Efficacy of Entecavir therapy in elderly patients with chronic hepatitis B infection

Abstract

Chronic infection with hepatitis B virus (CHB) affects as many as 350-400 million people worldwide and 93 million people in China. 1 Moreover, elderly patients with CHB are increasing. Hence, the treatment of elderly patients with CHB is an important issue. However, to our knowledge, there is no report about the efficacy of Entecavir (ETV) treatment on elderly patients (≥60 years) with CHB.A retrospective cohort study was conducted between February 2006 and March 2008; 40 consecutive Chinese patients aged ≥60 years were enrolled in this study at Zhenjiang No. 3 Hospital. We also selected 40 patients aged <60 years with CHB on ETV therapy at same time, who were matched to the ≥60 age group with respect to sex, alanine aminotransferase (ALT), HBV-DNA level, HBV genotype, and HBeAg status and duration of therapy. The study protocol was approved by the ethics committees of the hospital. All patients were treated with Entecavir at a dose of 0.5 mg/day peroral. Table 1 shows the rates of normalization of ALT level and non-detection of HBV-DNA, among patients aged ≥60 years and <60 years after six months and three years on ETV therapy. The rates of ALT normalization of and of non-detection of HBV-DNA in the two groups were similar (p > 0.05 for the two comparisons). Thirteen aged ≥60 years and nine patients aged less than 60 years underwent long-term liver biopsy (median time: 23 months, range: 12-39 months). Histological improvement (over 2-point decrease in the Knodell necroinflammatory Table 1 -Rates of ALT normalization and of non-detection of HBV-DNA in patients aged ≥60 years and <60 years. n ALT normalization rates (%) HBV-DNA non-detection rates (%) 6 months 12 months 24 months 36 months 6 months 12 months 24 months 36 months Age ≥60 years 40 87.5 87.5 90 87.5 82.5 87.5 87.5 92.5 Aged <60 years 40 85 87.5 85 82.5 80 90 85 90score and no worsening of the Knodell fibrosis score) were 76.9% (10/13) versus 77.8% (7/9) and fibrosis improvement (the Ishak fibrosis score ≥1-point decrease) were 38.5% (5/13) versus 44.4%(4/9) in two groups, respectively (p > 0.05 for the two comparisons). The cumulative emergence rates of ETV resistance in patients aged ≥60 years and in those <60 years were 0% and 0% at one year, 2.5% and 0% at two years, and 2.5% and 2.5% at three years, respectively. The emergence rates of ETV resistance in patients aged ≥60 years were similar to those of patients aged <60 years at all three time intervals. The cumulative rates of breakthrough hepatitis in patients aged ≥60 and <60 years were 0% and 0% at one year, 2.5% and 0% at two years, and 2.5% and 2.5% at three years, respectively (not significant). The mutation clusters were rtI169T + rtL180M + rtM204V + rtM250 V and rtL180M + rtT184G + rtS202I, and rtM204 V, respectively. After emergence of the HBV mutant, we added adefovir dipivoxil (ADV) to ongoing ETV therapy.The benefits of ETV in patients with compensated HBVrelated liver disease have been suggested by several groups. [2][3][4][5] Our study is the first to show long-term efficacy of ETV m...

5-year efficacy of entecavir in Indian patients with chronic hepatitis B

“…Some studies have found longer time to and lower rate of HBV DNA negativity in the subgroups of patients with e antigen positivity and higher baseline HBV DNA level [11,13,15,17], but others have not as in our study [18,19]. Studies have also found that previous NA exposure, age more than 60 years and the presence of cirrhosis do not influence viral suppression during prolonged therapy as our study [4,13,18,20].…”