Treatment Response and Tolerability of Pegylated Interferon-α Plus Ribavirin Combination Therapy in Elderly Patients (≥ 65 years) With Chronic Hepatitis C in Korea

Background: the prevalence of hepatitis c virus (hcv) infections in elderly patients has been increasing in a number of countries. a few reports concerning pegylated interferon-α (peg-ifn-α)-based combination treatment in elderly chronic hepatitis c (chc) patients have been published, with slightly different treatment outcomes.objectives: we investigated the treatment response and safety of peg-ifn-α plus ribavirin combination therapy in elderly patients with chc.patients and methods: among a total of 181 treatment-naive chc patients (60 patients with genotype 1, 121 patients with genotype 2 or 3), 38 were aged . 65 years (defined as the elderly group) and 143 were aged < 65 years (defined as the non-elderly group).results: the overall sustained virologic response (svr) was lower in the elderly group than in the non-elderly group, but it was not significantly different (65.8 % vs. 76.2 %, p = 0.15). in a subgroup analysis, among patients with genotype 1, the elderly group had a significantly lower svr rate than the non-elderly group (30.8 % vs. 66.0 %, p = 0.03). however, the svr rate in patients with hcv genotype 2 or 3 was comparable between the two groups (84.0 % vs. 81.3 %, p = 0.85). hcv genotype was significantly associated with svr in the elderly patients (genotype 1 vs. 2 or 3, odds ratio: 0.18, 95% confidence interval: 0.000-0.869, p = 0.03). the incidence of premature discontinuation of treatment (21.1 % vs. 9.1 %, p = 0.05) and dose modification (52.6 % vs. 31.5 %; p = 0.02) due mainly to adverse events or laboratory abnormalities,were higher in the elderly group than in the non-elderly group.conclusions: peg-ifn-α plus ribavirin combination therapy might be considered for elderlychc patients, especially for genotype 2 or 3, with vigilant monitoring of adverse events.