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Safety of ribavirin plus pegylated interferon alfa in geriatric patients with HCV

The most recent issue of Alimentary Pharmacology & Therapeutics evaluates the efficacy and safety of ribavirin plus pegylated interferon alfa in geriatric patients with chronic hepatitis C.

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Limited data are available on the efficacy and safety of antiviral therapy in geriatric patients with chronic hepatitis C virus (HCV) infection.
 
Professor Chien and colleagues from Taiwan evaluated the efficacy and safety of pegylated interferon (pegIFN) plus ribavirin therapy in geriatric HCV-infected patients.
 
The team found that 91 geriatric patients with HCV infection, and 91 gender- and HCV genotype-matched middle-aged patients were assigned to receive weekly pegIFN injection plus weight-based oral RBV for 24 weeks.

The on- and off-treatment virological responses were evaluated for treatment efficacy.

The withdrawal rate was 13% in the elderly group
Alimentary Pharmacology & Therapeutics

The researchers found that the sustained virological response rate was substantially decreased in the elderly patients.

The sustained virological response rate was significantly lower in geriatric patients than in middle-aged patients with HCV genotype non-1, but the difference was not significant with HCV genotype 1.

The team found that the older patients infected with HCV genotype non-1 who achieved a rapid virological response had a similar sustained virological response rate to that of the younger patients.

The research team observed that the withdrawal rate was 13% in the elderly group, and 8% in the younger group.
 
Dr Chien's team concludes, "Compared with middle-aged patients, the therapeutic efficacy of pegylated interferon plus ribavirin therapy is lower in hepatitis C virus-infected geriatric patients with an acceptable withdrawal rate."

"Considering prolonged lifespan in geriatric patients, we recommend treating geriatric hepatitis C virus-infected patients who have significant hepatic fibrosis and no other health problems."

Aliment Pharmacol Ther 2012: DOI: 10.1111/apt.12112
09 November 2012

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