Central Asian Journal of Medicine


Research objective: to assess efficiency of application of bio preparations in the correction of intestinal dysbacteriosis taking into account the results of “Load” test in vitro in children with chronic hepatitis B together with giardiasis. Material and methods. We examined one hundred and fifty children with chronic hepatitis B (CHB) with concomitant giardiasis in the age from 3 to 18 years old. The diagnosis was based on data from history, results of clinical tests, biochemical and instrumental tests. Laboratory diagnostics of giardiasis was performed using the following methods: immune fluorescent method (G. Lamblia antigen in feces), polymerase chain reaction (G. Lamblia DNA in blood and feces), and triple microscopic test for precipitation components of feces. For the definition of lymphocyte sensitivity to bio preparations to choose the agent we applied loading test in vitro. For the correction of dysbacteriosis using the basic therapy we used very sensitive polycomponent probiotics in capsules such as “Bifilax-immuno”, “Lacto-G”, and “Narimax-plus”.Lamblia eradication was performed using Macmirror (Nifuratel) 15mg/kg two times a day for 10 days. Assessment of the efficiency of the prescribed therapy was done according to the clinical, biochemical, and bacteriological data. Results. We determined a direct proportional decrease of lymphocyte ability for E-rosette formation dependent on the expression of intestinal dysbacteriosis. The most sensitive biopreparation in in vitro test was Bifilax-immuno (62.7%), which differed by its quantitative and qualitative composition compared to Lacto-G (48.0%) and Narimax-plus (38.7%), р<0.05. Prescription of anti-giardiasis therapy with individually chosen very sensitive biopreparation for the correction of intestinal dysbacteriosis in children with CHB provided achievement of stabilization (60.0%) and regression of pathological process in liver, prevention of unfavorable outcomes such as hepatic cirrhosis and hepatocellular carcinoma. Conclusion. Differential approach to the choice of probiotic for the correction of intestinal dysbacteriosis provides the increase of the efficiency of therapy in children with CHB with concomitant giardiasis by 40.1%. Development of clinical, biochemical, and microbiological remission was achieved using Bifilax-immuno in 76.5% cases, Lacto-G in 64.4%, and Narimax-plus in 62.0% of the cases respectively (p < 0.01). In relation to that, children with CHB and concomitant giardiasis together with the test for intestinal dysbacteriosis have to undergo loading test in vitro for the prescription of efficient and targeted correction taking into account individual sensitivity of an organism to biopreparations.

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