Direct-acting antiviral (DAA) therapy is highly efficacious for the treatment of hepatitis C virus (HCV) infection in older adults; however, those aged ≥75 years are more likely to have clinically significant pretreatment drug-drug interactions (DDIs) and experience adverse events (AEs) during therapy. This according to a retrospective review between June 2014 and January 2017 that included individuals aged ≥65 years treated with DAA therapy for HCV during the study period (n=113) divided into 2 cohorts: aged 65 to 74 years (n=88) and aged ≥75 years (n=25). DDIs, AEs, and rates of sustained virologic response (SVR) with DAA therapy were assessed. Among the findings:
- SVR rate was 97.7% in those aged 65 to 74 years and 95.8% in those aged ≥75 years.
- Individuals aged ≥75 years were more likely to be taking >2 medications per day for chronic conditions and more likely to have clinically significant DDIs necessitating cessation or adjustment of medications before inauguration of DAA therapy.
- Those aged ≥75 years were also more likely to experience an AE during therapy.
Mazzarelli C, Considine A, Childs K, et al. Efficacy and tolerability of direct-acting antivirals for hepatitis C in older adults. [Published online ahead of print May 25, 2018]. J Am Geriatr Soc. doi:10.1111/jgs.15392.
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Glecaprevir/Pibrentasvir Efficacy & Safety Assessed, J Hepatol; ePub 2018 Nov 23; D’Ambrosio, et al
HCV Infection Among Children & Young Persons, J Hepatol; ePub 2018 Nov 26; Modin, et al
HCV Patients with Limited Access to Antiviral Therapy, Dig Liver Dis; ePub 2018 Nov 29; Lens, et al
Progression in the Elimination of HCV Infection, PLoS One; ePub 2018 Dec 4; Juanbeltz, et al
Increased HCV Screening in Veteran Populations, Jt Comm J Qual Patient Saf; ePub 2018 Sep 25; Wray, et al