How to cure hepatitis C with modern drugs and not go broke

One day I turned as yellow as a lemon.

It was a cold January 2000. I woke up with chills, looked in the mirror and was stunned: the whites of my eyes turned into “yolks”, and my skin acquired a cheerful shade of citrus fruit. A terrible hydrogen sulfide belch also appeared, and I realized that I urgently needed to see a doctor.

Go to the doctor

Our articles are written with love for evidence-based medicine. We cite reputable sources and seek comments from reputable doctors. But remember: responsibility for your health lies with you and your doctor. We do not write prescriptions, we give recommendations. Whether you rely on our point of view or not is up to you.

How I was diagnosed

The local therapist immediately called an ambulance, which took me to the city infectious diseases hospital, to the ward with the same “fruits”. Then a blood test and diagnosis: viral hepatitis C.

I won’t say that the news about hepatitis shocked me. It just so happened: reckless youth in the dashing nineties. I couldn’t let the heroin wave pass me by - I got completely screwed. At that time, I had already had more than two years of “experience.” And although there was still money for a new syringe, the use of common utensils to prepare the potion for use occurred sporadically. Back then I couldn’t believe it was so dangerous. I still have no idea at what point I caught the virus. But if it’s through drugs, there’s no option.

What is viral hepatitis C

Hepatitis C is a liver disease caused by the hepatitis C virus. The disease can occur in both acute and chronic forms.

Hepatitis C is one of the main causes of liver cancer. Chronic inflammation provokes damage to this organ, which often leads to malignant degeneration of cells.

The hepatitis C virus is transmitted through blood. Transmission is possible through injecting drug use, during medical procedures, including transfusion of contaminated blood, and in rare cases through sexual contact.

In 2021, hepatitis C was detected in 45 thousand Russians. In total, this disease in our country affects, according to various estimates, from 2.2 to 4.9 million people. 70% of them learned about their diagnosis by accident.

The attending physician’s lecture about the “gentle killer,” cirrhosis and other delights of this incurable, according to the lecturer, disease did not impress me at all. At the age of 25, it wasn’t that I didn’t believe, but rather, I didn’t see anything terrible in the fact that I would die someday later. And this “later” will not happen tomorrow or even the day after tomorrow. And if it’s “incurable,” then what’s the point of reflecting?

With these thoughts, I was discharged two weeks later, having removed all the symptoms of acute hepatitis with the help of droppers, injections and tablets. With the discharge, I went to the infectious disease specialist at my place of residence, and she registered me. She ordered me to get tested every six months. On this we parted ways.

For the next ten years I hardly remembered my problem. My head fell into place: I settled down, changed my lifestyle, got married. My wife found out about my virus in the first days of our acquaintance. Being an educated and sensible person, she took this news adequately. In the future, we did not focus on this point. The impact of the disease on our life together was manifested only in the need to use condoms, since the risk of transmitting the virus to a woman during unprotected sexual intercourse is quite high, 5-7%. As for the rest, hepatitis did not remind me of itself.

At some point, I noticed that I still knew exactly where my liver was located. Any increased physical activity led to a feeling of bloating and heaviness in the right hypochondrium. Since bad habits in the form of alcohol were still present in my life, I began to notice that hangovers were becoming more severe and were accompanied by a bitter taste in my mouth. After some time, similar symptoms began to be caused by banal overeating. I again realized that I urgently needed to see a doctor.

Legalon 140

Legalon 140 is a hepatoprotective drug. It interacts with free radicals - kinetically independent particles that have unpaired electrons, and neutralizes their aggressive effect on the body, thereby preventing cell destruction. In damaged liver cells, it activates the formation of protein compounds and phospholipids - complex lipids containing phosphoric acid. Transfers cell membranes to a stable state, prevents the consumption of transaminases, and accelerates the restoration of hepatocytes. Blocks the entry into the cell of substances that have a toxic effect on liver cells. Absorbed slowly in the gastrointestinal tract. In the liver it undergoes metabolic transformations through the formation of conjugates. The half-life averages 6 hours. Elimination from the body is carried out mainly through the gastrointestinal tract. It is not stored in the body. Legalon 140 is indicated for liver intoxication (due to chronic alcoholism, poisoning with halogenated hydrocarbons, heavy metal salts, pharmacological drugs) and for maintaining liver function as a prophylactic agent. The optimal time to take it is after a meal. Single dose – 1 capsule. The frequency of administration is three times a day (as a therapeutic agent), twice a day (as a preventative agent). The drug has a favorable safety profile, is non-toxic and is well tolerated by patients. In rare cases, allergic reactions and diarrhea are possible. The drug is not used in case of individual intolerance to the ingredients, as well as during pregnancy and lactation.

