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.
1. Chifunda K, Kelly P. Parasitic infections of the gut in children. PaediatrInt Child Health. 2019 Feb;39(1):65-72. 2. El-Shabrawi M, Abdelgawad M, Elgaddar O, Hassanin F, Khalil A, Mahfouz A, Elbanna B. A clinical and immunological study of children with chronic hepatitis B virus infection. PrzGastroenterol. 2019;14(3):211-216. 3. Escobedo AA, Almirall P, Hanevik K, Cimerman S, Rodríguez-Morales AJ, Almanza C, Auza-Santivañez J. Giardiasis: a diagnosis that should be considered regardless of the setting. Epidemiol Infect. 2018 Jul;146(10):1216-1218. 4. Hooshyar H, Rostamkhani P, Arbabi M, Delavari M. Giardia lamblia infection: review of current diagnostic strategies. GastroenterolHepatol Bed Bench. 2019 Winter;12(1):3-12. 5. Khan J, Shil A, Mohanty SK. Hepatitis B vaccination coverage across India: exploring the spatial heterogeneity and contextual determinants. BMC Public Health. 2019 Sep 12;19(1):1263. 6. Kimirilova OG1, Kharchenko GA1. The results of the diagnosis of giardiasis in children with the use of the method of microscopy, enzyme immunoassay, polymerase chain reaction. Klin Lab Diagn. 2019;64(6):376-379. 7. Komatsu H, Inui A, Suzuki Y, Sugiyama M, Fujisawa T. Deep sequencing of hepatitis B surface antigen gene in the preserved umbilical cords in immunoprophylaxis failure against mother-to-child HBV transmission. // BMC Infect Dis. 2019. Nov 21.19(1):985. 8. Lai MW, Chang MH. Updates in the management of hepatitis B in children. Expert Rev GastroenterolHepatol. 2019$ Nov.13(11)^1065-1076. 9. Leung AKC, Leung AAM, Wong AHC, Sergi CM, Kam JKM.Giardiasis : An overview. Recent Pat Inflamm Allergy Drug Discov. 2019 Jun 18. 10. Nandy S, Shah I. Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock. J Family Med Prim Care. 2015 Oct-Dec;4(4):596-7. 11. Westin J, Aleman S, Castedal M, Duberg AS, Eilard A, Fischler B, Kampmann C, Lindahl K, Lindh M, Norkrans G, Stenmark S, Weiland O, Wejstål R. Management of hepatitis B virus infection, updated Swedish guidelines. Infect Dis (Lond). 2019 Oct 15:1-2. 12. Slim, M., Calandre, E.P. and Rico-Villademoros, F., 2015. An insight into the gastrointestinal component of fibromyalgia: clinical manifestations and potential underlying mechanisms. Rheumatology international, 35(3), pp.433-444. 13. Begaidarova, R.K., Nasakaeva, G.Y., Kuzgibekova, A.B., Yukhnevich-Nassonova, Y.A. and Alshynbekova, G.K., 2014. Modern aspects of clinic, diagnostic and treatment of giardiasis. Медицина и экология, (1 (70)). 14. Murray, T.S., Groth, M.E., Weitzman, C. and Cappello, M., 2005. Epidemiology and management of infectious diseases in international adoptees. Clinical Microbiology Reviews, 18(3), pp.510-520. 15. Fink, M.Y. and Singer, S.M., 2017. The intersection of immune responses, microbiota, and pathogenesis in giardiasis. Trends in parasitology, 33(11), pp.901-913. 16. Conrad, M.A. and Rosh, J.R., 2017. Pediatric inflammatory bowel disease. Pediatric Clinics, 64(3), pp.577-591. 17. Pinn, D.M., Aroniadis, O.C. and Brandt, L.J., 2015. Is fecal microbiota transplantation (FMT) an effective treatment for patients with functional gastrointestinal disorders (FGID)?. Neurogastroenterology & Motility, 27(1), pp.19-29. 18. Brenchley, J.M. and Douek, D.C., 2012. Microbial translocation across the GI tract. Annual review of immunology, 30, pp.149-173. 19. Post, R.E. and Hainer, B.L., 2010. Gastrointestinal Tract Infections. In Management of Antimicrobials in Infectious Diseases (pp. 231-265). Humana Press. 20. Ardura, M.I. and Kim, S.C., 2017. Infectious complications of pediatric inflammatory bowel disease. In Pediatric Inflammatory Bowel Disease (pp. 605-614). Springer, Cham
Nurmatova, Nargiza F.; Inoyatova, Flora I.; Mirsalikhova, Nargis K.; and Asilbekova, Malohat O.
"THE CHOICE OF BIOPREPARATION FOR THE CORRECTION OF INTESTINAL DYSBACTERIOSIS IN CHILDREN WITH CHRONIC HBV INFECTION AND GIARDIASIS,"
Central Asian Journal of Medicine: Vol. 2019
, Article 6.
Available at: https://uzjournals.edu.uz/tma/vol2019/iss4/6