Author/Authors :
Il Kim, Hyeong Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Kim, In Hee Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Jun Jeon, Byung Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Lee, Seok Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Hun Kim, Seong Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Wook Kim, Sang Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Ok Lee, Seung Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Teik Lee, Soo Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea , Ghon Kim, Dae Chonbuk National University Medical School and Hospital - Department of Internal Medicine, South Korea
Abstract :
Background: The prevalence of hepatitis C virus (HCV) infections in elderly patients has been increasing in a number of countries. A few reports concerning pegylated interferon-α (PEG-IFN-α)-based combination treatment in elderly chronic hepatitis C (CHC) patients have been published, with slightly different treatment outcomes.Objectives: We investigated the treatment response and safety of PEG-IFN-α plus ribavirin combination therapy in elderly patients with CHC.Patients and Methods: Among a total of 181 treatment-naive CHC patients (60 patients with genotype 1, 121 patients with genotype 2 or 3), 38 were aged . 65 years (defined as the elderly group) and 143 were aged 65 years (defined as the non-elderly group).Results: The overall sustained virologic response (SVR) was lower in the elderly group than in the non-elderly group, but it was not significantly different (65.8 % vs. 76.2 %, P = 0.15). In a subgroup analysis, among patients with genotype 1, the elderly group had a significantly lower SVR rate than the non-elderly group (30.8 % vs. 66.0 %, P = 0.03). However, the SVR rate in patients with HCV genotype 2 or 3 was comparable between the two groups (84.0 % vs. 81.3 %, P = 0.85). HCV genotype was significantly associated with SVR in the elderly patients (genotype 1 vs. 2 or 3, odds ratio: 0.18, 95% confidence interval: 0.000-0.869, P = 0.03). The incidence of premature discontinuation of treatment (21.1 % vs. 9.1 %, P = 0.05) and dose modification (52.6 % vs. 31.5 %; P = 0.02) due mainly to adverse events or laboratory abnormalities,were higher in the elderly group than in the non-elderly group.Conclusions: PEG-IFN-α plus ribavirin combination therapy might be considered for elderlyCHC patients, especially for genotype 2 or 3, with vigilant monitoring of adverse events.
