Background
Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice.

/pdf/impact-of-safety-related-dose-reductions-or-discontinuations-47nongxa7y.pdf

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

https://www.gastroenterologyandhepatology.net/files/2015/05/saab1.pdf

Antiviral Therapy in Elderly Patients With Hepatitis C Virus Infection.

The standard of care (SOC) for the treatment of HCV genotype 2 (HCV-2) was pegylated interferon alpha plus ribavirin (PEG-IFN/RBV) at weight-based doses for a response-guided duration. The launches of sofosbuvir and daclatasvir in 2014 have resulted in new, better tolerated and shorter treatment. The combination of sofosbuvir and RBV for 12 weeks appears to be the new SOC in both European and American guidelines. The cost and therefore the access to this treatment remains a problem in many countries because of major economic constraints. For the few more difficult-to-treat patients, a combination of direct acting antivirals may be suitable and is being studied in ongoing trials. Because of rapidly changing treatment recommendations, the decision to treat HCV-2 patients with currently approved drugs or to wait until a better option is available in the future, must be made according to the stage of fibrosis.

Optimal therapy of genotype-2 chronic hepatitis C: what's new?

1ФГБОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава РФ, Москва, Российская Федерация 2Государственное учреждение здравоохранения «Свердловская областная клиническая больница No 1», г. Екатеринбург, Российская Федерация 3Общество с ограниченной ответственностью «Клиническая больница Центросоюза», Москва, Российская Федерация 4Государственное бюджетное учреждение здравоохранения Ставропольского края «Ставропольский краевой клинический центр специализированных видов медицинской помощи», г. Ставрополь, Российская Федерация 5ФГВОУ ВПО «Военно-медицинская академия им. С. М. Кирова» МО РФ, г. Санкт-Петербург, Российская Федерация 6Общество с ограниченной ответственностью Медицинская компания «Гепатолог», г. Самара, Российская Федерация 7ГБОУ ВПО «Ставропольский государственный медицинский университет» Минздрава РФ, г. Ставрополь, Российская Федерация 8Муниципальное бюджетное учреждение здравоохранения «Городская больница No 1 им. Н. А. Семашко», г. Ростов-на-Дону, Российская Федерация

Pegilated interferon alpha 2b «Pegaltevir» chronic hepatitis C treatment (randomized clinical trial)

Introduction: Hepatitis C virus (HCV) is a major public health problem especially in the elderly. The classical interferon/ribavirin regimen was unfavorable for elderly patents due to intolerability and adverse eects. More studies are needed about the safety profile of new direct-acting antiviral (DAA) in the elderly. Case Presentation: Here, a case of chronic HCV was described in a 65-year-old female with diabetes and low platelet count. The patient was treated successfully by a combination of sofosbuvir+ ribavirin without major side eects. Conclusions: This report highlighted the importance and the safety of this regimen to treat HCV in the elderly.

Sofosbuvir and Ribavirin to Treat Hepatitis C Virus Genotype 4 Infection in a 65-Year-Old Patient With Diabetes and Low Platelet: A Case Report

Summary

The population of patients with chronic hepatitis C viral infection is ageing; however, elderly, hepatitis C-infected patients are understudied and less frequently treated. This subanalysis of data from the multinational PROPHESYS study examined associations between age (≤65 vs >65 years), on-treatment virological response and sustained virological response (SVR) in patients treated with peginterferon alfa-2a (40KD)/ribavirin in accordance with local licences. PROPHESYS comprised three cohorts studied in 19 countries according to country-specific legal and regulatory requirements. This subanalysis includes treatment-naive HCV mono-infected patients assigned to receive peginterferon alfa-2a (40KD)/ribavirin, with 6276 individuals aged ≤65 years and 349 aged >65 years. Rapid virological response (RVR) rates by Week 4 were consistently lower in older genotype (G) 1 (21.6% vs 27.2% in younger patients), G2 (80.7% vs 85.1%) and G3 (60.0% vs 74.2%) patients. SVR rates were significantly lower (29.8% vs 43.0%) and relapse rates significantly higher (43.1% vs 26.7%) in older G1 patients (P = 0.0002 vs ≤65 years). In contrast, SVR and relapse rates were similar in G2 and G3 patients regardless of age. The positive predictive value of RVR for SVR was comparable in older and younger G1 patients (66.7% vs 68.6%, respectively) and higher in older G2 (80.7% vs 75.6%) and G3 (77.8% vs 66.8%) patients. Virological response rates are generally lower in elderly CHC patients, and RVR is a reliable positive predictor of SVR in patients >65 years.

Impact of age on viral kinetics of peginterferon alfa-2a/ribavirin in chronic hepatitis C: final analysis from the PROPHESYS cohort.

1108 selection of hcv genotype 1 patients for dual therapy with peginterferon alfa-2a/ribavirin with a high probability of sustained virologic response according to baseline characteristics alone

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Impact of age on viral kinetics of peginterferon alfa-2a/ribavirin in chronic hepatitis C: final analysis from the PROPHESYS cohort.

1108 selection of hcv genotype 1 patients for dual therapy with peginterferon alfa-2a/ribavirin with a high probability of sustained virologic response according to baseline characteristics alone