Abstract
Key Summary PointsAimWhat are the real-world efficacy and safety of direct-acting antivirals (DAAs) in old chronic HCV population?FindingsThe overall sustained virological response rate was 98.9%. Higher albumin, higher platelet count, lower bilirubin and lower stage of fibrosis were among predictors of favorable response.MessageDifferent DAAs regimens were safe and effective in old patients with chronic HCV. AbstractBackground and aimOld people with chronic hepatitis C (HCV) were considered a difficult-to-treat category with more frequent adverse events until recently. Interferon-free direct-acting antivirals (DAAs) improved treatment adherence and quality of life of old patients. In this study, we aimed at reporting the real-world efficacy and safety of DAAs, in addition to predictors of sustained virological response (SVR) in old chronic HCV population.MethodsThis is a prospective observational intention-to-treat analysis that included old chronic hepatitis C genotype-4 patients (>65years) treated in a single specialized viral hepatitis treatment center in Egypt. Treatment regimens were allocated according to national guidelines for treatment of hepatitis C. Primary outcome was undetectable HCV-RNA at 12-week post-treatment by PCR. Secondary outcomes were identification of predictors of SVR and assessment of safety related issues.ResultsOur study included 864 patients (64% females) with mean age of 67.72.8years. Overall SVR rate was 98.9% while SVR rates for sofosbuvir/daclatasvir/ribavirin, paritaprevir/ombitasvir/ritonavir/ribavirin, sofosbuvir/daclatasvir, sofosbuvir/ledipasvir/ribavirin, sofosbuvir/simeprevir/daclatasvir/ribavirin, sofosbuvir/simeprevir, interferon/sofosbuvir/ribavirin and sofosbuvir/ribavirin were 100%, 100%, 100%, 100%, 100%, 99.3%, 98% and 94.2%, respectively. DAAs were well tolerated. None of the patients discontinued the treatment due to adverse effects. Higher albumin, higher platelet count, lower bilirubin and lower stage of fibrosis were among predictors of favourable response.Conclusion Different DAAs regimens were safe and effective in old Egyptian patients with chronic HCV.