Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey
Yusuf Onlen, Tayibe Bal, M. Cabalak, Nefise Oztoprak, Nagehan Didem Sari, B. Kurtaran, Ebubekir Senates, Alper Gunduz, Esra Zerdali, Hasan Karsen, A. Batirel, Ridvan Karaali, R. Guner, T. Yamazhan, Sukran Kose, Nurettin Erben, Nevin Koc Ince, Iftihar Koksal, Figen Sarigul Yildirim, Gulsen Yoruk, Suheyta Komur, Ulku User, Sibel Kaya, Saban Esen, Ozgur Gunal, Ilknur Esen Yildiz, Dilara Inan, Sener Barut, M. Namiduru, S. Tosun, K. Turker, Alper Sener, Kenan Hizel, Nurcan Baykam, F. Duygu, Esragul Akinci, Guray Can, Hanefi Cem Gul, Ayhan Akbulut, G Çelebi, Mahmut Sunnetcioglu, Oguz Karabay, Hayat Kumbasar Karaosmanoglu, Fatma Sirmatel, Fehmi Tabak
article (Uluslararası, Hakemli) | Yazar(lar): Yusuf Onlen, Tayibe Bal, M. Cabalak, Nefise Oztoprak, Nagehan Didem Sari, B. Kurtaran, Ebubekir Senates, Alper Gunduz, Esra Zerdali, Hasan Karsen, A. Batirel, Ridvan Karaali, R. Guner, T. Yamazhan, Sukran Kose, Nurettin Erben, Nevin Koc Ince, Iftihar Koksal, Figen Sarigul Y
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.