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老年患者丙型肝炎病毒的直接抗病毒治疗:老年早期和晚期患者的真实世界回顾性比较

Direct-acting antiviral treatment for Hepatitis C Virus in geriatric patients: a real-world retrospective comparison between early and late elderly patients.

作者信息

Yen Hsu-Heng, Su Pei-Yuan, Liu I-Ling, Zeng Ya-Yuei, Huang Siou-Ping, Hsu Yu-Chun, Yang Chia-Wei, Chen Yang-Yuan

机构信息

Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.

General Educational Center, Chienkuo Technology University, Changhua, Taiwan.

出版信息

PeerJ. 2021 Mar 16;9:e10944. doi: 10.7717/peerj.10944. eCollection 2021.

Abstract

INTRODUCTION

Chronic hepatitis C virus (HCV) infection rates are high in the geriatric population considering that interferon-based therapy is usually intolerable. With the introduction of oral antiviral therapy for HCV, increased treatment tolerability and good treatment responses have been observed. However, treatment data regarding the geriatric population have been limited. Therefore, this retrospective study aimed to evaluate the efficacy and safety of direct-acting antiviral therapy for HCV in the geriatric population.

MATERIALS AND METHODS

The primary end point was sustained virologic response (SVR) 12 weeks after treatment completion, whereas the secondary end points were treatment-related side effects and short-term survival rate following treatment.

RESULTS

In total, 492 patients (median age, 73 years; 43.9% males), including 278 early elderly patients, were enrolled. Among the included patients, 45% had cirrhosis. HCV genotypes 1 (72.4%) and 2 (25.4%) were the most common. The overall SVR rate was 96.7%, with no difference in SVR rates observed between early and late elderly groups (96.8% vs. 96.7%;  = 0.983). Both groups showed similar side effects, including dizziness (11.4%), and fatigue (8.7%), with three patients discontinuing therapy owing to side effects. Both groups had a similar 3-year survival rate. Significant factors associated with post-treatment survival included cirrhosis, albumin, and creatinine level.

CONCLUSIONS

Our real-world data showed that both early and late elderly patients could undergo direct-acting antiviral treatment for HCV with excellent treatment outcomes.

摘要

引言

考虑到基于干扰素的治疗通常难以耐受,老年人群中慢性丙型肝炎病毒(HCV)感染率较高。随着HCV口服抗病毒治疗的引入,已观察到治疗耐受性增加且治疗反应良好。然而,关于老年人群的治疗数据有限。因此,本回顾性研究旨在评估老年人群中HCV直接抗病毒治疗的疗效和安全性。

材料与方法

主要终点为治疗完成后12周的持续病毒学应答(SVR),次要终点为治疗相关副作用及治疗后的短期生存率。

结果

共纳入492例患者(中位年龄73岁;男性占43.9%),其中包括278例老年前期患者。纳入患者中,45%患有肝硬化。HCV基因1型(72.4%)和2型(25.4%)最为常见。总体SVR率为96.7%,老年前期和老年后期组的SVR率无差异(96.8%对96.7%;P = 0.983)。两组的副作用相似,包括头晕(11.4%)和疲劳(8.7%),3例患者因副作用停药。两组的3年生存率相似。与治疗后生存相关的显著因素包括肝硬化、白蛋白和肌酐水平。

结论

我们的真实世界数据表明,老年前期和老年后期患者均可接受HCV直接抗病毒治疗,且治疗效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be77/7977377/13da9562dbe1/peerj-09-10944-g001.jpg

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