For Older Adults, Newer Hepatitis C Treatments are Safe and Effective

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Journal of the American Geriatrics Society Research Summary

Viral hepatitis is a disease that causes inflammation of the liver. There are three viruses responsible for most cases of the disease: hepatitis A, B, and C. Hepatitis A is typically caused by consuming contaminated food or water.  Hepatitis B and C usually occur when someone comes in contact with infected bodily fluids, such as blood. The severity of hepatitis can range from a mild illness lasting a few weeks to a serious, lifelong illness.

In 2016, there were an estimated 2.4 million people living with hepatitis C, one of the more severe forms of the disease, in the United States. A hepatitis C infection can be particularly serious for older adults, since many don’t seek treatment until the condition is in advanced stages. What’s more, hepatitis C is considered harder to treat for older people who have lived with the condition for a long time compared to younger people are.  Treatment is often unsuccessful, too, because many of the common treatment options aren’t easy for older adults to tolerate or may no longer be effective as our body changes with age.

Thankfully, newer treatments known as interferon-free direct-acting antivirals offer a promising approach to addressing hepatitis C.  These medications offer cure rates of more than 90 percent in clinical trials and in real life, but they haven’t been studied extensively for older adults. A team of researchers studied this issue and published their findings in the Journal of the American Geriatrics Society. The researchers examined how well people older than 65 tolerated interferon-free direct-acting antivirals compared with younger patients.

The researchers included 1,151 people living with hepatitis C in their study. More than 630 participants were younger than 65; 516 patients were 65-years-old or older. The researchers observed that the older adults had more severe liver disease, along with other conditions such as diabetes, high blood pressure, high cholesterol, and chronic kidney disease, compared to the younger adults. However, the treatment resulted in high cure rates for older adults.

“Our results provide strong evidence that interferon-free direct-acting antiviral therapy in patients aged 65 years and older offers similar effectiveness as it does in younger patients,” said the researchers. The researchers also said that older adults should be treated as early as possible, since hepatitis C causes liver damage as people age.

The researchers concluded that the age of the patient did not seem to impact the effectiveness of interferon-free direct-acting antivirals, even though many of the older study participants were taking other medications at the same time. Ultimately, the researchers said older adults should have the opportunity to benefit from the high cure rates and health benefits associated with interferon-free direct-acting antiviral therapy.

This summary is from “Efficacy of Direct-Acting Antivirals for Chronic Hepatitis C in a Large Cohort of Older Adults in the United States.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Calvin Q. Pan, MD; Vijay Gayam, MD: Charles Rabinovich, BS; Milana Normatov, PhamD4; Bazhena Fidman, PhamD; Dan Wang, BS; and Pavani Garlapati, MD.

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