Impact of age on the characteristics and medical care of chronic hepatitis C patients treated with direct-acting antivirals


Impact of age on the characteristics and medical care of chronic hepatitis C patients treated with direct-acting antivirals


Michel Doffoel1*, Frédéric Chaffraix1, Florence Ernwein1, Lucile Haumesser2, Simona Tripon1, Robert Bader3, Jean-Philippe Lang1, Anais Lang1, Dominique Paya4, Maude Royant1, Aurélie Velay-Rusch5, Martine Tebacher6, Nicolas Meyer2, François Habersetzer7, Thomas Baumert8

1Service expert de lutte contre les hépatites virales d’alsace (SELHVA) Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires, Strasbourg, France, +33608913605 2Groupe méthode en recherche clinique, Pôle de santé publique au travail, Hôpitaux universitaires, Strasbourg, France. 3Service d’hépato gastroentérologie, Groupement hospitalier régional mulhouse sud alsace, Mulhouse, France. 4Pharmacie, Hôpitaux universitaires, Strasbourg, France. 5Laboratoire de Virologie, Hôpitaux universitaires, Strasbourg, France. 6Centre régional de pharmacovigilance grand est, Hôpitaux universitaires, Strasbourg, France. 7Service d’hépato gastroentérologie, Pôle hépato-digestif, Nouvel hôpital civil, Hôpitaux universitaires, Strasbourg, France. 8Institut de recherche sur maladies virales et hépatiques, Inserm U1110, Université de Strasbourg, Strasbourg, France.


Aim: Chronic hepatitis C is more severe in elderly patients. In France, Direct Acting Antiviral therapy must be implemented via multidisciplinary team meetings in regional reference centers. This study aimed to define the impact of age on hepatitis C characteristics and medical care types across three groups: <50, 50-70, and >70-yo.

Methods: All patients with treated hepatitis C virus mono-infection during 8 to 24 weeks were included. Group comparison was based on 21 hepatitis C characteristic and medical care variables.

Results: Male predominance decreased in >50-yo (59.7% vs. 72.5%, p <0.001), disappearing in >70-yo (36.2%, p <0.001). The transmission route varied depending on age, with a sharp fall in drug-use transmission in >50-yo (27.8% vs. 51.9%, p=0.02) and increase in transfusion and nosocomial infection to 30% in >70-yo. Advanced fibrosis increased in >50-yo (57.5% vs. 41.5%, p <0.001), with nearly 2/3 of >70-yo affected. Psychiatric comorbidity incidence was halved in >70-yo (7.1% vs. 14.8%, p <0.01), excessive alcohol consumption was rare (<1%), and smoking significantly dropped with age, as did cannabis consumption (p <0.001). The care structure was not age-dependent, excepting a decreased use of addictology drug prevention and care centers in ≥50-yo. Using therapeutic patient education programs decreased with age (23.8% for >70-yo vs. 43.8% for <50-yo, p <0.01), while drug interaction frequency increased, reaching nearly 25% in >70-yo. Substained virological response 12 rates did not significantly differ across the three groups.

Conclusions: Age changes the characteristics and the medical care of hepatitis C, but has no impact on the cure rate.


Keywords: aging, antivirals, hepatitis, liver cirrhosis, managed care programs

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How to cite this article:
Michel Doffoel, Frédéric Chaffraix, Florence Ernwein, Lucile Haumesser, Simona Tripon, Robert Bader, Jean-Philippe Lang, Anais Lang, Dominique Paya, Maude Royant, Aurélie Velay-Rusch, Martine Tebacher, Nicolas Meyer, François Habersetzer, Thomas Baumert. PImpact of age on the characteristics and medical care of chronic hepatitis C patients treated with direct-acting antivirals. Open Journal of Gastroenterology and Hepatology, 2021, 4:56. DOI: 10.28933/ojgh-2021-10-1207


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