THE STATE OF THE COLON MICROBIOTA IN PATIENTS WITH CHRONIC VIRAL HEPATITIS B

Abstract

Introduction. The hepatobiliary system inextricably interacts with the microbiotic biocenosis of the intestine in the processes of detoxification, metabolism, formation and regulation of general and local immunity. The aim of the study was to study the microbial composition of the colon in patients with chronic viral hepatitis B, combined with intestinal dysbiosis in dynamics during treatment. Materials and methods. We examined 72 patients diagnosed with chronic viral hepatitis B with signs of impaired population content of the colon microbiota, divided into two groups. The diagnosis of viral hepatitis B was confirmed by serological markers of viral hepatitis B, detection of genetic material (HBV-DNA). The state of the microflora was studied microbiologically by sowing tenfold dilutions of stool on differential diagnostic nutrient media. Both groups of patients received etiotropic therapy (entecavir), patients of the main group were additionally prescribed synbiotic. Results and discussion. Exacerbation of chronic viral hepatitis B in patients with imbalance of microbiocinosis of the colon, as a rule, is characterized by the presence of asthenovegetative syndrome, “right hypochondrium” syndrome, extrahepatic manifestations, intestinal dyspepsia syndrome. In biochemical terms, there is a deterioration in the “functional tests of the liver”: hyperbilirubinemia and cytolytic syndrome of moderate severity. Microbiological examination of feces revealed a decrease in the number of lactoand bifidobacteria, an increase in Esherichia coli with low enzymatic activity, as well as the growth of conditionally pathogenic microorganisms. The inclusion of a drug to normalize the gastrointestinal microflora in the treatment of chronic viral hepatitis B contributes to a faster regression of asthenovegetative manifestations, right hypochondrium syndrome and intestinal dyspepsia, normalization of pigment metabolism and aminotransferase levels, as well as restoration of the balance of obligate and facultative intestinal microflora. Conclusion. As a result of the study, it turned out that using of conventional therapy in patients with chronic viral hepatitis B with intestinal dysbiosis does not ensure the restoration of the population content of the microbiota, therefore, we consider it advisable to prescribe pre- and probiotic drugs to patients with this combined pathology.