ORIGINAL ARTICLE   

Minerva Medica 2024 Apr 09

DOI: 10.23736/S0026-4806.24.09238-3

Copyright © 2024 EDIZIONI MINERVA MEDICA

language: English

Effectiveness and safety of direct-acting antivirals in the therapy of HCV-infected elderly people

Michał BRZDĘK ¹ ✉, Dorota ZARĘBSKA-MICHALUK ¹, Krzysztof TOMASIEWICZ ², Magdalena TUDRUJEK-ZDUNEK ², Beata LORENC ³, Włodzimierz MAZUR ⁴, Hanna BERAK ⁵, Justyna JANOCHA-LITWIN ⁶, Jakub KLAPACZYŃSKI ⁷, Marek SITKO ⁸, Ewa JANCZEWSKA ⁹, Dorota DYBOWSKA ¹⁰, Anna PARFIENIUK-KOWERDA ¹¹, Anna PIEKARSKA ¹², Jerzy JAROSZEWICZ ¹³, Robert FLISIAK ¹¹

¹ Department of Infectious Diseases and Allergology, Jan Kochanowski University, Kielce, Poland; ² Department of Infectious Diseases, Medical University of Lublin, Lublin, Poland; ³ Pomeranian Center of Infectious Diseases, Medical University Gdansk, Gdansk, Poland; ⁴ Clinical Department of Infectious Diseases, Clinical University of Silesia in Katowice, Chorzów, Poland; ⁵ Daily Department, Hospital for Infectious Diseases, Warsaw, Poland; ⁶ Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wroclaw, Poland; ⁷ Department of Internal Medicine and Hepatology, The National Institute of Medicine of the Ministry of Interior and Administration, Warsaw, Poland; ⁸ Department of Infectious and Tropical Diseases, Jagiellonian University, Krakow, Poland; ⁹ Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland; ¹⁰ Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland; ¹¹ Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland; ¹² Department of Infectious Diseases and Hepatology, Medical University of Lodz, Lodz, Poland; ¹³ Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice, Bytom, Poland

BACKGROUND: The introduction of direct-acting antivirals (DAAs) with their effectiveness and safety has revolutionized the approach to treating hepatitis C virus (HCV) infections. Nevertheless, elderly patients have often been excluded from clinical trials, so the results of real-world studies are particularly important in the context of the geriatric population. The study aimed to analyze the effectiveness and safety of antiviral DAA treatment in HCV-infected patients over the age of 65, with notable inclusion of those over the age of 85.
METHODS: The analyzed patients were divided by age into three groups: group A (65-74 years), group B (75-84 years) and group C (85 years or older). Patients started DAA based therapy at 22 hepatology centers between July 2015 and December 2022.
RESULTS: A total of 3505 elderly patients were included in the analysis, and this group consisted of 2501 patients in group A, 893 in group B, and 111 in group C. The study population, regardless of age, was dominated by women. Patients had a high prevalence of comorbidities (84.9%, 92.2%, and 93.7%, respectively) as well as a high rate of concomitant medications. The sustained virological response was 97.9% in groups A and B and 100% in group C. The therapy was well-tolerated, with a comparable safety profile observed in all analyzed groups.
CONCLUSIONS: DAA-based therapies are highly effective and well tolerated by the elderly patients, including those over 85. Age should not be a barrier to treatment, but careful management is necessary.

KEY WORDS: Hepatitis C, chronic; Interferons; Aged