Journal of Gastroenterology and Hepatology · 2010 · 24 citations · 16 references
PharmacyInternal MedicinePharmacotherapyClinical PharmacologyGeriatric PharmacotherapyHepatitis PharmacotherapyAntiviral TherapyChronic Liver DiseaseInterferon-based TherapyLiver DiseaseViral HepatitisViral Hepatitis TreatmentChronic Viral HepatitisCombination Antiviral RegimensCombination TherapyPegylated Interferon AlfaRibavirin TherapyRibavirin-based RegimensSustained Virologic Response DurationTreatment Discontinuation Rates
BACKGROUND AND AIM: In the present study, we evaluated the safety and efficacy of combination therapy with pegylated interferon and ribavirin for treating chronic hepatitis C (CHC) patients aged 60 years and older. METHODS: A total of 314 CHC patients, who were treated with combination therapy, were classified into three groups according to age: (i) younger than 50 years (n = 137); (ii) 50-59 years (n = 109); and (iii) 60 years or older (n = 68). The sustained virological response (SVR) and discontinuation rates were compared between the three groups. RESULTS: Discontinuation of therapy due to adverse event was more frequent in the older patient groups: 1%, 5%, and 10% for the < 50-year, the 50-59-year, and the ≥ 60-year patient groups, respectively (P = 0.018). However, the older patient groups showed a SVR rate that was comparable to the SVR rates of the other age groups: 80%, 73%, and 75% for the < 50-year, 50-59-year, and ≥ 60-year- patient groups, respectively (P = 0.420). A multivariate analysis showed that the aspartate aminotransferase : platelet ratio index (APRI) was an independent predictor of an SVR. An SVR was achieved in 95% (19/20) of the elderly patients with an APRI < 0.80. CONCLUSIONS: Although physicians must pay more attention to adverse events in the older patients, combination therapy can be considered for older patients, especially for patients with a low APRI.
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Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance
Dongliang Ge, Jacques Fellay, Alexander Thompson et al. · Nature · 2009 · 3.5K citations · Full text
Life Sciences, Genetics, Immunology +13