Virologic responses and tolerance of peginterferon alfa plus ribavirin treatment for patients with chronic hepatitis C virus infection in different age categories

Niger J Clin Pract. 2016 Jan-Feb;19(1):133-9. doi: 10.4103/1119-3077.173708.

Abstract

Objective: This study aimed to evaluate the effect of age on the treatment comprising peginterferon plus ribavirin administered to patients with chronic hepatitis C (CHC).

Materials and methods: A total of 314 patients with CHC treated with peginterferon plus ribavirin were classified into three categories according to age. The efficacy and safety outcomes were compared between groups.

Results: Elderly patients yielded significantly lower rapid virological response and sustained virological response (SVR) (31.3% and 35.4%, respectively, P < 0.05) rates than younger patients. The discontinuation rate of the patients aged ≥ 60 years were significantly higher (29.2%, P = 0.004) than that of the younger patients. The elderly patients suffered from adverse events, such as fatigue (P = 0.005), neutropenia (P = 0.013), jaundice (P = 0.013), hepatocellular carcinoma (P = 0.013), and gastric cancer (P = 0.018), more frequently than the younger patients. In multivariable analysis, age was a negative factor that affected the SVR of the patients with CHC (odds ratio [OR] =0.983, 95% confidence interval [95% CI] =0.967-1.0, P = 0.05). The SVR rate of the patients with hepatitis C virus (HCV) genotype non-1 was significantly higher than that of the patients with HCV-1 (OR = 0.559, 95% CI = 0.349-0.895, P = 0.015). An early virological response could be considered as a powerful positive predictor to obtain an SVR (OR = 2.353, 95% CI = 1.411-3.922, P = 0.001).

Conclusions: Increasing age negatively affected the efficacy of peginterferon and ribavirin therapy in the treatment of patients with CHC. Elderly patients experienced poorer treatment tolerance and adherence, and as a result, treatment efficacy is poor.

MeSH terms

  • Adult
  • Age Factors
  • Antiviral Agents / therapeutic use*
  • China
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Hepacivirus / drug effects*
  • Hepacivirus / isolation & purification
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferon-alpha / administration & dosage*
  • Interferon-alpha / therapeutic use
  • Male
  • Polyethylene Glycols
  • Recombinant Proteins
  • Retrospective Studies
  • Ribavirin / administration & dosage*
  • Ribavirin / therapeutic use
  • Sustained Virologic Response*
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a