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01-10-2001 | Therapy In Practice

Current Management Strategies for Hepatitis B in the Elderly

Authors: Philippe Merle, Christian Trépo, Professor Fabien Zoulim

Published in: Drugs & Aging | Issue 10/2001

Abstract

Despite the availability of an efficient vaccine, chronic hepatitis B virus (HBV) infection remains a major public health problem worldwide. The World Health Organization estimates that there are still 350 million chronic carriers of the virus who are at risk of developing chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC).

Antiviral therapy consists of the administration of either interferon-α (IFNα) or lamivudine. In the elderly, specific issues should be addressed. Because of the long duration of viral infection, screening for HCC is warranted in these patients, as new therapeutic options are being developed. Antiviral treatment for chronic hepatitis B is indicated in patients with elevated transaminases, the presence of HBV replication, and inflammatory activity on liver histology analysis, providing the patient has no other serious health problem impacting on life expectancy. Since IFNα therapy may cause many general adverse effects, lamivudine may be the best current treatment option in this patient population. The pharmacokinetics of lamivudine in the elderly are slightly different from those in younger adults but this does not require dose adjustment, except in the presence of renal function impairment. However, the beneficial effects of lamivudine therapy must be weighed against the selection of drug-resistant mutants.

New therapeutic strategies are now under evaluation and may be available in the future for the elderly population.

Besides mass HBV vaccination programmes, people sharing a house with patients infected with HBV should be vaccinated to prevent viral transmission.

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Title: Current Management Strategies for Hepatitis B in the Elderly
Authors: Philippe Merle
Christian Trépo
Professor Fabien Zoulim
Publication date: 01-10-2001
Publisher: Springer International Publishing
Published in: Drugs & Aging / Issue 10/2001
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI: https://doi.org/10.2165/00002512-200118100-00002

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