Hepatitis C treatment difficult in older patients

NEW YORK (Reuters Health) - Because of side effects, patients over the age of 60 with hepatitis C find it more difficult to stick with standard treatments than do their younger counterparts, according to a study in Japan.

Impaired heart, lung and kidney function can make older patients more susceptible to anemia induced by ribavirin, one of the drugs used for treating hepatitis C, explain Dr. Yoshiaki Iwasaki, from Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and colleagues.

Iwasaki's group analyzed outcomes among 208 patients with chronic hepatitis C. The treatment involved injections of interferon daily for 2 weeks then three times weekly for 22 weeks, and daily ribavirin.

The researchers report in the medical journal Hepatology that only 92 (44 percent) continued without dose reductions until the end of treatment.

Rates of discontinuation or dose reduction were 38 percent in those younger than 50 years old, 48 percent in those between 50 and 59, and 77 percent in patients 60 or older.

Overall, the treatment was successful in eliminating the hepatitis C virus in 37 percent of the patients, with age being associated with a poorer response rate.

"Treatment schedule should be modified, or other therapeutic modalities should be considered for older patients with chronic hepatitis C," Iwasaki's group concludes.

SOURCE: Hepatology, January 2006.