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Excellent Safety and Sustained Virologic Response to Direct-Acting Antivirals Treatment in HCV-Infected Geriatric Patients: A Real-World Data

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Abstract

Background

Direct-acting antivirals (DAAs) are current standard of HCV treatment (Rx). However, data remain lacking on real-world safety, patterns of biochemical, virologic responses, and sustained virologic response (SVR12) rate in geriatric patients.

Aims

The present study assessed clinical presentation, safety, SVR12 rate, dynamic changes in HCV RNA, ALT, and AFP in geriatric patients (age ≥ 65 year old, G1) versus non-geriatric patients (G2) with chronic hepatitis C and received DAA treatment.

Methods

This was a single-center, retrospective study on 183 patients with DAA Rx and 12-week post-Rx follow-up.

Results

There were no significant differences in patterns of biochemical and virologic responses between the two groups. Undetectable HCV RNA rates were 67.2% versus 75.7% (p = 0.22) and 77.3% versus 84.3% (p = 0.24) at Rx week 2 and Rx week 4, respectively. The SVR12 rate was comparable in 2 groups, 94.1% (G1) versus 95.7% (G2, p = 0.64). ALT normalization rates were 91.2% versus 91.3% (p = 0.98), 92.6% versus 93.9% (p = 0.74), and 97.1% versus 97.4% (p = 0.89) at Rx week 2, post-Rx week12, and post-Rx week 24, respectively. AFP normalization was lower in G1 with 89.7% versus 95.7% (p = 0.12), 77.9% versus 87.8% (p = 0.08), and 79.4% versus 92.2% (p = 0.01), at Rx week 2, and post-Rx week 12, and post-Rx week 24, respectively. Both groups showed similar side effects profile including fatigue 11.8% versus 12.2% (p = 0.93) and headache 11.8% versus 13.9% (p = 0.68).

Conclusion

Based on our real-world data, geriatric patients had excellent and comparable treatment outcomes with non-geriatric patients in safety and SVR12 rates to different DAA regimens.

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Authors and Affiliations

  1. Department of Pharmacy, University of California Irvine Medical Center, Orange, CA, USA

    Tung Huynh

  2. Division of Gastroenterology and Hepatology, University of California Irvine, School of Medicine, 101 The City Drive, Building 56, Ste. 801, Orange, CA, 92868, USA

    Ke-Qin Hu

Authors
  1. Tung Huynh
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Correspondence to Ke-Qin Hu.

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Conflict of interest

Tung Huynh and Ke-Qin Hu declare that they have no conflict of interest related to this study. This study was an investigator-initiated study, and no external funding in any source has been obtained. Tung Huynh has nothing to disclose. Dr. Hu is on speaker bureau for Gilead Sciences.

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Huynh, T., Hu, KQ. Excellent Safety and Sustained Virologic Response to Direct-Acting Antivirals Treatment in HCV-Infected Geriatric Patients: A Real-World Data. Dig Dis Sci 66, 1327–1334 (2021). https://doi.org/10.1007/s10620-020-06286-3

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  • DOI: https://doi.org/10.1007/s10620-020-06286-3

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