), pain in the epigastrium (p<0.001), and manifestations of dysphagia (p<0.001), which were confirmed by fibrogastroscopy - disappearance of esophagitis (p<0.001) and gastroesophageal reflux (p<0.001). In 80% of the patients of the second group, positive dynamics of the clinical and endoscopic picture was also observed (p<0.005), and in the rest of the patients, the improvement was unreliable (p>0.05). After the treatment, a decrease in manifestations of asthenovegetative and dyspeptic syndromes, cholestatic syndrome was recorded in all groups of patients, with a predominance in group 3. Conclusions: The use of complex physiopharmacological treatment has a reliable advantage over standard pharmacological treatment, as it has a positive effect not only on GERD manifestations, but also on clinical and laboratory manifestations of CHC and improves the quality of life.