Treatment of elderly patients with co-infection with hepatitis B and C viruses
Authors:
J. Stránský
Authors‘ workplace:
I. interní klinika 3. lékařské fakulty UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Jiří Horák, CSc.
Published in:
Vnitř Lék 2005; 51(3): 354-358
Category:
Case Reports
Overview
A co-infection with hepatitis B (HBV) virus and hepatitis C (HCV) virus is not anyway a rare disease. Acute hepatitis caused by HBV and HCV co-infection occurs in about 5 % cases, predominantly in IV drug addicts, and it can reach 15–20 % in chronic hepatitis. It is impossible to find out retrospectively in older cases of chronic hepatitis, whether hepatitis experienced originated as a co-infection with both viruses or the super-infection with HBV or HCV occurred in the next course, but it is unsubstantial for antiviral treatment indication. Elderly patients with chronic hepatitis B and C over 60 years old belong among a little studied population which is generally excluded from the trials with antiviral treatment. Such patients however exist though they are rather sporadic cases. Elderly patients are not anymore suitable for liver transplantation and surprisingly the antiviral treatment of HBV and HCV co-infection is not unambiguously defined even in the literature. The article is a contribution to the possible treatment of some patients with chronic HBV and HCV infection and presents three typical patient case reports with a proposition of antiviral treatment.
Key words:
HBV and HCV co-infection – treatment – elderly patients
Sources
1. Alberti A, Pontisso P, Chemello L et al. The interaction between hepatitis B virus and hepatitis C virus in acute and chronic liver disease. J Hepatol 1995; 22(Suppl 1): 38–41.
2. Ganem D, Prince AM. Hepatitis B virus infection – natural history and clinical consequences. N Engl J Med 2004; 350(11): 1118–1129.
3. Guptan RC, Sarin SK, Thakur V. Recombinant interferon therapy in patients with dual infection due to hepatitis B and C. Digestive Disease Week Symposium, Washington DC, May 10.–16. 1997, abstract 289.
4. Liaw YF, Tsai SL, Chang JJ et al. Displacement of hepatitis B virus by hepatitis C virus as the cause of continuing chronic hepatitis. Gastroenterology 1994; 106: 1048–1053.
5. Liaw YF. Role of hepatitis C virus in dual and triple hepatitis virus infection. Hepatology 1995; 22(2): 1101–1108.
6. Maio G, D’Argenio P, Stroffolini T et al. Hepatitis C virus infection and alanine transaminase levels in the general population: a survey in a southern Italian town. J Hepatol 2000; 33(1): 116–120.
7. Merle P, Trépo C, Zoulim F. Current management strategies for hepatitis B in the elderly. Drugs and Aging 2001; 18(10): 725–735.
8. Strader DB. Understudied populations with hepatitis C. Hepatology 2002; 36(5; Suppl 1): S226–S236.
9. Stránský J, Malina L, Cieslarová B et al. Overt and hidden coinfection with hepatitis B and C viruses in chronic liver disease and porphyria cutanea tarda. Acta Virol 2000; 44(1): 23–28.
10. Stránský J, Burešová H, Stříteský J et al. Dlouhodobá léčba chronické hepatitidy B lamivudinem nebo v kombinaci s interferonem. Prakt Lék 2003; 83(8):461–466.
11. Stránský J. Virová hepatitida B a její klinický význam. Praha: Grada 2001: 89 a 127.
12. Stránský J. Virová hepatitida C. Praha: Grada 1999: 95–97 a 144.
13. Zignego AL, Fontana R, Puliti S et al. Relevance of inapparent coinfection by hepatitis B virus in alpha interferon-treated patients with hepatitis C virus chronic hepatitis. J Med Virol 1997; 51(4): 313–318.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2005 Issue 3
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