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Liver-related events and mortality among elderly patients with advanced chronic hepatitis C treated with direct-acting antivirals.


ABSTRACT:

Background

Direct-acting antivirals (DAAs) are effective in patients aged ?65 years. However, little is known about the effects of DAAs on survival, liver decompensation and development of hepatocellular carcinoma (HCC).

Objective

To compare the incidence of liver-related events and mortality between patients aged ?65 and <65 years.

Methods

Prospective study comparing patients aged ?65 and <65 years treated with DAAs. The incidence of liver-related events and mortality, and HCC was compared between age groups.

Results

Five hundred patients (120 aged ?65 and 380 aged <65 years) were included. The incidence of liver-related events was 2.62 per 100 patient-years (py) in older and 1.41/100 py in younger patients. All-cause mortality was 3.89 and 1.27/100 py in older and younger patients, respectively. The respective liver-related mortality rates were 1.12 and 0.31/100 py. In patients with cirrhosis (stage F4), all-cause mortality (P = 0.283) and liver-related mortality (P = 0.254) did not differ between groups. All five liver-related deaths were related to multifocal HCC. The incidence of HCC was 1.91 and 1.43 per 100 py in the older and younger groups, respectively (P = 0.747). The diagnosis of HCC was 8 months after the end of treatment.

Conclusions

The incidence of liver-related events and liver-related mortality was low in older people treated with DAAs and was similar to that in younger patients. The extra mortality in people aged ?65 years treated with DAAs seems to be secondary to non-liver-related causes. These results support the utilization of DAAs in patients aged ?65 years.

SUBMITTER: Rodriguez-Osorio I 

PROVIDER: S-EPMC6546209 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Liver-related events and mortality among elderly patients with advanced chronic hepatitis C treated with direct-acting antivirals.

Rodríguez-Osorio Iria I   Mena Alvaro A   Meijide Héctor H   Morano Luis L   Delgado Manuel M   Cid Purificación P   Margusino Luis L   Pedreira José Domingo JD   Castro Ángeles Á  

PloS one 20190603 6


<h4>Background</h4>Direct-acting antivirals (DAAs) are effective in patients aged ≥65 years. However, little is known about the effects of DAAs on survival, liver decompensation and development of hepatocellular carcinoma (HCC).<h4>Objective</h4>To compare the incidence of liver-related events and mortality between patients aged ≥65 and <65 years.<h4>Methods</h4>Prospective study comparing patients aged ≥65 and <65 years treated with DAAs. The incidence of liver-related events and mortality, and  ...[more]

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