Predictive Factors for Response to Peginterferon-Alpha and Ribavirin Treatment of Chronic HCV Infection in Patients Aged 65 Years and More

Abstract

Pre- and on-treatment virological parameters can be used to identify elderly patients who are more likely to obtain a SVR to standard-of-care antiviral therapy for chronic HCV infection.

Hepatitis C in the elderly: A multicentre cross-sectional study by the Italian Association for the Study of the Liver

“…Therefore, the better rate of SVR in this group if compared to patients treated before 65 years is biased by a more efficacious treatment strategy. In addition, those treated after 65 years were more frequently infected by genotype 2,3 and this finding might not only explain the higher SVR rate, as recently shown [34,35] but also indicate the attitude to select easy-to-treat patients when clinicians start antiviral treatment in elderly patients. Unfortunately we have no data concerning the tolerability of antiviral therapy in this category of patients.…”

Efficacy and safety of ribavirin plus pegylated interferon alfa in geriatric patients with chronic hepatitis C

“…The reported efficacy using RBV plus pegIFN to treat geriatric HCV‐infected patients in the literature showed an SVR rate of 37–70% (Table ). The SVR rate was higher in those infected with HCV genotype non‐1 (66–90%) than in those infected with HCV genotype 1 (23–52%) …”

“…Furthermore, a number of pre‐treatment factors are known to improve the SVR rate: younger age, low body weight (<75 kg), higher pre‐treatment alanine aminotransferase level, high haemoglobin, high platelet count, absence of cirrhosis, low HCV viral load, and HCV genotype non‐1 . The SVR rate of geriatric HCV‐infected patients treated with pegIFN plus RBV was 40–70% in the literature . Therefore, when HCV‐infected elderly patients without comorbidities are at risk for disease progression but have several factors predictive of favourable response to pegIFN plus RBV therapy, it is recommended to treat them thereby improving patient survival and reducing liver‐related complications.…”

Assessment of baseline pretreatment factors and on‐treatment virological response to predict sustained virological response in patients with chronic hepatitis C treated with pegylated interferon and ribavirin

“…However, clinical trials generally exclude patients > 65 years of age, especially those in the subgroup infected with HCV-1, had greater frequency of adverse events and poor adherence to the standard-of-care regimen, which may be major reason for treatment inferiority [10,20]. Female had been shown to achieve higher SVR rates than male using the old combination of standard IFN and RBV [30].…”

“…Pretreatment demographic and viral parameter such as age, sex, body weight, race, interleukin-28 B genotype, fibrotic stage, body-mass index, insulin resistance, steatosis, standard dose of RBV, previous response, HCV viral loads, genotypes and response during treatment (RVR or EVR) have been identified for prediction of SVR [19][20][21][22][23]. Nevertheless, only a few studies with limited case numbers reported in Ping-Tung, a rural society country with lower economics.…”