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Treating hepatitis C in the elderly: pharmacotherapeutic considerations and developments

Chung-Feng Huang1,2,3, Ming-Lung Yu1,2,4,5,6

  • 1a Hepatobiliary Division, Department of Internal Medicine , Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung , Taiwan.

Expert Opinion on Pharmacotherapy
|November 1, 2017
PubMed

Insights

Hepatitis C virus (HCV) eradication is crucial for elderly patients. While interferon-free direct-acting antivirals (DAAs) show similar efficacy and safety to younger groups, long-term benefits require further study.

Area of Science:

  • Hepatology
  • Geriatric Medicine
  • Infectious Diseases

Background:

  • Hepatitis C virus (HCV) infection is more prevalent in older adults.
  • Age is a significant factor negatively impacting liver outcomes.
  • Geriatric patients with chronic hepatitis C (CHC) require effective viral eradication strategies.

Purpose of the Study:

  • To present the treatment strategy for CHC in the elderly.
  • To evaluate the clinical efficacy and drug safety of antiviral therapies in geriatric populations.
  • To compare outcomes between interferon-based and interferon-free direct-acting antiviral (DAA) eras.

Main Methods:

  • Review of antiviral therapies for CHC, focusing on interferon (IFN)-based and interferon-free direct-acting antiviral (DAA) treatments.
  • Analysis of treatment strategies, clinical efficacy, and drug safety in elderly CHC patients.
  • Comparison of outcomes between elderly patients and younger populations.

Main Results:

  • In the interferon era, elderly patients had lower sustained virological response (SVR) rates and more safety concerns.
  • In the DAA era, similar SVR rates and safety profiles were observed between elderly and younger patients.
  • Aging remains a risk factor for fibrosis progression and hepatocellular carcinoma (HCC) development post-HCV eradication.

Conclusions:

  • Direct-acting antivirals (DAAs) offer improved outcomes for elderly CHC patients compared to older therapies.
  • Further research is needed to understand the long-term benefits of DAAs and the impact on extra-hepatic manifestations in the elderly.
  • Aging influences fibrosis regression and HCC risk even after successful HCV viral eradication.
Abstract

Keywords:
DAAHCVIFNadvanced ageelderlytreatment

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