BACKGROUND: The aim of this study was to evaluate the efficacy of lamivudine therapy in elderly patients with chronic HBV infection. METHODS: Patients aged >or=60 years (n = 40) received lamivudine monotherapy between February 1995 and September 2005 at Toranomon Hospital. We compared the efficacy of lamivudine therapy in these patients and in 639 patients aged <60 years, including 80 patients aged <60 years matched for sex, hepatitis B e antigen (HBeAg) status, and hepatitis B virus (HBV) DNA level. RESULTS: The rates of normalization of alanine aminotransferase (ALT) level in 40 patients aged >or=60 years and 639 patients aged <60 years were 85% versus 76%, and 86% versus 73% at 1 and 3 years, respectively. The respective rates of loss of HBV-DNA were 74% versus 74%, and 76% versus 68% at 1 and 3 years. The respective cumulative emergence rates of the YMDD mutant were 16% and 17% at 1 year, and 46% and 49% at 3 years. In 80 patients <60 years old matched for sex, HBeAg status, and HBV-DNA level, the rates of normalization of the ALT level and loss of HBV-DNA were similar to those in the 639 patients aged <60 years. The emergence rate of YMDD mutants in patients aged >or=60 years were similar to those in matched patients aged <60 years. Multivariate analyses identified low serum bilirubin (<1 mg/dl) as an independent factor associated with the emergence of the YMDD motif mutation in patients aged >or=60 years. CONCLUSIONS: Our results suggest that treatment with lamivudine is both well tolerated and efficacious in elderly patients with chronic HBV infection.
BACKGROUND: The aim of this study was to evaluate the efficacy of lamivudine therapy in elderly patients with chronic HBV infection. METHODS:Patients aged >or=60 years (n = 40) received lamivudine monotherapy between February 1995 and September 2005 at Toranomon Hospital. We compared the efficacy of lamivudine therapy in these patients and in 639 patients aged <60 years, including 80 patients aged <60 years matched for sex, hepatitis B e antigen (HBeAg) status, and hepatitis B virus (HBV) DNA level. RESULTS: The rates of normalization of alanine aminotransferase (ALT) level in 40 patients aged >or=60 years and 639 patients aged <60 years were 85% versus 76%, and 86% versus 73% at 1 and 3 years, respectively. The respective rates of loss of HBV-DNA were 74% versus 74%, and 76% versus 68% at 1 and 3 years. The respective cumulative emergence rates of the YMDD mutant were 16% and 17% at 1 year, and 46% and 49% at 3 years. In 80 patients <60 years old matched for sex, HBeAg status, and HBV-DNA level, the rates of normalization of the ALT level and loss of HBV-DNA were similar to those in the 639 patients aged <60 years. The emergence rate of YMDD mutants in patients aged >or=60 years were similar to those in matched patients aged <60 years. Multivariate analyses identified low serum bilirubin (<1 mg/dl) as an independent factor associated with the emergence of the YMDD motif mutation in patients aged >or=60 years. CONCLUSIONS: Our results suggest that treatment with lamivudine is both well tolerated and efficacious in elderly patients with chronic HBV infection.
Authors: F Nevens; J Main; P Honkoop; D L Tyrrell; J Barber; M T Sullivan; J Fevery; R A De Man; H C Thomas Journal: Gastroenterology Date: 1997-10 Impact factor: 22.682
Authors: C L Lai; R N Chien; N W Leung; T T Chang; R Guan; D I Tai; K Y Ng; P C Wu; J C Dent; J Barber; S L Stephenson; D F Gray Journal: N Engl J Med Date: 1998-07-09 Impact factor: 91.245