The efficacy of peginterferon-α-2a plus ribavirin for patients aged 60 years and older with chronic hepatitis C in Korea

Dong Hyun Sinn 2, Su Rin Shin 3, Jae Sook Kil 1, Jeong Kim 1, Geum-Youn Gwak 1, Moon Seok Choi 1, Joon Hyeok Lee 1, Kwang Cheol Koh 1, Byung Chul Yoo 1, Seung Woon Paik 1,*

Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future issues)
DOI: 10.1111/j.1440-1746.2010.06478.x
Journal compilation © 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd

Author Information
1 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
2 Department of Medicine, Armed Forces Capital Hospital, Seongnam, South Korea
3 Department of Medicine, Kangnam Sacred Heart Hospital, Hallym University, Seoul, South Korea

*Correspondence: Seung Woon Paik,

*Correspondence: Seung Woon Paik Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, South Korea Tel: +82-2-3410-3409 Fax: +82-2-3410-6983 E-mail: sw.paik@samsung.com

Publication History
Accepted manuscript online: 17 AUG 2010 12:20PM EST
Received date: 16-Apr-2010 Accepted date: 27-Jul-2010

Keywords:
hepatitis C virus;elderly patients;peginterferon;ribavirin;APRI

Abstract

Background and Aim: 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: Three hundred fourteen CHC patients, who were treated with combination therapy, were classified into three groups according to age: younger than 50 years of age (n = 137); 50 to 59 years old (n = 109); and 60 years of age or older (n = 68). The sustained virological response (SVR) rates 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, 50-59, and ≥60-year-old patients groups, respectively (p = 0.018). However, the older patients group showed a SVR rate that was comparable to the SVR rates of the other age groups; 80%, 73% and 75% for the <50, 50-59, and ≥60-year-old patients groups, respectively (p = 0.420). Multivariate analysis showed the AST to platelet ratio index (APRI) was an independent predictor of a SVR. A SVR was achieved in 95% (19 out of 20) of the elderly patients with an APRI < 0.80.

Conclusion: Although physicians must pay more attention for adverse events in the older patients, combination therapy can be considered for older patients, especially for the patients with a low APRI.

Source