ELDERLY patients infected with the hepatitis C virus (HCV) can be treated with direct-acting antivirals (DAA) safely and effectively, according to new research from a recent German study. Previously, little was known about the effected of increasing patient age on HCV infection, and as such researchers set out to elucidate the answers.
A total of 7,133 patients were enrolled in the German Hepatitis C Registry (DHC-R). Of these, 10% were aged ≥70 years and the majority of the participants were Caucasian. Researchers investigated the demographic characteristics of patients who began oral DAA therapeutic regimens after September 2014. The patients were compared based on age: elderly (≥70 years old) or non-elderly (<70 years old).
The HCV transmission method differed between the two patient groups. The most common forms of transmission in elderly patients was via blood products or surgical or medical procedures, whereas for the non-elderly patients, the most common forms of transmission were drug use and sexual transmission.
When assessing treatment with DAA, results showed that treatment response rates was similar between elderly and non-elderly patients (93% versus 91%, respectively). In addition, there were similar cases of adverse events in elderly and non-elderly patients (53% versus 55%, respectively), though the incidence of serious adverse events was slightly higher in elderly patients (8% versus 4%, respectively). The incidence of serious liver-related adverse events was higher in the elderly patient group (2% versus 1%), but it was found that this was almost entirely due to the higher incidence of hepatocellular carcinoma in this patient group (0.9% versus 0.2%). The discontinuation of treatment rate was low in both patient groups, with 0.7% in the elderly group, and 0.2% non-elderly patient group.
Overall, the results show that the use of DAA for the treatment of HCV in elderly patients is just as safe and effective as it is in non-elderly patients. The authors concluded: “An absolute age limit for HCV treatment does not exist. Accordingly, as the infection is frequently unrecognised, hepatologists, geriatric physicians, and general practitioners should be encouraged to screen for HCV in elderly patients whenever elevated liver enzymes are detected or chronic liver disease is suspected”.