Elderly chronic hepatitis C patients benefit from DAAs

Direct-acting antivirals (DAAs) are effective for chronic hepatitis C even in elderly adults, resulting in respectable rates sustained virological response (SVR) independently of age, a recent study has shown.

Researchers retrospectively examined 1,151 elderly chronic hepatitis C patients who were further disaggregated according to age: ≥65 years (mean age, 70.85±5.47 years; 59.1 percent male) and <65 years (mean age, 54.06±9.37 years; 62.4 percent male). Comparative DAA efficacy was the primary outcome.

The treatment response rate in the overall cohort was 97.7 percent. This was slightly higher in the younger subgroup (98.3 percent vs 97.1 percent), though the difference was not statistically significant. Twenty-six patients failed treatment; 15 belonged to the older group.

SVR rates 12 weeks after treatment (SVR12) were 97.4 percent, 97.2 percent and 86.7 percent for the 65–74-years, 75–84-years and ≥85-years age groups, respectively. No between- and among-group differences were reported.

Multivariate logistic regression analysis revealed that the combination of DAAs received (p≤0.001) and coinfection with HIV (p=0.001) were the only significant predictors of SVR12. Both factors were also initially predictive of treatment response in the older subgroup, though their respective significance were attenuated upon multivariable analysis.

Other variables, such as comorbidities, fibrosis stage, baseline viral load, previous treatment history and demographic factors, were all unrelated to the likelihood of treatment response.

“Treatment should not be withheld purely on the grounds of advanced age, and older age should not be a barrier to [hepatitis C virus] treatment,” said researchers. “Older adults should have the opportunity to benefit from the high cure rates and health benefits associated with viral eradication.”