Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey
Makaleler > Tam Makale · 2022
Yazarlar: Yusuf Önlen, Tayibe Bal, Mehmet Çabalak, Nefise Çuvalcı Öztoprak, Nagehan Didem Sarı, Behice Kurtaran, Ebubekir Şenateş, Alper Gündüz, Esra Zerdali, Hasan Karsen, Ayşe Batırel, Rıdvan Karaali, Rahmet Güner, Tansu YAMAZHAN, Şükran Köse, Nurettin Erben, Nevin İnce, İftihar Köksal, Figen Sarıgül Yıldırım, Gülşen Yörük, Süheyla Kömür, Sibel Kaya, Şaban Esen, Özgür Günal, İlknur Esen Yıldız, Dilara İnan, Şener Barut, Mustafa Namıduru, Selma Tosun, Kamuran Türker, Alper Şener, Kenan Hızel, Nurcan Baykam, Fazilet Duygu, Esragül Akıncı, Güray Can, Ülkü User, Hanefi Cem Gül, Ayhan Akbulut, Güven Çelebi, Mahmut Sünnetçioğlu, Oğuz Karabay, Hayat Kumbasar Karaosmanoğlu, Fatma Sırmatel, Fehmi Tabak
Turkish Journal of Gastroenterology, Uluslararası, Scopus, 2022, cilt 33, ss 862-873
Özet
BACKGROUND: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. METHODS: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. RESULTS: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively). CONCLUSION: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.