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Management of Hepatitis C in the Older Adult

Elias B Chahine, Erenie H Guirguis, Caroline B Derrick

    The Senior Care Pharmacist
    |December 30, 2019
    PubMed

    Insights

    Hepatitis C is common in baby boomers and people who inject drugs. Screening is recommended for these groups, and direct-acting antivirals (DAAs) offer a well-tolerated, curative treatment option.

    Area of Science:

    • Hepatology
    • Infectious Diseases
    • Public Health

    Background:

    • Hepatitis C virus (HCV) disproportionately affects specific populations, including baby boomers and individuals who inject drugs.
    • Older adults represent a significant demographic impacted by Hepatitis C, necessitating tailored clinical considerations.

    Purpose of the Study:

    • To review the epidemiology, clinical presentation, screening, diagnosis, treatment, and prevention of Hepatitis C.
    • To emphasize the specific challenges and recommendations for managing Hepatitis C in older adults.

    Main Methods:

    • Literature search of PubMed and Google Scholar using terms like "hepatitis C," "HCV," "direct-acting antivirals (DAAs)," and "older adults."
    • Review of guidelines from the Centers for Disease Control and Prevention (CDC) and professional societies, alongside DAA prescribing information and clinical trials.

    Main Results:

    • Hepatitis C screening is recommended for adults born between 1945-1965 and high-risk individuals.
    • Direct-acting antivirals (DAAs) are highly effective, well-tolerated oral treatments for 8-12 weeks, achieving sustained virologic response.
    • Regimen selection for DAAs considers HCV genotype, cirrhosis, comorbidities, and drug interactions, particularly relevant in older adults.

    Conclusions:

    • Hepatitis C remains prevalent in baby boomers and people who inject drugs, underscoring the importance of recommended screening.
    • Direct-acting antiviral (DAA) therapy provides a curative and generally well-tolerated treatment for Hepatitis C, though access can be a barrier.

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