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Elderly chronic hepatitis C patients benefit from DAAs

06 Nov 2019

Direct-acting antivirals (DAAs) are effective for chronic hepatitis C even in elderly adults, resulting in respectable rates sustained virological response (SVR) independently of age, a recent study has shown.

Researchers retrospectively examined 1,151 elderly chronic hepatitis C patients who were further disaggregated according to age: 65 years (mean age, 70.85±5.47 years; 59.1 percent male) and <65 years (mean age, 54.06±9.37 years; 62.4 percent male). Comparative DAA efficacy was the primary outcome.

The treatment response rate in the overall cohort was 97.7 percent. This was slightly higher in the younger subgroup (98.3 percent vs 97.1 percent), though the difference was not statistically significant. Twenty-six patients failed treatment; 15 belonged to the older group.

SVR rates 12 weeks after treatment (SVR12) were 97.4 percent, 97.2 percent and 86.7 percent for the 65–74-years, 75–84-years and 85-years age groups, respectively. No between- and among-group differences were reported.

Multivariate logistic regression analysis revealed that the combination of DAAs received (p0.001) and coinfection with HIV (p=0.001) were the only significant predictors of SVR12. Both factors were also initially predictive of treatment response in the older subgroup, though their respective significance were attenuated upon multivariable analysis.

Other variables, such as comorbidities, fibrosis stage, baseline viral load, previous treatment history and demographic factors, were all unrelated to the likelihood of treatment response.

“Treatment should not be withheld purely on the grounds of advanced age, and older age should not be a barrier to [hepatitis C virus] treatment,” said researchers. “Older adults should have the opportunity to benefit from the high cure rates and health benefits associated with viral eradication.”

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Most Read Articles
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.
11 Aug 2020
During the Allergic Rhinitis (AR) Boot Camp held in conjunction with the Bayer Pharmacist Congress 2020, Professor Dr Baharudin Abdullah discussed the management of AR in the primary care setting and the importance of using patient profiles to guide the choice of antihistamines.
Rachel Soon, 28 Aug 2020
MOH Director-General Tan Sri Dato' Seri Dr Noor Hisham Abdullah speaks about NHMS 2019 and pharmacists' roles in combating NCDs among Malaysians.
Audrey Abella, 07 Sep 2020
Mavacamten, a first-in-class myosin inhibitor, may be the first targeted therapy to address the underlying cause of obstructive hypertrophic cardiomyopathy (OHCM), the EXPLORER-HCM trial has shown.