%0 Journal Article
%T Treatment of Elderly Patients with Chronic Hepatitis C: A Retrospective Cohort Study
%A Adriana Vince
%A Davor Jugovi£¿
%A Davorka Du£¿ek
%A Ivan Kurelac
%A Jelena Budimir
%A Neven Papi£¿
%A Nina Krajcar
%J Archive of "Acta Clinica Croatica".
%D 2018
%R 10.20471/acc.2018.57.01.07
%X SUMMARY ¨C The prevalence of chronic hepatitis C increases in elderly patients. The aims of this study were to identify the factors associated with hepatocellular carcinoma (HCC) and end-stage liver disease development and to evaluate the efficacy and safety of pegylated interferon (PEG-IFN¦Á) plus ribavirin (RBV) therapy in elderly patients. A retrospective cohort study included all consecutive patients with hepatitis C virus (HCV) infection treated with PEG-IFN¦Á+RBV between 2003 and 2013. Elderly patients had a higher frequency of poor prognostic factors including genotype 1 infection, high fibrosis, and high fibrosis index based on four factors (FIB-4) score. The sustained virologic response (SVR) rate for genotype 1 was significantly lower (35.8% vs. 57.1%), while the frequency of PEG-IFN¦Á (27.2% vs. 7.8%), RBV dose reduction (19.6% vs. 9.7%) and treatment discontinuation (13.0% vs. 4.1%) was significantly higher in elderly patients. However, age was not associated with SVR in multivariate analysis, and comparable SVR rates were achieved when adjusted for fibrosis score (Ishak ¡Ü3: 66.7% vs. 69.8%). During the follow-up, HCC was diagnosed in 18 elderly patients (3 SVR+, 4 SVR- and 9 untreated patients). In conclusion, selected elderly patients can achieve comparable SVR rates as younger patients, but with a higher rate of side effects. Since complications of HCV infection occur more frequently in elderly patients, they should be given priority for antiviral therapy
%K Hepatitis C
%K chronic ¨C treatment
%K End stage liver disease
%K Aged
%K Hepatitis C ¨C prognosis
%K Pegylated interferon alpha
%K Immunotherapy
%K Antiviral agents
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400365/