Artículos de revistas
Impact of age on viral kinetics of peginterferon alfa-2a/ribavirin in chronic hepatitis C: Final analysis from the PROPHESYS cohort
Fecha
2014-01-01Registro en:
Journal of Viral Hepatitis, v. 21, n. 5, p. 377-380, 2014.
1365-2893
1352-0504
10.1111/jvh.12179
2-s2.0-84898426682
Autor
University of Chicago Medical Center
Clinical Hospital Dr. I. Cantacuzino
Matei Bals Infectious Diseases Institute
Unità Operativa Epatologia Ed Ecografia Interventistica Ospedale Gragnano
Clinic for Infectious Disease, Clinical Center Serbia
Divisione di Medicina Interna, Ospedale Regina Margherita
Royal Free and University College School of Medicine
2nd Department of Medicine, Semmelweis University
Hôpital Beaujon
Azienda Ospedaliero-Universitaria di Parma
High Desert Gastroenterology Suite B
Botucatu School of Medicine
Divisione di Medicina, Ospedale Elena d'Aosta
IST GmbH
F. Hoffmann-La Roche
Genentech
Hospital de Clinicas de Porto Alegre
Institución
Resumen
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. © 2013 John Wiley & Sons Ltd.