Milk thistle tincture has been used in folk medicine for liver diseases for a long time. Silymarin contained in this plant has confirmed its effectiveness in phytochemical, pharmacological, and histological studies. Based on this biologically active compound, they began to create medicines, the most active of which is Legalon, i.e.

contains twice the dose of silymarin than Silybor, Karsil, etc. Silymarin enters the liver, then, together with bile, into the intestines, after which it is again absorbed and ends up in the liver (enterohepatic circulation), and therefore its content in hepatocytes are one hundred times more than in the bloodstream. Liver cells are renewed every three weeks. Silymarin accelerates this process: it increases the stability of cell membranes, compacts them, and suppresses lipid peroxidation reactions. Legalon 140 is used for hepatitis of viral origin during the recovery period: as a rule, after 2-3 weeks of taking Legalon 140, patients note a decrease or elimination of intoxication phenomena. The drug is also indicated for patients with acute and chronic hepatitis: pharmacotherapy eliminates increased fatigue, discomfort in the right hypochondrium, and normalizes biochemical blood parameters. Legalon has a positive effect on the condition of patients suffering from cirrhosis of the liver: asthenic phenomena are eliminated, the activity of the digestive tract is normalized, the liver decreases in size, and the level of bilirubin in the plasma decreases. According to statistics, the survival rate of patients with liver cirrhosis who took Legalon for more than 40 months is about 60%, while in the control group it was 40%. The drug is effective for drug intoxication (poisoning with antibacterial and psychotropic drugs, paracetamol). The use of Legalon reduces recovery time after liver surgery. The drug shows good results in the treatment of liver diseases associated with excessive alcohol consumption. Cases of pharmacological interactions with other drugs have not been described in the medical literature; none have been noted in post-marketing studies of the drug, which allows the use of Legalon as part of combination drug therapy.

How I thought about treatment

The infectious disease specialist from the local clinic, a woman about 60 years old, was neither happy nor upset when she saw me. The duty officer asked why I had never come in all this time, and wrote me a referral for tests with a week to come for the results.

A week later I was like a bayonet. I found out that everything is bad with me, as it should be given my attitude to health: the viral load - the number of viral particles in the body - is growing, liver enzymes are also elevated, and on ultrasound the liver itself is not well enlarged.

I repented of my sloppiness and promised to improve. The doctor prescribed me medications to maintain liver health - so-called hepatoprotectors, gave me a printout with a special diet and was already ready to say goodbye to me. And then I asked if there was any news in terms of a complete cure for my hepatitis. Her answer surprised me a little:

- There is treatment, but do you need it?

It turns out that since the nineties there has been a treatment regimen for hepatitis C with interferons - special proteins similar to those secreted by the human body in response to the invasion of any viruses. It is believed that this protein is capable of modifying the membrane of uninfected liver cells and thereby protecting them from the penetration of the virus. In general, the scheme works, but there are some nuances:

• The effectiveness, depending on the genotype of the virus, ranges from 45 to 90%.
• The course of treatment lasts from six months to one and a half years.
• Treatment is by daily injections.
• The drugs have a huge list of side effects, some quite serious.

Simply put, it is possible to undergo treatment, but it is long and difficult, with no guarantee of cure and with a high probability of significantly worsening the quality of life as a result. But there is a program, and they will put me on the waiting list if I insist. In the meantime, as a farewell, the doctor gave me a business card with contacts of a local group of patients undergoing interferon treatment.

And here I dived deeply into the topic for the first time. I met and communicated with a girl named Yulia, who at that time had been on the pegylated interferon + ribavirin regimen for almost six months. Pegylated interferon works in the body much longer than usual. Thanks to this, Yulia needed to get an injection once a week, and not daily. But this is every week throughout the year! And you can’t get injections in your hands or give them to yourself. You need to come to the clinic every week. And that's not the worst part.

