Virologic responses and tolerance of peginterferon alfa plus ribavirin treatment for patients with chronic hepatitis C virus infection in different age categories.

Abstract

This study aimed to evaluate the effect of age on the treatment comprising peginterferon plus ribavirin administered to patients with chronic hepatitis C (CHC). A total of 314 patients with CHC treated with peginterferon plus ribavirin were classified into three categories according to age. The efficacy and safety outcomes were compared between groups. Elderly patients yielded significantly lower rapid virological response and sustained virological response (SVR) (31.3% and 35.4%, respectively, P < 0.05) rates than younger patients. The discontinuation rate of the patients aged ≥ 60 years were significantly higher (29.2%, P = 0.004) than that of the younger patients. The elderly patients suffered from adverse events, such as fatigue (P = 0.005), neutropenia (P = 0.013), jaundice (P = 0.013), hepatocellular carcinoma (P = 0.013), and gastric cancer (P = 0.018), more frequently than the younger patients. In multivariable analysis, age was a negative factor that affected the SVR of the patients with CHC (odds ratio [OR] =0.983, 95% confidence interval [95% CI] =0.967-1.0, P = 0.05). The SVR rate of the patients with hepatitis C virus (HCV) genotype non-1 was significantly higher than that of the patients with HCV-1 (OR = 0.559, 95% CI = 0.349-0.895, P = 0.015). An early virological response could be considered as a powerful positive predictor to obtain an SVR (OR = 2.353, 95% CI = 1.411-3.922, P = 0.001). Increasing age negatively affected the efficacy of peginterferon and ribavirin therapy in the treatment of patients with CHC. Elderly patients experienced poorer treatment tolerance and adherence, and as a result, treatment efficacy is poor.