title: Safety, Tolerability, and Efficacy of Sofosbuvir Plus Ribavirin in Elderly Patients Infected with Hepatitis C Virus Genotype 2.
abstract: BACKGROUND
  An interferon-free regimen including sofosbuvir and ribavirin (RBV) for patients with hepatitis C virus (HCV) genotype 2 (G2) infection leads to a drastic improvement of sustained virological response (SVR). However, the safety, tolerability, and efficacy in patients aged 75 or older have not been completely understood.
  
  
  CONCLUSIONS
  Fifty-six patients with HCV G2 infection who were treated with sofosbuvir and weight-based dose of RBV were enrolled. Thirty-seven patients aged ≥75 and 19 patients aged ≤74 were classified as the aged and non-aged groups, respectively. The aged group was characterized by significantly more number of women, history of hepatocellular carcinoma, low serum albumin (ALB) level, low hemoglobin (Hb) concentration, low estimated glomerular filtration rate (eGFR), and high fibrosis-4 index (p = 0.0029). Forty-one patients were evaluated for SVR at 12 weeks after the end of therapy (SVR12); of them, all but one completed the treatment scheduled for 12 weeks. The aged group showed lower SVR12 rate than the non-aged group (81.3% for aged and 96.0% for non-aged groups). Although the Hb concentration and eGFR are significantly lower in the aged group throughout the clinical course, all patients in the aged group completed the 12-week treatment with a gradual increase of serum ALB level. Key Messages: The combination of sofosbuvir plus RBV is tolerable and beneficial in patients aged >75. However, intensive management of anemia by dose reduction of RBV is necessary, which could lead to a low SVR12 rate compared to that observed in patients younger than 75 years.
authors.forename: Naoshi
authors.initials: N
authors.lastname: Nishida
authors.forename: Masashi
authors.initials: M
authors.lastname: Kono
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Minami
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chishina
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Arizumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takita
authors.forename: Norihisa
authors.initials: N
authors.lastname: Yada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ida
authors.forename: Satoru
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Ueshima
authors.forename: Tashiharu
authors.initials: T
authors.lastname: Sakurai
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006454:Hemoglobins / Q000032:analysis; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000145:classification; D008113:Liver Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000008:administration & dosage*; D012449:Safety; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors; D000069474:Sofosbuvir / Q000008:administration & dosage*; D016896:Treatment Outcome; D014542:Uridine Monophosphate / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D006454:Hemoglobins; D012709:Serum Albumin; D012254:Ribavirin; D007372:Interferons; D014542:Uridine Monophosphate; D000069474:Sofosbuvir