The most unpleasant thing is the side effects. From the first injections, the temperature rises and a prolonged flu-like state sets in with aching bones. Yulia told me that you get used to it after about a month. Much worse is constant itching of the skin and various digestive disorders. Almost all patients also experience severe depression, which in itself is a serious pathological condition.

And the most painful topic for the female half is hair. During treatment they begin to fall out. I’ll say right away that Yulia endured all these “charms” like a steadfast tin soldier. Working, raising a child. She also constantly encouraged me to start therapy. And thank God, her treatment worked, the virus went away and did not return.

But then I didn’t make up my mind. I read how they give up injections halfway through, when there is no more strength to continue. Or due to lack of response to treatment. I thought about it and didn’t sign up for the program. In addition, with hepatoprotectors, my discomfort gradually subsided, and for several more years I limited myself to symptomatic treatment.

How I learned about modern methods of treating hepatitis C

I would like to note that I went through all the tests and studies, as promised to the doctor, strictly. But everything that they did at the clinic - they took blood for biochemistry and performed an ultrasound - did not help in any way to assess how quickly my hepatitis was moving towards cirrhosis. Another safe and painless diagnostic method was fibroscan - ultrasound using a special device that determines the degree of fibrosis, that is, damage to liver tissue. If there is no access to a fibroscan, the only option left is a biopsy - a puncture in the liver with a special needle, which removes a piece of tissue for examination.

Fibroscan was found in a specialized gastroenterology center, and I went there. I paid about 2500 R and went through the research. I was diagnosed with the first, very initial stage of fibrosis. By luck, the result had to be taken from a local hepatologist. The young woman explained to me the essence of the research results and asked why I was not receiving treatment.

I immediately figured that they probably had their own paid program at the center. Well, I immediately briefly said everything I thought about interferon therapy. She wasn't embarrassed at all. I just asked why I don’t take normal pills.

- Normal pills?

Then I learned that three years ago the American company Gilead registered the first tablet form of a drug that directly affects the RNA of the hepatitis C virus and prevents it from being copied. This drug is called sofosbuvir. Combinations of this drug with later new products from the DAA line - direct-acting antiviral drugs - are by far the most effective means of treating hepatitis C. The cure rate is 95-97%, with virtually no side effects, and in tablet form!

This was great news. The bad thing is that a course of treatment with the original drug cost somewhere at the price level of a five-room apartment with European-quality renovation. But we were lucky. Gilead has licensed 11 Indian companies to produce generic drugs for the needs of poorer countries. Therefore, it was possible to purchase an analogue of the original drugs for quite reasonable money. The problem was that generics were not officially supplied to Russia, since our country was not considered the poorest. It was necessary to contact authorized trading companies in India directly and place the order privately.

How effective is modern therapy for hepatitis C?

Nikolay Golovenko gastroenterologist at GMS Clinic

With the advent of drugs from the group of RNA polymerase inhibitors, treatment of hepatitis C with interferons has lost its relevance. For example, the effectiveness of treatment with PEG - pegylated interferon - did not exceed 60%. Treatment took from six months to two years and was accompanied by multiple side effects.

Moreover, the effectiveness of RNA polymerase inhibitors, according to various sources, ranges from 80 to 95%. In case of insufficient effectiveness in the first three months, this drug is prescribed for another 12 weeks, which, as a rule, leads to complete elimination of the virus and recovery of the patient. The exceptions are patients with transformation of hepatitis into cirrhosis and patients with hepatocellular carcinoma.

Unfortunately, according to the requirements of the Ministry of Health, infectious diseases hospitals and hepatology departments can only purchase the original drug, the cost of a course of treatment ranges from 500,000 to 1,000,000 RUR. Therefore, due to a shortage of drugs, some patients are still prescribed interferon therapy. Or they informally offer treatment at their own expense.

Thanks to the appearance of generics on the market, the cost of a course of treatment with polymerase inhibitors has decreased and currently ranges from 35,000 to 100,000 RUR. The effectiveness of generics is approximately the same compared to the effectiveness of the original drug.

The hepatologist estimated the average cost of a course of generics at $1,000 (74,166 RUR). For the exact amount, it was necessary to decide on a specific drug and its quantity, and then check with the sellers. The sellers in this case were intermediary companies that had established communication with the Indian side. These were pure intermediaries. They simply processed requests from Russian patients on their websites and forwarded the information to a trading partner in India. Buyers paid for the medicines and delivery directly to the Indians.

