Abstract:

Introduction: Direct-acting antiviral agents are highly effective and safe treatments for chronic hepatitis C infection; however, the treatment may be more problematic in elderly patients due to accompanying comorbid conditions. This study aimed to assess the efficacy and safety of direct-acting antiviral agents among the hepatitis C virus genotype 1 infected Turkish elderly population (≥65 years). Materials and Method: Ninety-six patients older than 18 years old treated with direct-acting antiviral regimens (sofosbuvir/ledipasvir ± ribavirin or ombitasvir/paritaprevir/ritonavir + dasabuvir ± ribavirin) were included in the study: 48 patients (50%) constituted Group 1 (<65 years) and 48 (50%) constituted Group 2 (≥65 years). Comorbidities, potential drug-drug interactions, the number of interacting drugs, adverse events, and sustained virologic response rates were evaluated and compared between the groups. Results: Sustained virologic response rates were 100% for both of the groups, except for the two patients with substance abuse in Group 1 who dropped from the study. Patients in Group 2 had more cirrhosis (p = 0.005) and respiratory diseases (p = 0.037). There was no significant difference between the two groups in terms of side effects (p = 0.683); however, side effects were significantly higher in the elderly group with two or more potential drug interactions (p = 0.049). The presence of cardiovascular disease was also found to be associated with more side effects in the elderly (p = 0.022). Conclusion: Direct-acting antiviral regimens are highly effective in elderly patients without a significant increase in the risk of side effects.

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