title: The effect of pegylated interferon-alpha2b and ribavirin combination therapy for chronic hepatitis C infection in elderly patients.
abstract: BACKGROUND
  The clearance of hepatitis C virus infection by interferon therapy significantly reduces the incidence of hepatocellular carcinoma and death in elderly chronic hepatitis patients. However, there are few reports concerning the efficacy and safety of pegylated interferon-alpha2b plus ribavirin combination therapy in elderly patients. The aims of the present study were to examine the effect and safety of pegylated interferon-alpha2b plus ribavirin combination therapy in 427 patients with chronic hepatitis C infection. We compared the rates of sustained virological response--defined as the absence of detectable hepatitis C virus in serum 24 weeks after the treatment ended--and the treatment discontinuation rate between 319 younger patients aged < 65 years and 108 elderly patients aged ≥ 65 years. We also examined the factors contributing to a sustained virological response.
  
  
  RESULTS
  There was no significant difference in the sustained virological response rate between younger patients and elderly patients according to their hepatitis C virus genotype (41.5% (100/241) and 40.7% (35/86) for genotype 1; P = 0.899, 89.7% (70/78) and 86.4% (19/22) for genotype 2; P = 0.703, respectively). There was also no significant difference in the treatment discontinuation rate between the two age groups (10.3% (33/319) and 13.9% (15/108), respectively; P = 0.378). There were no serious adverse events requiring hospitalization. The factors contributing significantly to a sustained virological response in elderly patients were gender, hepatitis C virus genotype, platelet count, and the presence of a rapid or early virological response (undetectable hepatitis C virus in serum at weeks 4 or 12 of treatment, respectively). However, upon multivariate analysis, the presence of an early virological response was the only significant factor (odds ratio: 0.115, 95% confidence interval: 0.040- 0.330, P < 0.001).
  
  
  CONCLUSIONS
  The efficacy and safety of pegylated interferon-alpha2b plus ribavirin combination therapy in elderly patients are not always inferior to those in younger patients. Obtaining an early virological response may be essential to achieve a sustained virological response in elderly patients with chronic hepatitis C infection.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan. h-nishikawa@osaka-med.jrc.or.jp
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nishikawa
authors.forename: Eriko
authors.initials: E
authors.lastname: Iguchi
authors.forename: Yorimitsu
authors.initials: Y
authors.lastname: Koshikawa
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ako
authors.forename: Tadashi
authors.initials: T
authors.lastname: Inuzuka
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Takeda
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Matsuda
authors.forename: Azusa
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Sinichiro
authors.initials: S
authors.lastname: Henmi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hatamaru
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Sumio
authors.initials: S
authors.lastname: Saito
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kita
authors.forename: Toru
authors.initials: T
authors.lastname: Kimura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D001792:Blood Platelets / Q000473:pathology / Q000821:virology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000187:drug effects* / Q000502:physiology; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D058889:Molecular Typing; D015999:Multivariate Analysis; D010976:Platelet Count; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012254:Ribavirin / Q000008:administration & dosage*; D012737:Sex Factors; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b