Many individuals offered drug delivery services. The doctor gave me a business card from one of these “helpers,” who, according to her, had already been checked. But first I had to make a fundamental decision to take such a sharp turn. The new information looked too fabulous to be true.

Pharmacological properties

Silymarin's ability to bind free radicals provides its antioxidant activity.
thus, the pathophysiological process of lipid peroxidation, leading to the destruction of cell membranes, is interrupted or prevented. in damaged hepatocytes, silymarin stimulates protein synthesis and normalizes phospholipid metabolism. As a result, silymarin stabilizes cell membranes and limits or prevents the loss of soluble components (in particular transaminases) of liver cells. Silymarin inhibits the penetration of certain hepatotoxic substances into the cell (poison of the toadstool).

Silymarin enhances protein synthesis due to specific stimulation of RNA polymerase A, an enzyme located in the nucleus. This leads to increased formation of ribosomal RNA and, as a consequence, stimulation of the synthesis of structural and functional proteins (enzymes). As a result, the recovery ability is improved and the regeneration of liver cells is accelerated.

How I decided to take generic treatment

And I took a break. I was observed for about another year at the gastrocenter. During this time, my maintenance treatment changed somewhat: the doctor replaced an expensive hepatoprotector drug with a cheaper drug and additionally prescribed several courses of anticholecystitis therapy to maintain gallbladder function. It turns out that in most cases any pain in the liver area is caused by the gall bladder. I only bought pills - doctor’s consultations and all examinations were free under the compulsory medical insurance policy.

At the same time, at this time I was actively surfing the Internet in search of information about a new treatment. I found out that these revolutionary tablets act as RNA polymerase inhibitors. They inhibit the enzyme necessary for the virus to multiply. I studied a lot of specialized forums with reviews about providers' websites, treatments and results. Everything looked like the treatment was really working.

I understood that something needed to be done about the pain. The viral load continued to grow, the symptoms also caused more and more inconvenience, and it was clear how it would all end.

And in September 2021, I finally made up my mind, saved up money for treatment and went to the doctor again, took a genotype and viral load test. Based on the test results, the hepatologist selected the drug Ledihep for me, an Indian generic of the original drug Harvoni. The active ingredients are two polymerase inhibitors: sofosbuvir and ledipasvir. The course of treatment was 12 weeks, one tablet per day. It was necessary to buy 3 jars of the drug, 28 tablets each.

I read specialized forums and, based on reviews, chose the site where I planned to place an order, but just in case, I also contacted the person on the doctor’s business card. My costs if ordering through him would be $300 higher compared to ordering through the website. I figured I could handle it myself and refused the services of a private contractor.

This is what the main page of the site where I bought medicine looks like. Source: HCV24

special instructions

If jaundice develops, it is necessary to consult a doctor to adjust therapy.

During pregnancy and breastfeeding. No studies have been conducted on the use of the drug during pregnancy and lactation.

Children. There is insufficient data regarding the use of the drug in children, therefore Legalon is not recommended for use in children under 12 years of age.

There was no effect on reaction speed when driving vehicles or operating machinery.

How I bought Indian tablets

Now I catch myself thinking that I was lucky several times in this story. I was lucky to meet a competent hepatologist and lucky with the choice of the supplier’s website. After contacting me through the feedback form, my personal manager contacted me. She accompanied me promptly and competently until the very end of the transaction. In general, the organization of sales on our Russian side was a pleasant surprise.

First of all, in response to my application, I was introduced to the entire available range of medications with the active ingredient I needed. Since I had already initially decided with the doctor about the drug, I did not change anything and confirmed my order for three jars of Ladyhep. In response, they sent me payment details and an invoice - that’s what an invoice for payment is called in international commerce.

The intermediary offered five different generics of Harvoni, which varied slightly in price

This is what the payment details sent to me looked like:

Invoice for my order, the total cost of which was $740

With the invoice, I went to my bank and made a currency transfer. Then I sent a scan of the payment notification to the manager

My new generation drug. Source: LadyHep

I had to wait 12 days for confirmation of funds being credited. But the next day after confirmation, the parcel was sent immediately. I received a tracking code and waited another 12 days. In total, 27 days passed from the moment of application on the website to the moment of receipt of the shipment at the EMC point of issue.

