Derbak M. A., Buchok O. V., Boldizhar O. O., Bletskan M. M., Svistak V. V.

THE EFFECT OF COMPLEX THERAPY INCLUDING VITAMIN D ON THE QUALITY OF LIFE OF PATIENTS WITH CHRONIC HEPATITIS C COMBINED WITH CHRONIC PANCREATITIS

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Derbak M. A., Buchok O. V., Boldizhar O. O., Bletskan M. M., Svistak V. V.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Chronic hepatitis C (CHC) and chronic pancreatitis (CP) are common, mutually aggravating diseases that are often accompanied by nutrient deficiencies, particularly vitamin D. However, currently existing data on the feasibility of inclusion of vitamin D in the complex therapy of patients with CHC and CP are contradictory and require further study. In order to evaluate the impact of complex therapy with the inclusion of vitamin D on the clinical course and quality of life of patients with CHC combined with CP, 52 patients with CHC+CP were divided into 2 groups depending on the prescription scheme of the polyenzyme drug and vitamin D. It was established that as a result of prescribing complex therapy with the addition of vitamin D, 100% of patients in group 1 and only 82.1% of patients in group 2 achieved sustained virological response (SVR). After the treatment, a decrease in the frequency of complaints of diarrhea, constipation, flatulence, abdominal pain, itching, heaviness in the right hypochondrium, hepatomegaly, arthralgia and myalgia was found in all patients, with a significant predominance in the group that additionally received vitamin D. After treatment, patients in group 1 were less likely to be bothered by anxiety, increased fatigue, emotional lability, and significantly higher quality of life indicators were found than in patients in group 2. Therefore, the inclusion of a polyenzyme drug with minimal lipase activity of 25,000 and vitamin D in a dose of 4,000 IU/day to the complex treatment of patients with CHC combined with CP increases the efficacy of antiviral therapy and leads to a marked regression of manifestations of hepatobiliary dysfunction, asthenovegetative and dyspeptic syndromes, thereby reducing the situational anxiety and improves the quality of life of these patients.

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Bibliography:

