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Hepatitis C Infection in the Elderly

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Abstract

Hepatitis C virus (HCV) infection in the elderly population is a global medical burden and healthcare utilization concern. The majority of patients with hepatitis C in the USA are “baby boomers,” who were born between 1945 and 1965. Consistently worldwide, HCV infection in elderly population is overrepresented and poses public health concerns. These individuals have been infected now for over two decades and are presenting with advanced liver disease. Traditionally, the use of pegylated interferon-based therapy has been limited in the elderly because of its adverse effects. The sustained virologic responses have also tended to be lower in the elderly than in younger adults. The emergence of non-interferon-based therapy with direct acting antiviral agents has expanded the pool of patients eligible for treatment. These agents have been found to be effective, tolerable, and safe in the elderly population.

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Abbreviations

HCV:

Hepatitis C virus

US:

United States

PegIFN:

Pegylated interferon

WHO:

World Health Organization

NHANES:

National Health and Nutrition Examination Survey

CHC:

Chronic hepatitis C

RBV:

Ribavirin

RNA:

Ribonucleic acid

ALT:

Alanine aminotransferase

HIV:

Human immunodeficiency virus

CI:

Confidence interval

OR:

Odds ratio

BMI:

Body mass index

HCC:

Hepatocellular carcinoma

SVR:

Sustained virologic response

BOC:

Boceprevir

TVR:

Telaprevir

SOF:

Sofosbuvir

DAA:

Direct acting antiviral

LDV:

Ledipasvir

NS3/4A:

Nonstructural protein 3–4A

NS5A:

Nonstructural protein 5A

NS5B:

Nonstructural protein 5B

HSC:

Hepatic stellate cell

ECM:

Extracellular matrix

TGF:

Transforming growth factor

IU:

International unit

SD:

Standard deviation

DR:

Discontinuation rate of treatment

NR:

Not reported

n :

Sample size

N :

Population size

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Authors and Affiliations

  1. Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

    Sammy Saab

  2. Department Surgery, University of California at Los Angeles, Los Angeles, CA, USA

    Sammy Saab

  3. Department of Medicine, Harbor-University of California at Los Angeles Medical Center, Torrance, CA, USA

    Justin Rheem

  4. Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Vinay Sundaram

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  1. Sammy Saab
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Correspondence to Sammy Saab.

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Saab, S., Rheem, J. & Sundaram, V. Hepatitis C Infection in the Elderly. Dig Dis Sci 60, 3170–3180 (2015). https://doi.org/10.1007/s10620-015-3717-6

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