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  3. Elderly age is not a negative predictive factor for virological response to therapy with pegylated interferon-α and ribavirin in chronic hepatitis C virus patients
 

Elderly age is not a negative predictive factor for virological response to therapy with pegylated interferon-α and ribavirin in chronic hepatitis C virus patients

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BORIS DOI
10.7892/boris.53729
Date of Publication
April 2014
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Departement Klinische...

Author
Frei, Pascal
Leucht, Anna-Kathrin
Held, Ulrike
Kofmehl, Reto
Manser, Christine N.
Schmitt, Johannes
Mertens, Joachim
Rau, Monika
Baur, Katharina
Gerlach, Tilman
Negro, Francesco
Heim, Markus
Moradpour, Darius
Cerny, Andreas
Departement Klinische Forschung, Forschungsgruppe Viszeralchirurgie
Dufour, Jean-François
Universitätsklinik für Viszerale Chirurgie und Medizin, Hepatologie
Müllhaupt, Beat
Geier, Andreas
Subject(s)

600 - Technology::610...

Series
Liver international
ISSN or ISBN (if monograph)
1478-3223
Publisher
Blackwell Munksgaard
Language
English
Publisher DOI
10.1111/liv.12279
Uncontrolled Keywords

age

elderly

hepatitis C therapy

host factor

matched pair analysis...

pegylated interferon-...

ribavirin

Description
BACKGROUND & AIMS:

Age is frequently discussed as negative host factor to achieve a sustained virological response (SVR) to antiviral therapy of chronic hepatitis C. However, elderly patients often show advanced fibrosis/cirrhosis as known negative predictive factor. The aim of this study was to assess age as an independent predictive factor during antiviral therapy.

METHODS:

Overall, 516 hepatitis C patients were treated with pegylated interferon-α and ribavirin, thereof 66 patients ≥60 years. We analysed the impact of host factors (age, gender, fibrosis, haemoglobin, previous hepatitis C treatment) and viral factors (genotype, viral load) on SVR per therapy course by performing a generalized estimating equations (GEE) regression modelling, a matched pair analysis and a classification tree analysis.

RESULTS:

Overall, SVR per therapy course was 42.9 and 26.1%, respectively, in young and elderly patients with hepatitis C virus (HCV) genotypes 1/4/6. The corresponding figures for HCV genotypes 2/3 were 74.4 and 84%. In the GEE model, age had no significant influence on achieving SVR. In matched pair analysis, SVR was not different in young and elderly patients (54.2 and 55.9% respectively; P = 0.795 in binominal test). In classification tree analysis, age was not a relevant splitting variable.

CONCLUSIONS:

Age is not a significant predictive factor for achieving SVR, when relevant confounders are taken into account. As life expectancy in Western Europe at age 60 is more than 20 years, it is reasonable to treat chronic hepatitis C in selected elderly patients with relevant fibrosis or cirrhosis but without major concomitant diseases, as SVR improves survival and reduces carcinogenesis.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/124244
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