OBJECTIVE:To investigate clinical efficacy and safety of tiopronin combined with lamivudine in the treatment of pulmonary tuberculosis complicated with chronic hepatitis B. METHODS:150 cases diagnosed as pulmonary tuberculosis with chronic hepatitis B were randomly divided into group A(drug combination group),group B(lamivudine group)and the group C (control group),with 50 cases in each group. 3 groups were given isoniazid+rifapentine+ethambutol+levofloxacin(2HTELfx/4HT) anti-TB treatment and liver protection treatment,etc. Group B was additionally given Lamivudine tablet orally,0.1 g,qd;group A was additionally given Tiopronin tablet 0.3 g,tid,on the basis of group B. The treatment course of 3 groups lasted for 6 months. Liver damage,serum fibrosis indexes of 3 groups were observed in 3 groups before and after treatment as well as hepatitis B virolo-gy indexes,clinical efficacy and the occurrence of ADR after treatment. RESULTS:After treatment,serum levels of ALT,AST and TBIL weresignificantly increased in group C,significantly decreased in group A,with statistical significance(P<0.05).There was no statistical significance in above indexes of group B before and after treatment(P>0.05). Serum levels of ALT,AST and TBIL after the treatment:group A0.05). Serum fibrosis indexes of group A and B decreased significantly compared to before treatment,with statistical significance (P<0.05);serum fibrosis indexes after the treatment:group A0.05). CONCLUSIONS:Tiopronin combined with lamivudine can significantly reduce liver function damage caused by an-ti-TB drugs. It is conducive to the smooth progress of tuberculosis chemotherapy with fewer adverse reactions.

OBJECTIVETo investigate the related to relapse of chronic hepatitis B (CHB) after recombinant interferon-alpha (rIFN-alpha) treatment.

METHODSThis investigation involved 523 pathologically confirmed CHB patients including 403 HBeAg-positive and 120 HBeAg-negative patients, who were treated with 5 MU rIFN-alpha subcutaneously thrice a week for 6-25 months. For each patient, serum alanine aminotransferase (ALT) was measured biochemically, serum HBV DNA level detected with quantitative fluorescent PCR, and HBeAg level with enzyme immuoassay every 1-3 months during therapy and every 3-6 months during the follow-up period.

RESULTSEarly response to rIFN-alpha treatment was observed in 302 (57.7%) patients at the end of treatment, among whom 39.4% (119/302) suffered relapse during the follow-up for 39.2-/+21.5 months. Age, HBeAg status before treatment, and follow-up duration were the predictive factors for post-treatment relapse. The mean age of patients with CHB relapse was significantly higher than that of the sustained responders (P<0.001), and the relapse rates in HBeAg-negative group (55.8%, 43/77) were significantly higher than that in HBeAg-positive group (33.8%, 76/225) at the end of follow up (P<0.001). The relapse rate and accumulative relapse rates at each year during the follow-up (for 5 years as the longest) differed significantly (P<0.001, P=0.000), but the accumulative relapse rates differed little between the years after the initial 2 of the follow-up (P=0.670). The relapse was not related to the patient's gender, pretreatment serum ALT, HBV DNA, grade of liver inflammation, stage of liver fibrosis, or duration of treatment. In HBeAg-positive patients, however, the mean HBV DNA was significantly higher in relapse group than in sustained response group (P=0.017).

CONCLUSIONAge, pretreatment HBeAg status, and follow-up duration are independent predictive factors for post-treatment CHB relapse. In HBeAg positive patients, pretreatment serum HBV DNA is also one of the risk factors for relapse.

Adult ; Age Factors ; Alanine Transaminase ; blood ; DNA, Viral ; blood ; Female ; Follow-Up Studies ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; therapy ; Humans ; Interferon-alpha ; therapeutic use ; Logistic Models ; Male ; Recurrence ; Treatment Outcome