I exhaled, decided to wait six days until the beginning of November, so that it would be easier to count the weeks, and start taking pills from the first.

How to legally import unregistered medicine into Russia

Polina Naydenkova lawyer in the field of pharmacology and medicine

There are two legal ways to buy the drug abroad: simple and complex.

Downtime is when the patient himself brings it in his luggage for his treatment. This option cannot be implemented by power of attorney; only legal representatives - parents and guardians - can transport medications. Obviously, not every patient and does not always have such an opportunity - this is a disadvantage of this method. In addition, this method is only suitable for drugs registered in the Russian Federation - you can check the availability of registration through the State Register of Medicines. However, if the drug is a prescription drug, you will need a prescription from your doctor to transport it.

The difficult way is to import it under a special permit issued by the Russian Ministry of Health. Under this permit, medications can be transported not only in person, but also by post.

To obtain such permission, you need to submit a package of documents to the Russian Ministry of Health:

• Protocol of the consultation of a federal specialized medical organization or institution of the Russian Academy of Medical Sciences or an institution of a constituent entity of the Russian Federation in which medical care is provided to a specific patient. This protocol must indicate the need to prescribe the drug for health reasons, and such a need for which the prescription of a drug registered in the Russian Federation is impossible. The protocol is signed by the chief physician of the institution.
• An appeal from the regional health authority about the need to import an unregistered drug, accompanied by a copy of the council’s conclusion.
• An electronic copy of the passport or birth certificate of the patient who is prescribed the drug, certified not by a notary, but certainly by the medical institution providing medical care.
• Application for obtaining permission to import into the territory of the Russian Federation an unregistered medicinal product necessary to provide medical care for the vital indications of a particular patient. The application form was approved by the Russian Ministry of Health.

All this - both on paper and at the same time in the form of an electronic document - is submitted to the address and to the Russian Ministry of Health. The Russian Ministry of Health will review the documents and make a decision within one week. Such an application is not subject to state duty.

Violation of the rules for the import of drugs unregistered in the Russian Federation is subject to administrative and criminal liability. If a medicine is not registered in Russia, and there are no documents confirming the right of a specific individual to receive it, government agencies recognize it as falsified or of poor quality.

According to Art. 6.33 of the Code of Administrative Offenses of the Russian Federation, illegal import of unregistered medicines into the territory of the Russian Federation entails the imposition of an administrative fine on a citizen in the amount of 70,000 to 100,000 RUR.

If the state sees in the actions of an individual a sales goal - this depends on the size of the batch of imported drugs - liability is threatened in the form of imprisonment for a term of 3 to 5 years.

Interactions

With the simultaneous use of silymarin in the highest possible doses and oral contraceptives or drugs used in estrogen replacement therapy, the effectiveness of the latter may decrease. due to inhibition of the cytochrome p450 system, silymarin thereby enhances the effect of certain drugs, namely: antiallergic drugs (fexofenadine); hypocholesterolemic drugs (lovastatin); anticoagulants (clopidogrel, warfarin); antipsychotic drugs (alprozolam, diazepam, lorazepam); antifungal drugs (ketoconazole); certain cancer drugs (vinblastine).

How I received treatment

And so it began. One tablet per day, preferably at the same time, with plenty of water. According to the instructions, side effects could appear in the first week of treatment: headache, rash and itching, fatigue and a few other non-serious symptoms. But according to my doctor, none of her patients have encountered them.

And I didn’t feel anything at all. I swallowed the pill like a piece of chalk, following a signal on my phone, and forgot about the treatment for a day. There were so many new sensations that, closer to the two-week mark, the thought began to itch: “Have they really been bred into a dummy?”

Two weeks later I went for the first control test. There are several of them: after 2, 4, 12 weeks, and then, after the end of treatment, after six months and a year. I took a qualitative PCR test, a test that determines the presence of a virus in a blood sample. It is the fact of presence itself, and not its quantity. I would like to note right away that I took all the control tests at my own expense in commercial laboratories, since I did not officially undergo treatment and there were no grounds for prescribing tests under the compulsory medical insurance contract. Depending on the laboratory and current promotions, I paid from 500 to 700 RUR for each sample.

The doctor explained that the first test, two weeks after the start of treatment, can be either positive or negative. The analysis after four weeks should already be negative, like all subsequent ones. If not, you need to supplement the treatment regimen or interrupt it.

