Efficacy and safety of ribavirin plus pegylated interferon alfa in geriatric patients with chronic hepatitis C
Article first published online: 5 NOV 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 37, Issue 1, pages 81–90, January 2013
How to Cite
Hu, C.-C., Lin, C.-L., Kuo, Y.-L., Chien, C.-H., Chen, S.-W., Yen, C.-L., Lin, C.-Y. and Chien, R.-N. (2013), Efficacy and safety of ribavirin plus pegylated interferon alfa in geriatric patients with chronic hepatitis C. Alimentary Pharmacology & Therapeutics, 37: 81–90. doi: 10.1111/apt.12112
- Issue published online: 4 DEC 2012
- Article first published online: 5 NOV 2012
- Manuscript Accepted: 9 OCT 2012
- Manuscript Revised: 8 OCT 2012
- Manuscript Revised: 18 JUN 2012
- Manuscript Received: 29 MAY 2012
- Chang Gung Memory Hospital Research. Grant Number: 280411
- National Science Council of Taiwan. Grant Number: 99-2314-B-182-030
Limited data are available on the efficacy and safety of antiviral therapy in geriatric patients with chronic hepatitis C virus (HCV) infection.
To evaluate the efficacy and safety of pegylated interferon (pegIFN) plus ribavirin (RBV) therapy in geriatric HCV-infected patients.
Ninety-one geriatric patients (age ≥65 years; the elderly group) with HCV infection and 91 gender- and HCV genotype-matched middle-aged patients (age 50–64 years; the younger group) were assigned to receive weekly pegIFN injection plus weight-based oral RBV for 24 weeks. The on- and off-treatment virological responses were evaluated for treatment efficacy.
In intention-to-treat analysis, the sustained virological response (SVR) rate was substantially decreased in the elderly patients (elderly group vs. younger group, 40.7% vs. 61.5%, respectively; P = 0.005). The SVR rate was significantly lower in geriatric patients than in middle-aged patients with HCV genotype non-1 (54.3% vs. 82.9%; P = 0.01), but the difference was not significant with HCV genotype 1 (32.1% vs. 48.2%; P = 0.083). Furthermore, the older patients infected with HCV genotype non-1 who achieved a rapid virological response had a similar SVR rate to that of the younger patients. The withdrawal rate was 13.2% in the elderly group and 7.7% in the younger group.
Compared with middle-aged patients, the therapeutic efficacy of pegylated interferon plus ribavirin therapy is lower in hepatitis C virus-infected geriatric patients with an acceptable withdrawal rate. Considering prolonged lifespan in geriatric patients, we recommend treating geriatric hepatitis C virus-infected patients who have significant hepatic fibrosis and no other health problems.