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The Effect of Age on Response to Therapy With Peginterferon α Plus Ribavirin in a Cohort of Patients With Chronic HCV Hepatitis Including Subjects Older Than 65 Yr

Antonucci, Giorgio, M.D.1; Longo, Maria Antonella, M.D.1; Angeletti, Claudio, D. Stat.2; Vairo, Francesco, M.D.1; Oliva, Alessandra, M.D.1; Comandini, Ubaldo Visco, Ph.D.1; Tocci, Guido, M.D.1; Boumis, Evangelo, M.D.1; Noto, Pasquale, M.D.1; Solmone, Maria Carmela, Ph.D.3; Capobianchi, Maria R., Ph.D.3; Girardi, Enrico, M.D.2

American Journal of Gastroenterology: July 2007 - Volume 102 - Issue 7 - p 1383–1391
ORIGINAL CONTRIBUTION: LIVER AND BILIARY TRACT
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OBJECTIVES In many industrialized countries HCV infection is characterized by an increasing prevalence during ageing; however, data on the efficacy of treatment among older patients are scarce. This study was set up to evaluate the effect of age on the treatment of chronic HCV hepatitis with peginterferon α plus ribavirin.

METHODS We retrospectively reviewed medical records of 153 adult patients with chronic HCV hepatitis treated with combination therapy; 30 of them (19.6%) were 65 years of age or older.

RESULTS In multivariable analysis, age groups ≥40 years had similar odds of achieving sustained virologic response (P = 0.71) and significantly lower odds of sustained response compared with younger patients (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.05–0.59, P = 0.006; OR 0.13, 95% CI 0.03–0.49, P = 0.002; OR 0.21, 95% CI 0.05–0.91, P = 0.037 for patients aged 40–49 years, 50–64 years, and older than 64 years, respectively). The effect of age was present in the 74 patients infected with genotype 1 or 4 (P = 0.04), while among the 79 patients with genotype 2 or 3 sustained virologic response rates were relatively uniform, with no statistically significant differences.

CONCLUSIONS The probability of good response to combination treatment with peginterferon α plus ribavirin is decreased for patients aged more than 40 years infected with genotype 1 or 4, but patients aged more than 65 had a similar rate of response to those aged 40–64 years. Combination treatment may be safely extended to elderly patients with no major contraindications.

1Clinical Department of Infectious Disease, 2Department of Epidemiology, and 3Laboratory of Virology, National Institute for Infectious Disease, L. Spallanzani, Rome, Italy

Reprint requests and correspondence: Giorgio Antonucci, M.D., INMI L. Spallanzani, I Divisione, Via Portuense, 292 00149, Rome, Italy.

Received September 20, 2006; accepted January 31, 2007.

© The American College of Gastroenterology 2007. All Rights Reserved.
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