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Original Article

Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey

Yusuf Önlen 1 , Tayibe Bal 1 , Mehmet Çabalak 1 , Nefise Çuvalcı Öztoprak 2 , Nagehan Didem Sarı 3 , Behice Kurtaran 4 , Ebubekir Şenateş 5 , Alper Gündüz 6 , Esra Zerdali 7 , Hasan Karsen 8 , Ayşe Batırel 9 , Rıdvan Karaali 10 , Rahmet Güner 11 , Tansu Yamazhan 12 , Şükran Köse 13 , Nurettin Erben 14 , Nevin İnce 15 , İftihar Köksal 16 , Figen Sarıgül Yıldırım 17 , Gülşen Yörük 18 , Süheyla Kömür 19 , Sibel Kaya 20 , Şaban Esen 21 , Özgür Günal 22 , İlknur Esen Yıldız 23 , Dilara İnan 24 , Şener Barut 25 , Mustafa Namıduru 26 , Selma Tosun 27 , Kamuran Türker 28 , Alper Şener 29 , Kenan Hızel 30 , Nurcan Baykam 31 , Fazilet Duygu 32 , Esragül Akıncı 33 , Güray Can 34 , Ülkü User 19 , Hanefi Cem Gül 35 , Ayhan Akbulut 36 , Güven Çelebi 37 , Mahmut Sünnetçioğlu 38 , Oğuz Karabay 39 , Hayat Kumbasar Karaosmanoğlu 40 , Fatma Sırmatel 41 , Fehmi Tabak 42
1.

Mustafa Kemal University Faculty of Medicine, Antakya, Turkey

2.

Antalya Training and Research Hospital, Antalya, Turkey

3.

İstanbul Training and Research Hospital, İstanbul, Turkey

4.

Çukurova University Faculty of Medicine, Adana, Turkey

5.

Department of Gastroenterology, Medeniyet University Faculty of Medicine, İstanbul, Turkey

6.

Department of Infectious Diseases, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey

7.

Department of Infectious Diseases, Haseki Training and Research Hospital, İstanbul, Turkey

8.

Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Urfa, Turkey

9.

Department of Infectious Diseases, Kartal Training and Research Hospital, İstanbul, Turkey

10.

Department of Infectious Diseases and Clinical Microbiology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey

11.

Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey

12.

Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey

13.

Department of Infectious Diseases, Tepecik Training and Research Hospital, İzmir, Turkey

14.

Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osman Gazi University, Eskişehir, Turkey

15.

Department of Infectious Diseases and Clinical Microbiology, Düzce University Faculty of Medicine, Düzce, Turkey

16.

Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey

17.

Department of Infectious Diseases, Antalya Training and Research Hospital, Antalya, Turkey

18.

Department of Infectious Diseases, İstanbul Training and Research Hospital, İstanbul, Turkey

19.

Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey

20.

Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey

21.

Department of Infectious Diseases and Clinical Microbiology, Samsun 19 Mayıs University Faculty of Medicine, Samsun, Turkey

22.

Department of Infectious Diseases, Samsun Training and Research Hospital, Samsun, Turkey

23.

Department of Infectious Diseases and Clinical Microbiology, RTE University Faculty of Medicine, Rize, Turkey

24.

Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey

25.

Department of Infectious Disease and Clinical Microbiology, Gaziosmanpasa University Medical Faculty, Tokat, Turkey

26.

Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey

27.

Department of Infectious Diseases, Bozyaka Training and Research Hospital, İzmir, Turkey

28.

Department of Infectious Diseases, Bağcılar Training and Research Hospital, İstanbul, Turkey

29.

Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey

30.

Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey

31.

Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey

32.

Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey

33.

Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey

34.

Department of Gastroenterology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey

35.

Department of Infectious Diseases, Gülhane Training and Research Hospital, Ankara, Turkey

36.

Department of Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey

37.

Department of Infectious Diseases and Clinical Microbiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey

38.

Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey

39.

Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Hatay, Turkey

40.

Department of Infectious Diseases, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey

41.

Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey

42.

İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty of Medicine, İstanbul, Turkey

Turk J Gastroenterol 2022; 33: 862-873
DOI: 10.5152/tjg.2022.21271
Keywords : Age, chronic hepatitis C, direct-acting antiviral agents, elderly, Turkey
Read: 1565 Downloads: 660 Published: 01 October 2022
Volume 33, Issue 10, October 2022
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Background: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C.

Methods: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups.

Results: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively).

Conclusion: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.

Cite this article as: Önlen Y, Bal T, Çabalak M, et al. Efficacy and safety of direct-acting antivirals in elderly patients with chronic hepatitis C: A nationwide real-life, observational, multicenter study from Turkey. Turk J Gastroenterol. 2022;33(10):862-873.

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