And now my first two weeks are over. I really hoped that I would receive confirmation that everything was not in vain. But the analysis turned out to be positive. And although I knew that the virus could still be detected at the first cutoff, after this result I began to openly worry about success. The next two weeks were the hardest. I still spent hours taking pills, dieting, giving up alcohol completely, and dreading the next test. And finally he waited.

For the first time in 17 years, the test did not detect HCV in my body. My “everything is lost” mood instantly changed to “hurray, we are breaking, the Swedes are bending.” And although I knew that sometimes the virus returns several months after treatment, it was at that moment that I believed that everything would work out for me. I already automatically took the therapy and did not feel any side effects. At the end of the course, the test again did not detect the virus in my blood.

The course ended, and I began to get used to living without hepatitis. I still couldn’t believe that the once incurable disease was gone. And I felt that I had left for good, even though there were still two control tests ahead.

By the first half of the year without hepatitis, I began to feel the effect of the treatment. The bitter taste in my mouth stopped bothering me. The feeling of bloating in the right hypochondrium disappeared, sleep improved, and performance increased. I had one last control test left to say with a clear conscience: I had cured hepatitis C.

This is how my epic with the treatment of hepatitis C ended. The legacy of the disease left antibodies in my blood, which are now always with me. Therefore, now it makes no sense for me to carry out ELISA - an antibody test to diagnose hepatitis - and doctors need to be warned about this. At the same time, despite the presence of antibodies, after treatment, immunity to the virus is not developed, so I can catch this infection in the second round. There are also problems with the gallbladder - cholecystitis has not disappeared. But you can live with it, it can be treated, and you can’t infect anyone with it.

My first positive test after two weeks from the start of treatment

The first “minus” four weeks after the start of treatment

12 weeks from the start of treatment - no virus detected

Six months after treatment: still no virus

A year after treatment - no virus, hurray!

How much did hepatitis C treatment cost me?

Now, three years later, the situation with the treatment of hepatitis C in Russia has not changed. The state can only offer interferon therapy as free treatment programs. Generics of modern inhibitors cannot be purchased in pharmacies. The situation with the procurement of patented drugs is extremely confusing. Purchases of small quantities of expensive original drugs are periodically announced, but they are not available either in pharmacies or in programs.

This whole story with the treatment of hepatitis once again convinced me that something is wrong with the world order in general. A huge number of people do not have access to modern medicines only because large corporations decide who and how much to make money from. I also learned that we have many competent doctors, caring specialists who, in the face of this global injustice, help people literally survive. Now I'm used to searching for health-related information on the Internet. This helps, when communicating with a doctor personally, to understand who is in front of me: an expert or simply a “person with a profession” who is ossified in the dogmas of the times of obtaining a medical diploma.

Well, the main lesson, or rather a confirmation of well-known truths: you have to pay for everything and some things are better to prevent than to correct later.

I paid about 51,000 RUR for the treatment of hepatitis C

Note!

Description of the drug Legalon 140 caps. 140 mg No. 60 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Remember

Non-alcoholic fatty hepatosis

“Due to the high probability of an unfavorable course of NAFLD, especially in combination with other manifestations of metabolic syndrome, all patients, regardless of the severity of the disease, require dynamic monitoring and treatment”

Chief physician of the State Center "Expert", professor of PSPbSMU named after. acad. I.P. Pavlova Mehdiev S.N.

Treatment of non-alcoholic fatty liver disease (non-alcoholic fatty liver disease, NAFLD) is carried out using examination and treatment methods developed by the head physician of the center, Professor Mehdiyev Sabir Nasredinovich , based on Russian and foreign clinical recommendations, as well as our own practical and research experience.

Treatment begins with an examination tailored to the individual characteristics and health status of the patient, which will allow:

1. Assess the degree of inflammation in the liver and the risks of developing health-threatening liver diseases (cirrhosis and liver cancer).
2. Identify lipid metabolism disorders (fat metabolism) and other metabolic disorders in the body.
3. Check for risk of developing cardiovascular diseases.
4. To provide a reliable assessment of the condition of the liver tissue without invasive intervention.

Based on the results of the examination, an individual treatment program , which will include:

• dietary recommendations and physical activity regimen;
• drug therapy to help the body return to a healthy state.

