The advantages of drinking mineral water in the rehabilitation of patients with viral hepatitis C with accompanying non-alcoholic fatty liver disease after suffering from COVID-19.

INTRODUCTION AND OBJECTIVE: Past COVID-19 significantly worsens Chronic viral hepatitis C patients with concomitant NAFLD. The aim of the study was to assess effectiveness of including mineral water in the rehabilitation complex in patients with chronic hepatitis C with concomitant non-alcoholic fatty liver disease who contracted COVID-19. MATERIAL AND METHODS: 71 patients with chronic hepatitis C with concomitant NAFLD wo contracted COVID-19 were examined. Group I (control) - 39 patients prescribed dietary nutrition and exercise therapy. Group II (main) - 32 patients, in addition to the above, received packaged 'Shayanskaya' mineral water. Methodology comprised anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, and statistical methods. RESULTS: Due to the treatment, there were significant improvements in carbohydrate and lipid metabolism, as well as the cytokine profile. CONCLUSIONS: The effectiveness was established of the use of silicon low-mineralized bicarbonate sodium mineral water in the complex rehabilitation of patients with chronic hepatitis C and suputor NAFLD after contracted COVID-19. There was a significant improvement in the clinical course of the disease and improvement in the functional state of the liver.

Features of clinical, biochemical, and sonographic parameters in patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease.

INTRODUCTION AND OBJECTIVE: Introduction. Difficulties encountered in treating patients with chronic viral hepatitis C (CHC) are associated with the presence of concomitant liver pathology, namely fatty degeneration, which contributes to the progression of HCV infection. The above circumstances prompted the authorsled to thoroughly examine of this category of patients for further development of a new pathogenetically directed course of treatment. Objective. To study clinical, biochemical, and instrumental features of the course of liver disease in CHC patients with concomitant non-alcoholic fatty liver disease (NAFLD). MATERIAL AND METHODS: Tested 339 patients with chronic hepatitis C with concomitant NAFLD; and 175 patients with СНС. Methodology: anamnestic, anthropometric and clinical, general clinical, biochemical, serological, and molecular genetic (markers of hepatitis C virus, HCV RNA PCR (qualitative and quantitative determination, genotyping), enzyme-linked immunosorbent assay, ultrasonographic examination of digestive organs, statistical methods. RESULTS: Conducted clinical, instrumental, and laboratory studies have shown that CHC patients with concomitant NAFLD are characterized by various disorders - a violation of the functional state of the liver, a violation of carbohydrate and lipid metabolism, an imbalance of the cytokine system, the presence of histological and non-inflammatory activity in the liver. CONCLUSIONS: The presence of concomitant NAFLD in patients with CHC aggravates the clinical picture, manifesting itself in a significant lipid metabolism disorder that provokes the rapid formation of liver fibrosis. An additional complicating factor is the development of insulin resistance, leading to persistent morphological changes in the liver parenchyma.