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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.
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.
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