Predictors for dose reduction of antiviral therapy in older patients infected with hepatitis C virus: a meta-regression analysis

Zhou, Hong‐Hao; Luo, Huimin; Xiao, Shuiyuan; Wang, H.; Gong, Ge

doi:10.1007/s10096-013-1992-8

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…without oviposition experience), 3-8 days-old females were randomly assigned to the different experimental treatments. Females T. podisi from our laboratory colony are synovigenic (ovigeny index < 0.05), typically emerging with very few mature oocytes (mean of approximately 2.0 [36]), and can survive for up to 100 days under laboratory conditions [37]. Unpublished data (M. Gaudreau, pers.…”

Section: Hosts and Parasitoidmentioning

confidence: 99%

Learning can be detrimental for a parasitic wasp

et al. 2021

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Animals have evolved the capacity to learn, and the conventional view is that learning allows individuals to improve foraging decisions. The parasitoid Telenomus podisi has been shown to parasitize eggs of the exotic stink bug Halyomorpha halys at the same rate as eggs of its coevolved host, Podisus maculiventris, but the parasitoid cannot complete its development in the exotic species. We hypothesized that T. podisi learns to exploit cues from this non-coevolved species, thereby increasing unsuccessful parasitism rates. We conducted bioassays to compare the responses of naïve vs. experienced parasitoids on chemical footprints left by one of the two host species. Both naïve and experienced females showed a higher response to footprints of P. maculiventris than of H. halys. Furthermore, parasitoids that gained an experience on H. halys significantly increased their residence time within the arena and the frequency of re-encounter with the area contaminated by chemical cues. Hence, our study describes detrimental learning where a parasitoid learns to associate chemical cues from an unsuitable host, potentially re-enforcing a reproductive cul-de-sac (evolutionary trap). Maladaptive learning in the T. podisi—H. halys association could have consequences for population dynamics of sympatric native and exotic host species.

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Section: Hosts and Parasitoidmentioning

confidence: 99%

Learning can be detrimental for a parasitic wasp

et al. 2021

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“…This was partially a result of adverse effects leading to higher rates of treatment discontinuation and requirement of dose reductions of ribavirin. 8 Elderly patients are also less likely to receive HCV therapy than younger patients, despite being more likely to develop cirrhosis and HCC. 9 Because of the emergence of DAAs, more patients, including elderly patients, are candidates for HCV treatment than ever before.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C Treatment Differences in Elderly Patients: Single-Center Retrospective Study

2019

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Background: Clinical studies evaluating direct-acting antivirals (DAAs) for hepatitis C virus (HCV) treatment show sustained virological response at 12 weeks (SVR12) rates >90%. However, there are few elderly patients included in these studies; thus, generalizability of high success rates to patients >70 years old cannot be assumed. Objective: To identify treatment differences between elderly and nonelderly patients. Methods: This is a retrospective cohort study of all patients who were treated with DAAs between June 2014 and September 2016 at our institution. Patients were divided into 2 groups: elderly, age ≥70 years at the time of initiation of DAAs, and nonelderly, <70 years. The primary outcome was achievement of SVR12. Results: Among the 551 patients, 60 with age range 70 to 86 years comprised the elderly group. SVR12 rates were significantly lower in the elderly population, especially in those with liver cirrhosis. SVR12 was achieved in 81% of the elderly group as compared with 95% in the nonelderly group. Among cirrhotic patients, 69.4% in the elderly group, and 94.1% in the nonelderly group achieved SVR12. Binary logistic regression modeling showed age >70 years to be the strongest predictor of treatment failure (odds ratio = 3.4), along with diagnosis of cirrhosis (odds ratio = 2.4), when corrected for gender, race, prior treatment experience, genotype, and presence of hepatocellular carcinoma. Conclusion and Relevance: Lower SVR12 was seen in elderly cirrhotic patients (69.4%), who are at higher risk of complications related to advanced liver disease and untreated HCV infection, highlighting the need to treat patients before cirrhosis develops.

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Hepatitis C treatment in the elderly: New possibilities and controversies towards interferon-free regimens

Gentilucci¹,

Galati²,

Gallo³

et al. 2015

WJG

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Due to the progressive aging of the hepatitis C virus (HCV) population which have acquired the infection during its maximum spread after the Second World War, the management of the elderly HCV-infected patient is emerging as a hot topic. Unfortunately, although it is recognized that the progression of HCV-related liver disease gets faster with aging, and that even extra-hepatic manifestations of HCV infection are probably worse in the elderly, till now, treatment attempts in this population have been significantly limited by the well-known contraindications and side effects of interferon (IFN). The arrival of several new anti-HCV drugs, and the possibility to combine them in safe and effective anti-viral regimens, is relighting the hope of a cure for many elderly patients who had been cut out of IFN-based treatments. However, although these new regimens will be certainly more manageable, it should be underscored that IFN-free doesn't mean free from any contraindication or side-effect. Moreover, one issue which promises to become central is that of the possible interactions between antiviral therapy and the multiple drugs frequently assumed by elderly patients because of comorbidities. In this review, we will revise the epidemiology pointing to HCV as an infection of the elderly, the evidences that HCV harms the health of the aged patient more than that of the young one, and the available experiences of HCV treatment in the elderly with the "old" IFN-based regimens and with the newer drugs. We will conclude that the availability of IFN-free regimens should prompt us to change our mind and consider a significantly larger number of possible candidates among elderly patients, who would take significant advantage from viral eradication. Rather than the anagraphic age, drug-drug interactions and, mainly in case of economic restrictions, an evaluation of life expectancy dependent on liver disease with respect to that dependent on comorbidities, are likely to be the key issues guiding treatment indication in the next future. The sooner we will change our mind with respect to an a priori obstacle for anti-HCV treatment in the elderly, the sooner we will begin to spare many aged HCV patients from avoidable liver-related complications.

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Predictors for dose reduction of antiviral therapy in older patients infected with hepatitis C virus: a meta-regression analysis

Cited by 3 publications

References 35 publications

Learning can be detrimental for a parasitic wasp

Learning can be detrimental for a parasitic wasp

Hepatitis C Treatment Differences in Elderly Patients: Single-Center Retrospective Study

Hepatitis C treatment in the elderly: New possibilities and controversies towards interferon-free regimens

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