Treatment is carried out under the supervision of a gastroenterologist; a second appointment will be required in 1-2 months. Repeated ultrasound and elastography of the liver to assess the success of treatment are carried out no earlier than six months later.

Treatment options for non-alcoholic fatty liver disease

Treatment of non-alcoholic fatty liver disease in the absence of complications is carried out on an outpatient basis. To date, there is no single drug to treat this disease, so treatment includes a range of measures, both with and without the use of drug therapy.

The main non-drug measures are proper nutrition, weight loss and sufficient physical activity. Losing body weight if you are overweight should be done gradually, no more than 0.5 - 1 kg per week. Rapid weight loss can cause deterioration and progression of steatohepatitis. It is advisable to select the diet individually, but its main provisions are to reduce the consumption of animal fats, simple carbohydrates and sweets.

Weight loss is the most important condition for success. A 10-14% reduction in weight significantly reduces the amount of fat in liver cells. If you fail to lose at least 1 kg in the first month, you may need the help of a nutritionist who, together with you, will analyze and adjust your diet to speed up weight loss.

In the absence of success of conservative measures to reduce body weight, with a high degree of obesity (BMI >40 kg/m2) and the progression of non-alcoholic fatty liver disease, bariatric surgery is used to treat obesity.

Drug therapy for fatty hepatosis and steatohepatitis is considered as an additional means to measures to introduce a healthy lifestyle. Drugs are used to correct metabolic syndrome—lowering the level of triglycerides in the blood, increasing tissue sensitivity to insulin, as well as hepaprotectors and antioxidant agents.

If necessary, drug therapy is adjusted during treatment. The duration of medication depends on the stage of fatty hepatosis and health status, but a diet and daily routine with a sufficient amount of physical activity will need to be followed even after the end of treatment. If a person returns to an unhealthy diet after recovery and gains excess weight again, non-alcoholic fatty liver disease returns.

Non-alcoholic fatty hepatosis can be combined with diseases of the cardiovascular system and pancreas or be the cause of their development.

Treatment of patients with non-alcoholic fatty hepatosis and diseases of the cardiovascular system

Gastroenterologist and cardiologist Olga Aleksandrovna Mekhtieva specializes in the treatment of patients with hypertension and non-alcoholic fatty hepatosis . She uses rhythmocardiography techniques, which detect the risk of developing cardiovascular diseases at an early stage. Simultaneous treatment of hypertension and non-alcoholic fatty hepatosis will help restore liver health, normalize blood pressure and reduce the risks of developing liver and cardiovascular diseases.

Treatment of patients with non-alcoholic fatty liver disease and type 2 diabetes

Patients with complex cases of a combination of non-alcoholic fatty hepatosis and pancreatitis or type 2 diabetes are managed by the chief physician of our center, Sabir Nasredinovich Mehdiev . Sabir Nasredinovich has been treating people with fatty hepatosis and its complications for more than 12 years, and is also engaged in scientific research on this topic.

For diseases of the pancreas and type 2 diabetes, a gastroenterologist and an endocrinologist in our center treat patients together.

As a result of treatment, the patient will receive

1. Stopping the process of fat accumulation in the liver, reducing the rate of disease development.
2. Reducing liver fat.
3. Reducing the risk of developing steatohepatitis, cirrhosis and liver cancer.
4. Reducing the risk of type 2 diabetes and cardiovascular diseases.
5. Improving the quality of life and increasing its duration.

Tips and tricks

In order to prevent fatty hepatosis, we recommend that people with a body mass index of more than 25 kg/m2, with abdominal obesity, and diabetes mellitus undergo an ultrasound of the liver and check biochemical blood parameters once a year.

You can learn more about non-alcoholic fatty liver disease (NAFLD) and get tips on how to keep your liver healthy from the article by the chief physician of our center S.N. Mehdiyev. “Fat in the liver destroys the heart and leads to diabetes” in Komsomolskaya Pravda.

The diet can be based on a Mediterranean type of diet, including a large amount of fruits and vegetables. It is recommended to start physical activity with walking, swimming or cycling; the main thing is regularity of exercise; daily exercise improves the condition of the liver, even if you cannot lose weight right away.

On the reasons for the development of fatty hepatosis, a fragment of the speech of Professor Sabir Nasredinovich Mehdiev at the scientific and practical seminar “Features of the course of NAFLD in a patient with chronic biliary-dependent pancreatitis”