The Sublimated Mare Milk Supplement in Hepatitis C

This clinical trial studies the effect of sublimated mare milk supplement on patients with hepatitis C.

Chronic viral hepatitis C is one of the medical, social and economic public health problems throughout the world. In majority of patients with chronic viral hepatitis C, dysbiotic changes are detected in the intestinal tract. Disturbances of microbial equilibrium are associated with the degree of inflammation, morphological changes in the liver, nature of the course and the stage of the disease. These dysbiotic changes and and associated immune disorders can significantly aggravate the course of immune processes in the liver, converting hepatitis C infection to a chronic disease. Mare milk is frequently reported for having therapeutic and dietary properties, which are initially associated with a specific chemical composition and certain physical properties of the product. It contains a total of about 40 biologically active components, the most important of them vitamins A, C, B1, B2, B6, B12, amino acids, enzymes and trace elements, there are low molecular weight peptides, lactalbumins and globulins. The use of mare milk can contribute to the restoration of impaired functions of damaged organs and tissues, and play the role of an auxiliary pathogenetic therapy, primarily in certain chronic diseases of the digestive system, including chronic viral hepatitis C. Mare milk can also be used as a powder supplement through sublimation process. In this trial, the effect of this supplement consisting of sublimated mare milk on hepatitis C patients will be evaluated. There will be two parallel groups: Interventional (sublimated mare milk supplement with standard treatment) and Standard treatment group. Differences in laboratory characteristics will be quantitively analyzed between groups.

Participants will take a supplement of 1 sachet (20 mg) 3 times/day accompanied with the standard therapy for 1 month.

Supplement consisting of sublimated mare's milk with single-dose 20 mg sachet. The supplement is dissolved in 36-27 degrees of Celsius water and taken 15-20 minutes before meal.

For hepatitis virus C genotype 1: sofosbuvir 400 mg + lepidavir 90 mg for 12 weeks OR sofosbuvir 400 mg + daclatasvir 60 mg for 12 weeks; For hepatitis virus C genotypes 2 and 3: sofosbuvir 400 mg + daclatasvir 60 mg for 12 weeks.

Change in liver function will be assessed from biochemical blood results of alanine transaminase and aspartate transaminase.

Proportions of aerobic and anaerobic bacteria will be assessed from stool samples using MiSeq Sequencing System.

Level of immune status markers (Immunoglobulin G, Immunoglobulin M) will be detected from blood samples.

Detection of changes in phospholipids spectrum of lymphocyte membranes (phosphatidylethanolamine, phosphatidylserine, phosphatidylcholine, sphingomyelin, lysophosphatidylcholine) will be performed using the thin-layer chromatography method.

Inclusion Criteria: Patients with verified diagnosis of hepatitis C Aged 18 to 65 years Normal intestinal microbiota composition (anaerobes-95%, aerobes-5%) Normal level of immune system markers in blood (Immunoglobulin M and Immunoglobulin G) Decreased levels of phosphatidylethanolamine, phosphatidylserine, phosphatidylcholine, sphingomyelin Elevated lysophosphatidylcholine Willingness to consent to participate in the study Consent to adhere to treatment Exclusion Criteria: Drug and/or alcohol dependence Allergy to dairy products People with mental disabilities and/or life-threatening conditions Pregnancy and/or lactation Lactose intolerance Refusal to participate in the study

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