Efficacy of lamivudine therapy in elderly patients with chronic hepatitis B 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.
Kawaoka
Tomokazu
T
Department of Hepatology, Toranomon Hospital, 2-2-2 Toranomon, Tokyo 105-8470, Japan.
Suzuki
Fumitaka
F
Akuta
Norio
N
Suzuki
Yoshiyuki
Y
Arase
Yasuji
Y
Sezaki
Hitomi
H
Kawamura
Yusuke
Y
Hosaka
Tetsuya
T
Kobayashi
Masahiro
M
Ikeda
Kenji
K
Kumada
Hiromitsu
H
D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006511:Hepatitis B Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D004279:DNA, Viral; D006511:Hepatitis B Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000410:Alanine Transaminase