Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020;12(3):296-309.
doi: 10.1007/s40506-020-00231-8. Epub 2020 Aug 11.

Hepatitis C Virus in the Elderly in the Direct-Acting Antiviral Era: from Diagnosis to Cure

Mubeen Khan Mohammed Abdul  1 , Heather S Snyder  2 , Mythili Chunduru  3 , Susan M K Lee  4 , Sanjaya K Satapathy  4   5
Affiliations
Review

Hepatitis C Virus in the Elderly in the Direct-Acting Antiviral Era: from Diagnosis to Cure

Mubeen Khan Mohammed Abdul et al. Curr Treat Options Infect Dis. 2020.

Abstract

Purpose of review: Hepatitis C (HCV) is the most common cause of viral hepatitis in elderly individuals. This patient population previously experienced suboptimal outcomes with interferon-based regimens. Unfortunately, patients aged 65 years and older were underrepresented in phase 2 and 3 clinical trials with newer direct acting antiviral (DAA) therapies. Since the advent of second-generation DAA in 2013, numerous robust real-world experiences highlighting the efficacy and safety of DAA in the elderly have been published. This review article summarizes the cascade of care for hepatitis C from diagnosis to cure from an evidence-based perspective of the aging population.

Recent finding: In a large study from the Veterans Affairs Healthcare System, the overall sustained virologic response (SVR) of 15,884 patients treated with DAA regimens was 91.2%. These newer therapies remained highly effective in the subset of patients aged 65 years and older with SVR rates above 90%. A Spanish National Registry reported outcomes in patients ≥ 65 years old treated for HCV with oral DAA regimens over a 2-year period. The overall SVR was 94% in the study of 1252 subjects.

Summary: Current real-world data imply DAA treatment regimens remain highly effective and safe in elderly patients when compared to the general population.

Keywords: Aging; Direct acting antivirals; Drug interactions; Elderly; Hepatitis C virus.

PubMed Disclaimer

Conflict of interest statement

Conflict of InterestDr. Satapathy reports grants from Gilead Sciences, grants from Conatus Pharma, grants and other from Intercept Pharma, other from Alexion, grants from Genfit, grants and other from Dova, grants and other from Bayer, grants from Exact Sciences, grants and other from Biotest, grants from Shire NASH, grants from Enanta, outside the submitted work. The other authors declare no conflicts of interest relevant to this manuscript.

Figures

Fig. 1
Fig. 1
Cascade of linkage to care in elderly with hepatitis C virus
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. WHO guidelines. Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection. Who. 2018. - PubMed
    1. Ly K, Hughes E, Jiles R, Holmberg S. Rising mortality associated with hepatitis C virus in the United States, 2003–2013. Clin Inf Dis. 2016;62(10):1287–1288. doi: 10.1093/cid/ciw111. - DOI - PMC - PubMed
    1. Smith BD, Morgan RL, Beckett GA, Falck-Ytter Y, Holtzman D, Teo CG, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR Recomm Rep. :2012. - PubMed
    1. Smith BD, Jorgensen C, Zibbell JE, Beckett GA. Centers for Disease Control and Prevention initiatives to prevent hepatitis C virus infection: a selective update. Clin Infect Dis. 2012;55:S49–S52. doi: 10.1093/cid/cis363. - DOI - PubMed
    1. Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997;349(9055):825–832. doi: 10.1016/S0140-6736(96)07642-8. - DOI - PubMed

LinkOut - more resources