TY - JOUR
T1 - Efficacy of peginterferon-α-2b plus ribavirin in patients aged 65 years and older with chronic hepatitis C
AU - Honda, Takashi
AU - Katano, Yoshiaki
AU - Shimizu, Junichi
AU - Ishizu, Yoji
AU - Doizaki, Masao
AU - Hayashi, Kazuhiko
AU - Ishigami, Masatoshi
AU - Itoh, Akihiro
AU - Hirooka, Yoshiki
AU - Nakano, Isao
AU - Urano, Fumihiro
AU - Yoshioka, Kentaro
AU - Toyoda, Hidenori
AU - Kumada, Takashi
AU - Goto, Hidemi
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Objectives:: The aim of this study was to evaluate the efficacy and indication of combination therapy with ribavirin plus peginterferon-α-2b in chronic hepatitis C virus (HCV) patients aged 65 years and older. Methods:: Five hundred and ninety-one consecutive HCV patients were treated with combination therapy. These patients were divided into elder patients (≥65 years) (n=115) and younger patients (<65 years) (n=476). The clinical characteristics, sustained virological response (SVR) rates and discontinuation rates were compared between the two groups. Results:: Compared with younger patients, baseline haemoglobin levels and baseline platelet counts were significantly lower (P<0.0001, P=0.013 respectively) and fibrosis was more advanced in elderly patients (P=0.0310). Moreover, the SVR rate was significantly lower (37.4 vs. 51.5%; P=0.0067) while the combination therapy discontinuation rate was significantly higher (32.2 vs. 17.0%; P=0.0003) in elderly patients. A multivariate analysis revealed that HCV load and genotype were significantly associated with an SVR in elderly patients. An SVR was achieved in over 50% of elderly male patients with genotype 1 and HCV RNA concentrations under 2 000 000 IU/ml. In contrast, the SVR rate was under 30% in elderly male patients with genotype 1 and with HCV RNA concentrations over 2 000 000 IU/ml and in all elderly female patients with genotype 1. Conclusions:: The SVR rate was lower in elderly patients than in younger patients. However, in elderly patients combination therapy was most beneficial for genotype 1 patients, male patients with HCV RNA concentrations <2 000 000 IU/ml and patients with genotype 2.
AB - Objectives:: The aim of this study was to evaluate the efficacy and indication of combination therapy with ribavirin plus peginterferon-α-2b in chronic hepatitis C virus (HCV) patients aged 65 years and older. Methods:: Five hundred and ninety-one consecutive HCV patients were treated with combination therapy. These patients were divided into elder patients (≥65 years) (n=115) and younger patients (<65 years) (n=476). The clinical characteristics, sustained virological response (SVR) rates and discontinuation rates were compared between the two groups. Results:: Compared with younger patients, baseline haemoglobin levels and baseline platelet counts were significantly lower (P<0.0001, P=0.013 respectively) and fibrosis was more advanced in elderly patients (P=0.0310). Moreover, the SVR rate was significantly lower (37.4 vs. 51.5%; P=0.0067) while the combination therapy discontinuation rate was significantly higher (32.2 vs. 17.0%; P=0.0003) in elderly patients. A multivariate analysis revealed that HCV load and genotype were significantly associated with an SVR in elderly patients. An SVR was achieved in over 50% of elderly male patients with genotype 1 and HCV RNA concentrations under 2 000 000 IU/ml. In contrast, the SVR rate was under 30% in elderly male patients with genotype 1 and with HCV RNA concentrations over 2 000 000 IU/ml and in all elderly female patients with genotype 1. Conclusions:: The SVR rate was lower in elderly patients than in younger patients. However, in elderly patients combination therapy was most beneficial for genotype 1 patients, male patients with HCV RNA concentrations <2 000 000 IU/ml and patients with genotype 2.
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U2 - 10.1111/j.1478-3231.2009.02064.x
DO - 10.1111/j.1478-3231.2009.02064.x
M3 - Article
C2 - 19523048
AN - SCOPUS:77950599137
VL - 30
SP - 527
EP - 537
JO - Liver International
JF - Liver International
SN - 1478-3223
IS - 4
ER -