1. World Health Organization. Hepatitis C. WHO; 2021 [viewed 2021 Feb 5]. Available from: https://www.who.int/news-room/fact-sheets/ detaІЛ/hepatitis-c.
2. Brunner N, Bruggmann P. Trends of the Global Hepatitis C Disease Burden: Strategies to Achieve Elimination. J Prev Med Public Health. 2021 Jul 31;54(4):251–8. DOI: 10.3961/jpmph.21.151.
3. Khomyn HO, Babinets LS, Halabitska IM. Otsinka morfolohichnykh zminhastroduodenalʹnoyi zony patsiyentiviz khronichnym pankreatytom u komorbidnosti iz khronichnym virusnym hepatytom C. Gastroenterologìa. 2023 Jun 22;57(2):70–7. DOI: 10.22141/2308- 2097.57.2.2023.534. [in Ukrainian].
4. Blackard JT, Kong L, Lombardi A, Homann D, Hammerstad SS, Tomer Y. A preliminary analysis of hepatitis C virus in pancreatic islet cells. Virol J. 2017 Dec;14(1):237. DOI: 10.1186/s12985-017-0905-3.
5. Simons-Linares CR, Imam Z, Chahal P. Viral-Attributed Acute Pancreatitis: A Systematic Review. Dig Dis Sci. 2021 Jul;66(7):2162–72. DOI: 10.1007/s10620-020-06531-9.
6. Beyer G, Habtezion A, Werner J, Lerch MM, Mayerle J. Chronic pancreatitis. The Lancet. 2020 Aug;396(10249):499–512. DOI: 10.1016/ S0140-6736(20) 31318-0.
7. Chen CH, Liu LK, Chen MJ, Lee WJ, Lin MH, Peng LN, et al. Associations between vitamin D deficiency, musculoskeletal health, and cardiometabolic risk among community-living people in Taiwan. Medicine (Baltimore). 2018 Dec 28;97(52):e13886. DOI: 10.1016/S0140- 6736(20)31318-0.
8. Liu D, Meng X, Tian Q, Cao W, Fan X, Wu L, et al. Vitamin D and Multiple Health Outcomes: An Umbrella Review of Observational Studies, Randomized Controlled Trials, and Mendelian Randomization Studies. Adv Nutr. 2021 Nov 23;13(4):1044–62. DOI: 10.1093/advances/ nmab142.
9. Cai F, Hu C, Chen CJ, Han YP, Lin ZQ, Deng LH, et al. Vitamin D and Pancreatitis: A Narrative Review of Current Evidence. Nutrients. 2022 May 18;14(10):2113. DOI: 10.3390/nu14102113.
10. Shostakovych-Koretska LL, Nikolaychuk MA, Budayeva IV, Shevchenko-Makarenko OP, Lytviy KY, Biletska SV. Comparative analysis of vitamin D contents in patients with chronic viral hepatitis C and healthy. Medicni perspektivi. 2019;24(4):94–101. DOI: 10.26641/2307- 0404.2019.4.189360.
11. Bjelakovic G, Nikolova D, Bjelakovic M, Gluud C. Vitamin D supplementation for chronic liver diseases in adults. Cochrane Database Syst Rev. 2017 Nov 3;2017(11):CD011564. DOI: 10.1002/14651858.CD011564.pub2.
12. Han Z, Margulies SL. Vitamin D Deficiency in Patients with Pancreatitis: Is Vitamin D Replacement Required? Pancreat Disord Ther [Internet]. 2016 [cited 2023 Oct 4];6(3). Available from: https://www.omicsgroup.org/journals/ vitamin-d-deficiency-in-patients-with-pancreatitis-is-vitamin-d-replacementreq uired-2165-7092-1000172.php?aid=71670. DOI: 10.4172/2165-7092.1000172.
13. Komolmit P, Kimtrakool S, Suksawatamnuay S, Thanapirom K, Chattrasophon K, Thaimai P, et al. Vitamin D supplementation improves serum markers associated with hepatic fibrogenesis in chronic hepatitis C patients: A randomized, double-blind, placebo-controlled study. Sci Rep. 2017 Aug 21;7:8905. DOI: 10.1038/s41598-017-09512-7.
14. Kondo Y. Hepatitis C infected patients need vitamin D3 supplementation in the era of direct acting antivirals treatment. World J Gastroenterol. 2017 Feb 28;23(8):1325–7. DOI: 10.3748/wjg.v23.i8.1325.
15. Zhu C, Zhang Y, Wang T, Lin Y, Yu J, Xia Q, et al. Vitamin D supplementation improves anxiety but not depression symptoms in patients with vitamin D deficiency. Brain Behav. 2020 Sep 18;10(11):e01760. DOI: 10.1002/brb3.1760.
16. MOZ Ukrainy. Nakaz MOZ Ukrainy №638 vid 10.09.2014 r. «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry khronichnomu pankreatyti». MOZ Ukrainy; 2014. [in Ukrainian]
17. Moroz LV, Alkhazov Yu, Abdullaieva N, Androsova OS, Haiduk OA. Comparative characteristics of the effectiveness of various hepatitis C treatment regimens (Own experience). Hepatology. 2017;(3):6–11. [in Ukrainian].
18. Udomsinprasert W, Jittikoon J, Sukkho S, Pojarassangkul N, Sangroongruangsri S, Chaikledkaew U. Decreased circulating vitamin D reflects adverse outcomes of hepatitis C virus infection: A systematic review and meta-analysis. J Infect. 2020 Oct;81(4):585–99. DOI: 10.1016/j.jinf.2020.06.025.

Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 4, 171, 166-171 pages, index UDC 616.36-002.2-022.6:578.833.2+616.37-002.2-008.64+615.356:577.161.1]-036.8-085

DOI:

10.29254/2077-4214-2023-4-171-166-171