Poor response to hepatitis C treatment in elderly patients

Annals of Hepatology

卷:12

Roberto Carvalho Filho¹  Ivonete Silva²  Iandra Zaros³  Ana Cristina Feldner³  Maria Lucia Ferraz³  Antonio Eduardo Silva³ 

[1] Department of Gastroenterology, Hepatology Unit, Federal University of São Paulo, São Paulo, Brazil.;

[2] Correspondence and reprint request:;

关键词: Aged patients;    Pegylated interferon plus ribavirin therapy;    Sustained virological response;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction. Treatment of genotype 1 chronic hepatitis C in elderly patients has been associated with low rates of a sustained virological response (SVR), but the reasons are unclear. Objective. To determine the SVR rate in patients ≥ 60 years with genotype 1 chronic hepatitis C treated with Peg-IFN and ribavirin, and to identify risk factors related to treatment response in this specific group of patients.Material and methods. Patients were divided into < 60 years (non-elderly) and >60 years (elderly) and were compard regarding clinical, laboratory and histological characteristics and response to treatment.Results. A total of 231 patients were included in the study. The elderly group (n=89) presented a predominance of women, more advanced hepatic disease, higher glucose, cholesterol and LDL levels, lower hemoglobin levels, and a larger proportion of overweight subjects. The SVR rate was lower (25 vs. 46%) and anemia, ribavirin dose reduction and use of filgrastim and erythropoietin were more frequent in elderly patients. Negative predictive factors of SVR in the whole group (n = 231) were glucose ≥ 100 mg/dL and age ≥ 60 years. In the elderly group, only pretreatment variables (lower serum glucose and higher hemoglobin levels) were associated with SVR.Conclusion. The SVR rate was low in elderly patients. However, this poor response was not due to poor tolerance, but mainly to pretreatment conditions. Among elderly patients, the best candidates for hepatitis C treatment are those with elevated pretreatment hemoglobin levels and adequate glycemic control.

【 授权许可】

Unknown