Title:Treatment of Chronic Hepatitis C Virus Using Direct Acting Antivirals in Geriatric Egyptian Patients
Volume: 16
Issue: 2
Author(s): Mahmoud Elkadeem*Shoman Rabeei Shoman
Affiliation:
- Department of Tropical Medicine & Infectious Diseases, Faculty of Medicine, Tanta University, Tanta,Egypt
Keywords:
Hepatitis C virus, direct acting antivirals, geriatric patients, ribavirin, chronic infection, vomiting.
Abstract:
Background & Aims: There is high proportion of geriatric patients
who acquired chronic hepatitis C virus infection. There is a shortage in evidence-
based data as regards direct-acting antivirals in this group of patients. The
aim was to assess safety, efficacy, and tolerability of direct acting antiviral drugs
in Egyptian geriatric patients.
Methods: This prospective study was performed on 177 patients with chronic hepatitis
C and administrated different regimens of direct acting antivirals. Patients
were divided into two groups: Group I: patients below 65 years old (N = 143),
and Group II: patients > 65 years old (N = 34). Pretreatment history taking, baseline
characteristics, and investigations were done for both groups. Follow up was
made to detect treatment efficacy and adverse effects.
Results: Geriatric group were found to have more comorbidities (diabetes mellitus,
hypertension, and cardiomyopathy); also liver cirrhosis. Minor adverse effects
occurred in both groups without significant difference included fatigue, insomnia,
headache, and dizziness. Vomiting, diarrhea, and skin rash occurred in
group II more than group I. Leucopenia, thrombocytopenia, jaundice, and significant
anemia occurred without significant difference between both groups. Eighteen
patients (25%) of 72 patients who took ribavirin had to reduce ribavirin dose
or to stop it. The overall treatment response in the entire study was 97.7% without
significant difference between both groups.
Conclusion: Direct acting antivirals are recommended regardless the age. These
drugs are effective and tolerable in elderly patients. Attention to other comorbidities,
drug-drug interactions, and follow up are recommended.
