Older hepatitis C patients prove difficult to treat

Chronic hepatitis C virus (HCV) was seen in the Japanese population decades before the US, with the result that HCV patients in Japan are 10 to 15 years older than patients in western countries.

The standard treatment is combination therapy with interferon or pegylated interferon and the antiviral drug ribavirin. However, this treatment tends to be associated with adverse effects that lead to either a dose reduction or discontinuation of therapy in up to 28% of patients.

Researchers at Okayama University in Japan recruited 208 HCV patients and scheduled them for 24 weeks of combination therapy with interferon and ribavirin. In total, 56% had to discontinue therapy or reduce their dosage due to adverse effects. Furthermore, the older the patient, the more likely it was that this was the case. The older group also showed a tendency toward a lower sustained virological response.

The researchers suggest that when treating hepatitis C with combination therapy it is important to take patient age into consideration especially when the individual is 60 years of age or older. They stress the importance of patient education and support to maximize patient compliance in completing the treatment regimen.

Although the study involved only Japanese patients, it should be noted that approximately 35,000 new HCV infections occur each year in the US; the proper treatment of older patients with chronic hepatitis C may therefore become an emerging problem in this country.