65 Years/Or Older:Predictors to treatment response in Hepatitis C

Predictors for response to treatment of chronic Hep C infection in older patients

This month's issue of Digestive Diseases and Sciences identifies predictive factors for response to peginterferon-Alpha and ribavirin treatment of chronic Hep C virus infection in patients aged 65 years and more.

Elderly patients with chronic hepatitis C virus infection represent an understudied population.

Little is known regarding the predictive factors for sustained virological response to antiviral therapy in these patients.

Dr Edoardo Giannini and colleagues from Italy evaluated the efficacy of pegylated interferon and ribavirin therapy in chronic hepatitis C virus patients aged 65 years, and identify pre- and on-treatment predictors of sustained virological response.

The researchers studied 57 patients aged 65 years or older who underwent pegylated interferon and ribavirin treatment, evaluating the sustained virological response rate and its association with pre-treatment demographic, clinical, biochemical, and virological parameters.

Furthermore, the research team assessed whether 12-week serum hepatitis C
virus-RNA assessment might predict sustained virological response.

A positive serum Hep C virus-RNA had 100% negative predictive value for sustained virological response
Digestive Diseases and Sciences
A sustained virological response was obtained in 25 patients.

The only pre-treatment predictor of sustained virological response was hepatitis C virus genotype 2 and 3.

The researchers observed a positive serum hepatitis C virus-RNA or a decline in viral load less or equal to 2log10 at week 12 had 100% negative predictive value for sustained virological response.

The team reported that no major liver-related events or deaths occurred during therapy.

The research team found that treatment was discontinued due to side effects—mainly cardiovascular—in 10 patients.

Dr Giannini's team concluded, "Pre- and on-treatment virological parameters can be used to identify elderly patients who are more likely to obtain a sustained virological response to standard-of-care antiviral therapy for chronic hepatitis C virus infection."

Dig Dis Sci 2010; 55(11):3193-9
18 November 2010


Dig Dis Sci. 2010 Nov;55(11):3193-9. Epub 2010 Sep 18.
Predictive factors for response to peginterferon-alpha and ribavirin treatment of chronic HCV infection in patients aged 65 years and more.

Giannini EG, Basso M, Savarino V, Picciotto A.
Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV no. 6, Genoa, Italy. egiannini@unige.it
Abstract

BACKGROUND:
Elderly patients with chronic hepatitis C virus (HCV) infection represent an understudied population, and little is known regarding the predictive factors for sustained virological response (SVR) to antiviral therapy in these patients.

AIMS:
To evaluate the efficacy of pegylated interferon (PEG-IFN) and ribavirin therapy in chronic HCV patients aged 65 years, and identify pre- and on-treatment predictors of SVR.

METHODS:
We studied 57 patients aged ≥65 years who underwent PEG-IFN and ribavirin treatment, evaluating the SVR rate and its association with pre-treatment demographic, clinical, biochemical, and virological parameters. Furthermore, we assessed whether 12-week serum HCV-RNA assessment might predict SVR.

RESULTS:
A SVR was obtained in 25 patients (45%). The only pre-treatment predictor of SVR was HCV genotype 2 and 3 (P = 0.02). A positive serum HCV-RNA or a decline in viral load ≤2log(10) at week 12 had 100% negative predictive value for SVR. No major liver-related events or deaths occurred during therapy. Treatment was discontinued due to side effects-mainly cardiovascular-in 10 patients (17%).

CONCLUSION:
Pre- and on-treatment virological parameters can be used to identify elderly patients who are more likely to obtain a SVR to standard-of-care antiviral therapy for chronic HCV infection.


PMID: 20848200 [PubMed - indexed for MEDLINE]