title: Simeprevir with peginterferon/ribavirin for patients with hepatitis C virus genotype 1: high frequency of viral relapse in elderly patients.
abstract: OBJECTIVE
  The tolerability and efficacy of simeprevir in combination with peginterferon and ribavirin in patients infected with hepatitis C virus (HCV) genotype 1 under actual clinical conditions were investigated.
  
  
  METHODS
  A total of 176 patients with chronic HCV genotype 1 infection were treated with simeprevir for 12 weeks plus Peg-IFN/RBV for 24 weeks. Overall, 107 (60.7 %) patients were aged 60 years or more, and 16 (9 %) patients were aged 70 years or more. Treatment discontinuation, sustained virological response 12 (SVR12), and viral relapse were evaluated and compared between younger patients and elderly patients.
  
  
  RESULTS
  The rates of undetectable HCV RNA at the end of treatment were 95.8, 100 and 93.1 % in treatment-naïve, prior relapse, and prior non-responders, respectively. However, the rates of SVR12 were 82.4, 88.2 and 69.2 %, respectively. Especially in prior non-responders, viral relapse was relatively frequent. Treatment discontinuation and SVR12 were not different between patients aged <70 and ≥70 years, but viral relapse after completing treatment was significantly more frequent in patients aged ≥70 years (p = 0.012).
  
  
  CONCLUSIONS
  In simeprevir with peginterferon and ribavirin therapy, viral relapse was relatively frequent. Especially in elderly patients, the relapse rate was high after completing treatment, instead of low frequency of discontinuation by the adverse events.
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Center for Liver-Biliary-Pancreatic Diseases, Matsuyama Red Cross Hospital, 1 Bunkyocho, Matsuyama, Ehime 790-8524 Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Joko
authors.affiliation: Department of Gastroenterology, Uwajima City Hospital, 1-1 Gotenmachi, Uwajima, Ehime 798-0061 Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Seike
authors.affiliation: Department of Gastroenterology, Ehime Prefectural Central Hospital, 83 Kasugamachi, Matsuyama, Ehime 790-0024 Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.affiliation: Department of Gastroenterology, Saiseikai Imabari Hospital, 7-1-6 Kitamura, Imabari, Ehime 799-1502 Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Horiike
authors.affiliation: Department of Gastroenterology, Matsuyama Shimin Hospital, 2-6-5 Ootemachi, Matsuyama, Ehime 790-0067 Japan.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Kisaka
authors.affiliation: Department of Gastroenterology, Matsuyama Shimin Hospital, 2-6-5 Ootemachi, Matsuyama, Ehime 790-0067 Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology, Ehime Prefectural Imabari Hospital, 4-5-5 Ishiicho, Imabari, Ehime 794-0006 Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Nakanishi
authors.affiliation: Department of Internal Medicine, Shiritsu Oozu Hospital, 570 Kou Nishioozu, Oozu, Ehime 795-0013 Japan.
authors.forename: Kimio
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Department of Internal Medicine, Ehime Prefectural Niihama Hospital, 3-1-1 Hongo, Niihama, Ehime 792-0042 Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.affiliation: Department of Gastroenterology, National Hospital Organization Ehime Medical Center, 366 Yokogawara, Toon, Ehime 791-0203 Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yamauchi
authors.affiliation: Department of Gastroenterology, Saiseikai Imabari Hospital, 7-1-6 Kitamura, Imabari, Ehime 799-1502 Japan.
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295 Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
keywords: Adverse events; Elderly patients; Simeprevir (TMC435); Viral relapse