Hepatitis C Virus Clearance in Older Adults

Antonio Massimo Ippolito, Angelo Iacobellis, Michele Milella, Fabio Conti, Vincenzo Messina, Maria Rosa Valvano, Grazia Anna Niro, Filomena Morisco, Michele Barone, Antonio Patrizio Termite, Giuseppina Brancaccio, Angelo Andriulli

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. Participants: Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). Measurements: We investigated the efficacy, safety, and global clinical effect of treatment with different combinations of direct antiviral agents (DAAs). Participants with cirrhosis were staged according to Child-Pugh-Turcotte class, Model for End-Stage Liver Disease score, and the D'Amico staging system. The type and number of comorbidities at baseline and hepatic and nonhepatic events during follow-up were registered. Results: Ninety-five percent of participants with cirrhosis and 95% of those with advanced fibrosis attained SVR. The rate was independent of sex, HCV genotype, and treatment schedule. During a mean follow-up of 14 ± 4 months (range 5–23 months), 34 events occurred in 27 participants: 10 hepatocellular carcinomas, 12 hepatic decompensations, 9 nonhepatic events, 3 deaths. Multivariate analysis of risk factors for experiencing adverse events during follow up showed that participants in D'Amico Stages 4 and 5, with a baseline serum albumin level of 3.5 mg/dL or less, and 3 or more comorbidities were the most at risk. Conclusion: In a real-world setting, DAAs are safe and effective in older adults with HCV-related advanced fibrosis or cirrhosis. Individuals with preserved albumin synthesis and fewer than 3 comorbidities at baseline have the most to gain from long-term DAA therapy.

Original languageEnglish
Pages (from-to)85-91
Number of pages7
JournalJournal of the American Geriatrics Society
Volume66
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Hepacivirus
Fibrosis
Antiviral Agents
Comorbidity
Therapeutics
End Stage Liver Disease
Liver
Chronic Hepatitis C
Virus Diseases
Serum Albumin
Albumins
Hepatocellular Carcinoma
Appointments and Schedules
Multivariate Analysis
Genotype
Safety

Keywords

  • chronic hepatitis
  • direct-acting antivirals
  • HCV
  • octogenarians

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Hepatitis C Virus Clearance in Older Adults. / Ippolito, Antonio Massimo; Iacobellis, Angelo; Milella, Michele; Conti, Fabio; Messina, Vincenzo; Valvano, Maria Rosa; Niro, Grazia Anna; Morisco, Filomena; Barone, Michele; Termite, Antonio Patrizio; Brancaccio, Giuseppina; Andriulli, Angelo.

In: Journal of the American Geriatrics Society, Vol. 66, No. 1, 01.01.2018, p. 85-91.

Research output: Contribution to journalArticle

Ippolito, AM, Iacobellis, A, Milella, M, Conti, F, Messina, V, Valvano, MR, Niro, GA, Morisco, F, Barone, M, Termite, AP, Brancaccio, G & Andriulli, A 2018, 'Hepatitis C Virus Clearance in Older Adults', Journal of the American Geriatrics Society, vol. 66, no. 1, pp. 85-91. https://doi.org/10.1111/jgs.15140
Ippolito, Antonio Massimo ; Iacobellis, Angelo ; Milella, Michele ; Conti, Fabio ; Messina, Vincenzo ; Valvano, Maria Rosa ; Niro, Grazia Anna ; Morisco, Filomena ; Barone, Michele ; Termite, Antonio Patrizio ; Brancaccio, Giuseppina ; Andriulli, Angelo. / Hepatitis C Virus Clearance in Older Adults. In: Journal of the American Geriatrics Society. 2018 ; Vol. 66, No. 1. pp. 85-91.
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AU - Niro, Grazia Anna

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