[Long-term therapeutic effects and liver fibrosis changes with direct-antiviral therapy in HIV/HCV co-infected patients].

Objective: To investigate the long-term characteristic changes of virus, immune status, and liver fibrosis markers in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients after receiving direct-antiviral agents (DAAs). Methods: HIV/HCV co-infected patients who visited the Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 2014 to December 2019 were selected as the research subjects. The changes of virological response rate, peripheral blood CD4(+)T lymphocyte level and serological markers of liver fibrosis (APRI score and FIB-4 index) were observed during 144 weeks of follow-up course after the end of DAAs treatment. Kruskal-Wallis test was used for statistical approach. Results: A total of 103 cases were included in the study. There were 87 males (87.5%), with a median age of 44 years. Sustained virological response rate at 12 weeks (SVR12) after DAAs treatment was 97.6%, and the SVR during the entire follow-up period was at least 95.9%. Compared with baseline, CD4(+)T lymphocyte count were significantly increased equally at 12 weeks (Z = -2.283, P = 0.022), 24 weeks (Z = -3.538, P < 0.001), 48 weeks (Z = -3.297, P = 0.001), 96 weeks (Z = -3.562, P < 0.001), and 144 weeks (Z = -2.842, P = 0.004). APRI score (Z = -6.394, P < 0.001) and FIB-4 index (Z = -2.528, P = 0.011) were significantly lower than baseline at week 4 of DAAs treatment, and thereafter remained at a low level, without further declination. Conclusion: HIV/HCV co-infected patients can maintain high SVR for a long time, acquire good immune reconstitution, and significantly improve liver fibrosis after DAAs treatment.

The clinical efficacy and safety of levetiracetam add-on therapy for child refractory epilepsy.

OBJECTIVE: To investigate the clinical efficacy and safety of Levetiracetam (LEV) add-on therapy for child refractory epilepsy. PATIENTS AND METHODS: Levetiracetam add-on therapy was tested on 65 children who suffered refractory epilepsy, and clinical seizures. Electroencephalogram (EGG) changes and adverse reactions were observed in these children respectively in three, six and twelve months after the therapy. RESULTS: The complete control rates observed after 3, 6 and 12 months were respectively: 6.9%, 10.3% and 3.4%, while the response rates were accordingly 44.8%, 58.6% and 39.6%. The ameliorative rate of EGG reached 65.5%, appearing in positive correlation with the clinical efficacy (r = 0.436, p = 0.001). The retention rate after one year was 89%. Adverse reactions were expressed in 3% of the child patients, and the symptoms were dysphoria, mental and behavior disorders. CONCLUSIONS: The levetiracetam add-on therapy for child refractory epilepsy, demonstrates fast and obvious efficacy as well as fewer adverse reactions.