title: Treatment Response and Tolerability of Pegylated Interferon-α Plus Ribavirin Combination Therapy in elderly Patients (≥ 65 years) With Chronic Hepatitis C in Korea.
abstract: BACKGROUND
  The prevalence of hepatitis C virus (HCV) infections in elderly patients has been increasing in a number of countries. A few reports concerning pegylated interferon-α (PEG-IFN-α)-based combination treatment in elderly chronic hepatitis C (CHC) patients have been published, with slightly different treatment outcomes.
  
  
  OBJECTIVE
  We investigated the treatment response and safety of PEG-IFN-α plus ribavirin combination therapy in elderly patients with CHC.
  
  
  METHODS
  Among a total of 181 treatment-naïve CHC patients (60 patients with genotype 1, 121 patients with genotype 2 or 3), 38 were aged ≥ 65 years (defined as the elderly group) and 143 were aged < 65 years (defined as the non-elderly group).
  
  
  RESULTS
  The overall sustained virologic response (SVR) was lower in the elderly group than in the non-elderly group, but it was not significantly different (65.8 % vs. 76.2 %, P = 0.15). In a subgroup analysis, among patients with genotype 1, the elderly group had a significantly lower SVR rate than the non-elderly group (30.8 % vs. 66.0 %, P = 0.03). However, the SVR rate in patients with HCV genotype 2 or 3 was comparable between the two groups (84.0 % vs. 81.3 %, P = 0.85). HCV genotype was significantly associated with SVR in the elderly patients (genotype 1 vs. 2 or 3, odds ratio: 0.18, 95% confidence interval: 0.000-0.869, P = 0.03). The incidence of premature discontinuation of treatment (21.1 % vs. 9.1 %, P = 0.05) and dose modification (52.6 % vs. 31.5 %; P = 0.02) due mainly to adverse events or laboratory abnormalities, were higher in the elderly group than in the non-elderly group.
  
  
  CONCLUSIONS
  PEG-IFN-α plus ribavirin combination therapy might be considered for elderly CHC patients, especially for genotype 2 or 3, with vigilant monitoring of adverse events.
authors.affiliation: Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, South Korea.
authors.forename: Hyeong Il
authors.initials: HI
authors.lastname: Kim
authors.forename: In Hee
authors.initials: IH
authors.lastname: Kim
authors.forename: Byung Jun
authors.initials: BJ
authors.lastname: Jeon
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.forename: Seong Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Kim
authors.forename: Seung Ok
authors.initials: SO
authors.lastname: Lee
authors.forename: Soo Teik
authors.initials: ST
authors.lastname: Lee
authors.forename: Dae Ghon
authors.initials: DG
authors.lastname: Kim