Poor response to hepatitis C treatment in elderly patients



Document title: Poor response to hepatitis C treatment in elderly patients
Journal: Annals of hepatology
Database: PERIÓDICA
System number: 000416121
ISSN: 1665-2681
Authors: 1
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1
1
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1
Institutions: 1Universidade Federal de Sao Paulo, Departamento de Gastroenterologia, Sao Paulo. Brasil
Year:
Volumen: 12
Number: 3
Pages: 392-3
Country: México
Language: Inglés
Document type: Artículo
Approach: Experimental
English abstract Treatment of genotype 1 chronic hepatitis C in elderly patients has been associated with low rates of a sustained virological response (SVR), but the reasons are unclear. Objective. To determine the SVR rate in patients ≥ 60 years with genotype 1 chronic hepatitis C treated with Peg-IFN and ribavirin, and to identify risk factors related to treatment response in this specific group of patients. Material and methods. Patients were divided into < 60 years (non-elderly) and ≥60 years (elderly) and were compared regarding clinical, laboratory and histological characteristics and response to treatment. Results. A total of 231 patients were included in the study. The elderly group (n=89) presented a predominance of women, more advanced hepatic disease, higher glucose, cholesterol and LDL levels, lower hemoglobin levels, and a larger proportion of overweight subjects. The SVR rate was lower (25 vs. 46%) and anemia, ribavirin dose reduction and use of filgrastim and erythropoietin were more frequent in elderly patients. Negative predictive factors of SVR in the whole group (n = 231) were glucose ≥ 100 mg/dL and age ≥ 60 years. In the elderly group, only pretreatment variables (lower serum glucose and higher hemoglobin levels) were associated with SVR. Conclusion. The SVR rate was low in elderly patients. However, this poor response was not due to poor tolerance, but mainly to pretreatment conditions. Among elderly patients, the best candidates for hepatitis C treatment are those with elevated pretreatment hemoglobin levels and adequate glycemic control
Disciplines: Medicina
Keyword: Gastroenterología,
Microbiología,
Terapéutica y rehabilitación,
Ancianos,
Interferón pegilado,
Ribavirin,
Respuesta viral,
Hepatitis crónica,
Hepatitis C
Keyword: Gastroenterology,
Microbiology,
Therapeutics and rehabilitation,
Aged,
Pegylated interferon,
Ribavirin,
Viral response,
Chronic hepatitis,
Hepatitis C
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