Real Life Experience with Direct-Acting Antivirals Agents Against Hepatitis C Infection in Elderly Patients

• Published in: Journal of clinical virology Vol. 88; pp. 58 - 61
• Main Authors: Rodríguez-Osorio, Iria, Cid, Purificación, Morano, Luis, Castro, Ángeles, Suárez, Marta, Delgado, Manuel, Margusino, Luis, Meijide, Héctor, Pernas, Berta, Tabernilla, Andrés, Pedreira, José D, Mena, Álvaro, Poveda, Eva
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2017
• Subjects: Aged; Aged, 80 and over; Allergy and Immunology; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Drug Therapy, Combination - adverse effects; Drug Therapy, Combination - methods; Drug-Related Side Effects and Adverse Reactions - epidemiology; Female; Hepatitis C, Chronic - drug therapy; Humans; Infectious Disease; Male; Prospective Studies; Spain; Treatment Outcome
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2017.01.003

Highlights • The efficacy and safety of different DAAs based therapies have opened the possibility to treat many special populations as elderly patients. There is a scarce data on this population, not well represented on clinical trials and with low data on real life cohorts. This study shows data in terms of efficacy, tolerance and adherence to HCV treatment in elderly patients. • Most of elderly patients are on chronic medications, this implies a close monitoring over drug-drug interactions. Our data shows an 86.7% patients who are on chronic medication. Before the initiation of HCV treatment an adjustment of medication was needed for 35.8% of patients, mainly for antihypertensive and statin therapies. • Tolerance used to be a major problem with interferon-based regimens in elderly patients. This study shows a high frequency of adverse events in elderly patients treated with DAAs, but they didńt have any impact on treatment discontinuations or efficacy. This cohort identifies ribavirin and protein inhibitor based regimen as the most likely drugs to cause adverse events. When a protein inhibitor is part of the regimen, adverse events were three times more frequent, independently of ribavirin use. • Two patients were diagnosed with hepatocellular carcinoma during treatment in this study. At this moment, any conclusion should be made and we need to be cautious with these results. Several data has been published recently in this field, and more studies need to be done. • ITT analyses showed a sustained virological response (SVR12) of 88.3%, while 95.5% per protocol of the study population achieved SVR12. No associated factor was linked to treatment failure.