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Related Concept Videos

Hepatitis01:25

Hepatitis

63
Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
63
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

375
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
375
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

356
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
356
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

357
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
357
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

333
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
333
Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

1
Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
1

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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
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Hepatitis B and elders: An underestimated issue.

Véronique Loustaud-Ratti1,2, Jérémie Jacques1, Marilyne Debette-Gratien1

  • 1Federation of Hepatology, Gastroenterology and Hepatology Unit, CHU Limoges.

Hepatology Research : the Official Journal of the Japan Society of Hepatology
|February 6, 2015
PubMed
Summary

Hepatitis B virus (HBV) poses unique challenges in older adults, with increased risks of cirrhosis and liver cancer. While treatments are similar to younger patients, vaccination is less effective in this age group.

Keywords:
elderlyhepatitis B virushepatocellular carcinomaliver aging

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Area of Science:

  • Hepatology
  • Geriatric Medicine
  • Infectious Diseases

Background:

  • Aging alters liver function, impacting disease presentation and outcomes.
  • Hepatitis B virus (HBV) prevalence is a growing concern in the elderly, even in vaccinated populations.
  • Reduced preventive measures in older individuals contribute to increased HBV burden.

Purpose of the Study:

  • To highlight the distinct clinical manifestations and risks of hepatitis B virus infection in the elderly population.
  • To discuss the implications of aging on HBV natural history, treatment efficacy, and vaccination strategies.

Main Methods:

  • Review of existing literature on hepatitis B virus in elderly patients.
  • Analysis of age-related differences in HBV presentation, including spontaneous clearance, chronicity, and risk of hepatocellular carcinoma.
  • Evaluation of current treatment guidelines and vaccination protocols for older adults.

Main Results:

  • Elderly individuals exhibit lower spontaneous hepatitis B surface antigen clearance rates.
  • There is a significantly higher risk of cirrhosis and hepatocellular carcinoma (HCC) in older HBV patients.
  • Hepatocellular carcinoma in the elderly presents differently and is less amenable to treatment; liver transplantation is contraindicated post-70 years.

Conclusions:

  • Hepatitis B virus infection requires specific consideration in the elderly due to altered liver function and disease progression.
  • Standard antiviral treatments are effective in older adults, but vaccination efficacy is reduced, necessitating tailored protocols.
  • Early diagnosis and management are crucial to mitigate severe outcomes like cirrhosis and HCC in aging populations.