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- Title
Efficacy of peginterferon-α-2b plus ribavirin in patients aged 65 years and older with chronic hepatitis C.
- Authors
Honda, Takashi; Katano, Yoshiaki; Shimizu, Junichi; Ishizu, Yoji; Doizaki, Masao; Hayashi, Kazuhiko; Ishigami, Masatoshi; Itoh, Akihiro; Hirooka, Yoshiki; Nakano, Isao; Urano, Fumihiro; Yoshioka, Kentaro; Toyoda, Hidenori; Kumada, Takashi; Goto, Hidemi
- Abstract
Objectives: The aim of this study was to evaluate the efficacy and indication of combination therapy with ribavirin plus peginterferon-α-2b in chronic hepatitis C virus (HCV) patients aged 65 years and older. Methods: Five hundred and ninety-one consecutive HCV patients were treated with combination therapy. These patients were divided into elder patients (≥65 years) ( n=115) and younger patients (<65 years) ( n=476). The clinical characteristics, sustained virological response (SVR) rates and discontinuation rates were compared between the two groups. Results: Compared with younger patients, baseline haemoglobin levels and baseline platelet counts were significantly lower ( P<0.0001, P=0.013 respectively) and fibrosis was more advanced in elderly patients ( P=0.0310). Moreover, the SVR rate was significantly lower (37.4 vs. 51.5%; P=0.0067) while the combination therapy discontinuation rate was significantly higher (32.2 vs. 17.0%; P=0.0003) in elderly patients. A multivariate analysis revealed that HCV load and genotype were significantly associated with an SVR in elderly patients. An SVR was achieved in over 50% of elderly male patients with genotype 1 and HCV RNA concentrations under 2 000 000 IU/ml. In contrast, the SVR rate was under 30% in elderly male patients with genotype 1 and with HCV RNA concentrations over 2 000 000 IU/ml and in all elderly female patients with genotype 1. Conclusions: The SVR rate was lower in elderly patients than in younger patients. However, in elderly patients combination therapy was most beneficial for genotype 1 patients, male patients with HCV RNA concentrations <2 000 000 IU/ml and patients with genotype 2.
- Subjects
GENETIC research; HEPATITIS C; OLDER patients; RIBAVIRIN; LIVER diseases; PATIENTS
- Publication
Liver International, 2010, Vol 30, Issue 4, p527
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/j.1478-3231.2009.02064.x