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Poor response to hepatitis C treatment in elderly patients.
MedLine Citation:
PMID:  23619255     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 compared 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.
Authors:
Ivonete Silva; Roberto Carvalho Filho; Ana Cristina Feldner; Iandra Zaros; Antonio Eduardo Silva; Maria Lucia Ferraz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of hepatology     Volume:  12     ISSN:  1665-2681     ISO Abbreviation:  Ann Hepatol     Publication Date:    2013 May-Jun
Date Detail:
Created Date:  2013-04-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101155885     Medline TA:  Ann Hepatol     Country:  Mexico    
Other Details:
Languages:  eng     Pagination:  392-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Hepatology Unit, Federal University of São Paulo, São Paulo, Brazil.
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