西北地区老年慢性丙型肝炎患者抗病毒治疗疗效和安全性

Objective To investigate the demographic characteristics of elderly patients with chronic hepatitis C(CHC) in Northwestern China, and to evaluate the clinical efficacy and safety of direct-acting antiviral agents(DAAs) therapy in this population. Methods A retrospective cohort study was conducted in 123 patients aged 65 years or older with chronic hepatitis C(CHC) who received DAAs treatment at 11 clinical centers in Northwest China from December 2017 to November 2024. We collected baseline clinical data and clinical characteristics at pre-treatment and 12 weeks post-DAA therapy completion. The primary endpoint was the situation of sustained virological response(SVR12) at 12 weeks, and the secondary endpoints were safety. Results Totally, 123 patients were enrolled in the intention-to-treat analysis(ITT), and 102 patients were included in the per-protocol analysis(PP). Of the 102 patients, the median age 69.5 years, 63.4% liver cirrhosis, 1.1% HBsAg+, 11.6% renal dysfunction. For ITT analysis, the SVR12 rate was 82.9%(102/123, 95%CI: 75.1～89.1%), and in PP analysis, all 102 patients obtained SVR12(100%). Compared with baseline at post-treatment 12-weeks, liver function and liver fibrosis improved significantly. Overall adverse events rate was 9.8%(10 patients). Severe adverse events occurred in 1 patient, fatigue(5.4%) was the most common adverse event. No patients died or discontinued treatment during follow-up. Conclusion Among elderly patients with CHC in Northwest China, treatment with DAAs has resulted in high SVR12 rates, good overall efficacy, and good to lerability.