Long-term lamivudine for chronic hepatitis B and cirrhosis: A real-life cohort study.

AIM: To investigate clinical outcomes of chronic hepatitis B (CHB) and liver cirrhosis (LC) patients under whole-course management with lamivudine (LAM). METHODS: This was a retrospective-prospective cohort study based on two nonrandom cohorts of Chinese patients (LAM group and history control group). Two hundred thirty-eight patients with LAM treatment for at least 12 mo under whole-course management were included in the LAM group. The management measures included regular follow-up and timely adjustment of the therapeutic regimen according to drug-resistance and relapse. Two hundred thirty-eight patients with CHB or LC without any antiviral treatment and with follow-up over 12 mo were included in the history control group. The LAM and control group patients were 1:1 matched by propensity score method to ensure both patients were similar in general datum, sex, age, E antigen, and diagnosis. The incidence rates of endpoint events [LC, hepatocellular carcinoma (HCC), and death] were compared between the LAM and control groups. RESULTS: Hepatitis B virus-DNA < 1000 copies per mL rate and rate of alanine transaminase < 1.3 of the upper normal limit in LAM and control groups were 89.1% vs 18.5% (P < 0.05) and 89.8% vs 31.1% (P < 0.05), respectively. Viral breakthrough occurred in 77 patients (32.4%); the one-, three-, and five-year cumulative rates were 6.8%, 33.1%, and 41.3%, respectively. In total, 44.5% (106/238) of patients had once stopped LAM, and 63 (59.4%) of them developed virologic relapse; the relapse rate of patients with and without reaching Asian Pacific Association for the Study of the Liver endpoint criteria were 52.4% and 69.8%, respectively. Six CHB patients in the LAM group developed LC compared to 47 patients in the control group; the three-, and five-year cumulative rates of CHB at baseline of LAM were lower than those of the control group: 0.7% vs 12.0% and 1.8% vs 23.8% (P < 0.01), respectively. The incidence of HCC in CHB at baseline of LAM was lower than that of the control group; the three-, and five-year cumulative rates were 0% vs 3.2% and 1.1% vs 3.2% (P = 0.05), respectively. The incidence of HCC in LC at baseline of LAM was lower than that of the control group: 9.8% (5/51) vs 25.0% (12/48), and the three-, and five-year cumulative rates were 4.5% vs 20.7% and 8.1% vs 37.5% (P < 0.01), respectively. The mortality rate in the LAM group was lower than the control group. CONCLUSION: Standardized long-term LAM treatment in combination with comprehensive management can reduce the incidence rates of LC and HCC as well as hepatitis B virus-related deaths.

[Relationship between serum ferritin levels and susceptibility to attention deficit hyperactivity disorder in children: a Meta analysis].

OBJECTIVE: To study the possible relationship between serum ferritin levels and susceptibility to attention deficit hyperactivity disorder (ADHD) in children. METHODS: The papers relating to the relationship between serum ferritin levels and susceptibility to childhood ADHD were searched in the Database CBM, CNKI, VIP and PubMed. The Meta-analysis software RevMan 5.0 was used for the heterogeneity test and for the pooled OR calculation. Sensitivity and publication bias analysis were performed. RESULTS: Five control studies were included for the Meta analysis, including 258 cases of ADHD and 138 control cases. There was heterogeneity in the studies on the relationship between serum ferritin levels and susceptibility to childhood ADHD (P=0.003). So the studies were analyzed using the random-effect model. The pooled OR of serum ferritin levels and susceptibility to childhood ADHD was -23.09 (95%CI:-33.06-13.13; P<0.00001). The funnel plots did not indicate the existence of publication bias. CONCLUSIONS: The results from present Meta analysis can prove that serum ferritin levels are associated with susceptibility to childhood ADHD.