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Observational Study
. 2014 Aug 21;20(31):10984-93.
doi: 10.3748/wjg.v20.i31.10984.

Age-related differences in response to peginterferon alfa-2a/ribavirin in patients with chronic hepatitis C infection

Claudia Roeder  1 , Sabine Jordan  1 , Julian Schulze Zur Wiesch  1 , Heike Pfeiffer-Vornkahl  1 , Dietrich Hueppe  1 , Stefan Mauss  1 , Elmar Zehnter  1 , Sabine Stoll  1 , Ulrich Alshuth  1 , Ansgar W Lohse  1 , Stefan Lueth  1
Affiliations
Observational Study

Age-related differences in response to peginterferon alfa-2a/ribavirin in patients with chronic hepatitis C infection

Claudia Roeder et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the safety and efficacy of pegylated interferon alfa-2a and ribavirin therapy in elderly patients with chronic hepatitis C infection.

Methods: Patients characteristics, treatment results and safety profiles of 4859 patients with hepatitis c virus (HCV) infection receiving treatment with pegylated interferon alfa-2a and ribavirin were retrieved from a large ongoing German multicentre non-interventional study. Recommended treatment duration was 24 wk for GT 2 and GT 3 infection and 48 wk for GT 1 and GT 4 infection. Patients were stratified according to age (< 60 years vs ≥ 60 years). Because of limited numbers of liver biopsies for further assessment of liver fibrosis APRI (aspartate aminotransferase - platelet ratio index) was performed using pre-treatment laboratory data.

Results: Out of 4859 treated HCV patients 301 (6.2%) were ≥ 60 years. There were more women (55.8% vs 34.2%, P < 0.001) and predominantly GT 1 (81.4% vs 57.3%, P < 0.001) infected patients in the group of patients aged ≥ 60 years and they presented more frequently with metabolic (17.6% vs 4.5%, P < 0.001) and cardiovascular comorbidities (32.6% vs 6.7%, P < 0.001) and significant fibrosis and cirrhosis (F3/4 31.1% vs 14.0%, P = 0.0003). Frequency of dose reduction and treatment discontinuation were significantly higher in elderly patients (30.9% vs 13.7%, P < 0.001 and 47.8% vs 30.8%, P < 0.001). Main reason for treatment discontinuation was "virological non-response" (26.6% vs 13.6%). Sustained virological response (SVR) rates showed an age related difference in patients with genotype 1 (23.7% vs 43.7%, P < 0.001) but not in genotype 2/3 infections (57.7% vs 64.6%, P = 0.341). By multivariate analysis, age and stage of liver disease were independent factors of SVR.

Conclusion: Elderly HCV patients differ in clinical characteristics and treatment outcome from younger patients and demand special attention from their practitioner.

Keywords: Epidemiology; Geriatric; Hepatitis C virus infection; Non-interventional study; Older patients; Patients ≥ 60 years; Therapy.

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Figures

Figure 1
Figure 1
Sustained virological response rates in percent for different genotypes: comparison of patients < 60 years vs ≥ 60 years with chronic hepatitis C.
Figure 2
Figure 2
Sustained virological response rates in % for different age groups and different genotypes for patients with chronic hepatitis C.
See this image and copyright information in PMC

References

    1. Alter MJ. Epidemiology of hepatitis C virus infection. World J Gastroenterol. 2007;13:2436–2441. - PMC - PubMed
    1. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis. 2005;5:558–567. - PubMed
    1. Cornberg M, Razavi HA, Alberti A, Bernasconi E, Buti M, Cooper C, Dalgard O, Dillion JF, Flisiak R, Forns X, et al. A systematic review of hepatitis C virus epidemiology in Europe, Canada and Israel. Liver Int. 2011;31 Suppl 2:30–60. - PubMed
    1. Alter MJ. HCV routes of transmission: what goes around comes around. Semin Liver Dis. 2011;31:340–346. - PubMed
    1. Guadagnino V, Stroffolini T, Caroleo B, Menniti Ippolito F, Rapicetta M, Ciccaglione AR, Chionne P, Madonna E, Costantino A, De Sarro G, et al. Hepatitis C virus infection in an endemic area of Southern Italy 14 years later: evidence for a vanishing infection. Dig Liver Dis. 2013;45:403–407. - PubMed

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