Abstract. The aim of the present study was to analyze the medicinal effect of Bicyclol tablets on patients with chronic hepatitis B (CHB) and concomitant mild alanine aminotransferase (ALT) elevation (40-80 IU/l). A retrospective cohort study, which included patients from the hospital information system (HIS; established by the Chinese Academy of Medical Sciences) viral hepatitis database comprised of 18 third-grade class A hospitals in China, was performed. Patients were divided into an exposed group (administered with Bicyclol tablets) and a non-exposed group (no administration of Bicyclol tablets). The CHB patients that exhibited mild ALT elevation provided the curative effect analysis data set, and the patients with viral hepatitis who underwent more than two creatinine/hemoglobin/leucocyte examinations served as the safety analysis data set. The factors influencing ALT normalization rate were analyzed and the safety of Bicyclol tablets was assessed. In total, 82 pairs of patients were included in the curative effect analysis, and single factor analysis revealed that the ALT normalization rate of the exposed group was statistically significantly higher than that of the non-exposed group (P=0.040) for patients with mild ALT elevation. After adjusting for patient age, gender, baseline ALT levels, state of illness upon admission, pattern of hospitalization, hospitalization days and drug combination, the odds ratio (95% confidence interval) of the ALT normalization rate of the exposed group was 2.156 (1.103-4.215) when compared with the non-exposed group. During treatment, the occurrence rates of creatinine/hemoglobin/leucocyte level abnormalities of the exposed group, which were included in the safety analysis were statistically significantly lower than those of the non-exposed group (P<0.05). These findings indicate that Bicyclol tablets improve the ALT normalization rate of CHB patients exhibiting mild ALT elevation.
IntroductionChronic hepatitis B (CHB), which is defined as persistence of hepatitis B surface antigen for six months or more, is a major public health problem. According to the World Health Organisation, there are an estimated 240 million chronically infected individuals worldwide, particularly in low-and middle-income countries (1). The major complications of CHB are cirrhosis and hepatocellular carcinoma (HCC). Between 20 and 30% of those who become chronically infected will develop these complications, and an estimated 650,000 individuals will succumb due to CHB annually (1). The majority of individuals are unaware of their hepatitis B virus (HBV) infection, and, therefore, often present at an advanced stage of the disease (1). China has been identified as a region with a high prevalence of HBV; based on the National Disease Supervision Information Management System of China, the mean reported incidence of HBV was 84.3 per 100,000 in China between 2005 and 2010 (2). Despite the reduction in the incidence of the HBV infection, there are ~93 million individuals chronically infected with HBV and ...