Patients ineligible for HCV treatment due to age, comorbidities
LONDON — Age and comorbid medical conditions are the most important reasons patients are ineligible for treatment of chronic hepatitis C virus infection, according to data presented at The International Liver Congress.
Researchers from the University of Bologna, Italy, analyzed conditions for eligibility for treatment with pegylated interferon plus ribavirin in 1,118 patients with chronic HCV at 45 Italian health centers.
Approximately half (51.6%) of the patients were male, with a mean age of 55.5 years. The mean BMI was 25.2, with no differences in gender. According to the researchers, 23.8% of patients were aged 60 to 90 years — the most represented age decade in the cohort.
Most patients were diagnosed with chronic HCV without cirrhosis (87.7%), followed by those with compensated cirrhosis (9.5%), decompensated cirrhosis (2.1%) and hepatocellular carcinoma (0.6%). Most patients also had genotype 1 infection (47.3%), followed by genotype 2 (23.8%), genotype 3 (13.1%) and other HCV infection types (15.8%).
Common comorbidities included vascular disease (21.4%) and metabolic (12.2%) and psychiatric disorders (10.8%).
Almost 40% of the patients were judged ineligible for treatment with pegylated interferon plus ribavirin, primarily due to age (33.4%) and comorbidity (32.3%).
According to the researchers, more effective HCV therapies and proper management of comorbid conditions may increase the number of patients who are eligible for HCV treatment.
“Considering substantially shorter treatment durations with the addition of direct-acting antivirals, eligibility can be increased with careful evaluation of risk/benefit profile for individual patients along with efficient management of comorbidities,” they wrote.
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Disclosure: The study was supported by a grant from Merck.