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Published on: October 1, 2015
Treatment of hepatitis C virus in elderly persons with interferon alpha
D H Van Thiel1, L Friedlander, P Caraceni
1Oklahoma Transplant Institute, Baptist Medical Center of Oklahoma, Oklahoma City, USA.
Insights
Older adults with Hepatitis C virus (HCV) can safely receive Interferon alpha (IFN) therapy. Treatment outcomes and side effects are comparable to younger adults, demonstrating IFN
Area of Science:
- Hepatology
- Virology
- Geriatric Medicine
Background:
- Hepatitis C virus (HCV) infection is more prevalent in older adults due to recent screening advancements.
- Limited treatment options for elderly HCV patients stem from concerns about Interferon alpha (IFN) tolerability.
- This study addresses the under-treatment of HCV in the elderly population.
Purpose of the Study:
- To evaluate the safety and efficacy of Interferon alpha (IFN) treatment in elderly patients with Hepatitis C virus (HCV).
- To compare treatment outcomes and adverse events in older adults versus younger adults receiving IFN therapy for HCV.
Main Methods:
- Twenty-five elderly subjects (>65 years) with Ab-HCV positive status received 5 MU Interferon (IFN) TIW for 6 months.
- A control group of 25 younger adults (mean age 44) matched for gender and histology was used for comparison.
- Treatment response was categorized as full (normal ALT) or partial (ALT decrease >50%).
Main Results:
- No significant biochemical differences were observed between elderly and younger adult groups post-treatment.
- HCV treatment response rates were similar: 48% in the elderly and 41% in younger adults.
- The elderly group completed therapy without discontinuation, and reported adverse events were comparable to the younger control group.
Conclusions:
- Elderly individuals with HCV can be effectively treated with Interferon alpha (IFN).
- Treatment efficacy, in terms of response rates, is consistent between elderly and younger adult populations.
- The safety profile of IFN therapy is similar in older and younger adults, with comparable rates and types of adverse effects.
Background:
Hepatitis C virus (HCV) is a health problem that is common in adults. Because screening of blood and blood products for HCV has only been possible recently, older adults are more likely than younger adults to have HCV. Despite the higher prevalence of HCV in older adults, few are treated. This failure to treat is a result of the concern that the untoward effects of Interferon alpha (IFN) may not be tolerable in older individuals.
Methods:
Twenty-five subjects age > 65 years who were Ab-HCV positive and desired IFN therapy were treated with 5 MU Interferon administered TIW for 6 months. Twenty-five adults (mean age 44 +/- 1 years) matched for gender and histologic disease were utilized as a control population. Responses were classified as full if the ALT level was normal, and partial if the ALT fell by > 50% but was still abnormal after 6 months of therapy. All other responses were defined as failures.
Results:
At the end of treatment, no biochemical difference between the elderly and younger adults was evident for any parameter. Moreover, the response rates (48% and 41%, respectively) were nearly identical. None of the elderly discontinued IFN therapy during the treatment period. The rate of untoward events reported by the elderly was similar to that reported by the younger controls.
Conclusions:
These data demonstrate that: (a) the elderly with HCV infections can be treated with IFN; (b) the response rate is similar in elderly and younger adults; and, (c) the rate and type of untoward IFN effects experienced by the elderly do not differ from that reported by younger adults.
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