The elderly and direct antiviral agents: Constraint or challenge?

摘要: Abstract Background Direct antiviral agents (DAAs) for chronic hepatitis C showed great effectiveness and good safety profile. So far, few data are available about their use in elderly subjects. Aim To assess management, outcome of DAAs treatments the elderly. Methods This retrospective, single-centre study enrolled all patients aged ≥65 years, compared by age (group A: 65–74 group B: ≥75 years), who completed between February 2015–November 2016. Variables potentially associated to adverse events (AEs) were analyzed. Sustained virological response (SVR) was evaluated at 12-weeks follow-up. Results administered 221 years (males: 112; 130, 91). Prescribed regimens were: sofosbuvir-based: 44 (19.9%), simeprevir-based: 25 (15%), ledipasvir-based: 49 (22.2%), daclatasvir-based: 12 (5.4%), paritaprevir/ritonavir + ombitasvir ± dasabuvir: 91 (41.2%). Ribavirin used 121 patients. In 58 subjects co-medications adjusted due drug interactions. At least one AE occurred 130 patients, including 13 SAEs, mainly older (p = 0.04). Female sex (p = 0.04), liver stiffness (p = 0.023), simeprevir (p = 0.03) ribavirin (p = 0.009) with AEs. SVR-12 achieved 96,9% Conclusions A careful baseline evaluation a strict monitoring allow optimise management