Efficacy and safety of direct-acting antivirals in elderly with chronic hepatitis C: results from a retrospective cohort study

R. Villani 1, I. Donatiello 2, F. Barone 2, F. Cavallone 1, G. Fioravanti 1, F. Di Cosimo 1, F. Bellanti 1, F. Sollitto 3, G. Vendemiale 1, G. Serviddio 1

1 C.U.R.E. (Centre for Liver Diseases Research and Treatment), Institute of Internal Medicine, Department of Medical and Surgical Sciences, University of Foggia, Italy; 2 Internal Medicine Unit, San Giovanni Hospital, Lagonegro, Potenza, Italy; 3 Department of Medical and Surgical Sciences, University of Foggia, Italy

Background. Seroprevalence of hepatitis C virus infection has increased over the last decade and because of hepatitis C virus acquisition time and age of most infected persons, the proportion of elderly with CHC is expected to increase over time. With the approval of direct-acting antivirals (DAAs), treatment access has expanded to interferon intolerant patient populations, including older age. However, elderly patients, especially those aged 75 years and older, have been excluded from most clinical trials and few data are available on safety and efficacy of DAAs in this special population.

Methods. We conducted a retrospective cohort study on three age subgroups of patients (< 65 years; 65-74 years and ³ 75 years) treated with DAAs between March 2015 and March 2017. Two hundred and sixty-two patients were followed up with clinical and laboratory evaluations during antiviral therapy.

Results. HCV genotype distribution significantly differed among the three subgroups. Antiviral treatments were not different between younger and elderly groups. Sofosbuvir-based regimens were used in about 60% of patients without significant differences among the three age-subgroups. All patients except three achieved SVR12 (99.3% in elderly vs 98.3% in younger patients). A total of 62 patients (23.7%) showed at least one adverse event (AE). AEs were not higher in elderly patients.

Conclusions. Our data showed that DAAs in elderly CHC patients were as effective as youngers without any significant increase of adverse events.

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