title: Indications and limitations for aged patients with chronic hepatitis C in pegylated interferon alfa-2b plus ribavirin combination therapy.
abstract: OBJECTIVE
  This study investigated the efficacy and adverse effects of pegylated interferon (Peg-IFN) plus ribavirin therapy in aged patients with chronic hepatitis C (CH-C).
  
  
  METHODS
  A total of 1040 naïve patients with CH-C (genotype 1, n=759; genotype 2, n=281), of whom 240 (23%) over 65 years old (y.o.), were treated with Peg-IFN alfa-2b plus ribavirin and assessed after being classified into five categories, according to age.
  
  
  RESULTS
  The discontinuance rate was higher for patients over 70 y.o. (36%), the most common reason being anemia. In the presence of genotype 1, the SVR rate was similar (42-46%) among patients under 65 y.o. and declined (26-29%) among patients over 65 y.o. For patients over 65 y.o., being male (Odds ratio, OR, 3.5, p=0.035) and EVR (OR, 83.3, p<0.001) were significant factors for SVR, in multivariate analysis. The Peg-IFN dose was related to EVR, and when EVR was attained, 76-86% of patients over 65 y.o. achieved SVR. SVR was not achieved (0/35, 0/38, respectively) if a 1-log decrease and a 2-log decrease were not attained at week 4 and week 8, respectively. In the presence of genotype 2, the SVR rate was similar (70-71%) among patients under 70 y.o. and declined among patients over 70 y.o. (43%).
  
  
  CONCLUSIONS
  Aged patients up to 65 y.o. with genotype 1 and 70 y.o. with genotype 2 can be candidates for Peg-IFN plus ribavirin therapy. The response-guided therapy can be applied for aged patients with genotype 1.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Tsugiko
authors.initials: T
authors.lastname: Oze
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiramatsu
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yakushijin
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mochizuki
authors.forename: Masahide
authors.initials: M
authors.lastname: Oshita
authors.forename: Hideki
authors.initials: H
authors.lastname: Hagiwara
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ito
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fukui
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inui
authors.forename: Taizo
authors.initials: T
authors.lastname: Hijioka
authors.forename: Masami
authors.initials: M
authors.lastname: Inada
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaytayama
authors.forename: Shinji
authors.initials: S
authors.lastname: Tamura
authors.forename: Harumasa
authors.initials: H
authors.lastname: Yoshihara
authors.forename: Atsuo
authors.initials: A
authors.lastname: Inoue
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
authors.forename: Michio
authors.initials: M
authors.lastname: Kato
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyagi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Tomohide
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kiso
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kanto
authors.forename: Akinori
authors.initials: A
authors.lastname: Kasahara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b