- Direct-acting antivirals (DAAs) are highly effective and safe for elderly patients with HCV infection.
- Nonserious adverse events are more common, particularly ribavirin-related anemia.
Why this matters
- Elderly patients have an increased risk for HCV, mainly explained by high infection rates among baby-boomers born between 1945 and 1965.
- Meta-analysis of 63 studies involving 34,082 DAA-treated patients; 15 were randomized controlled trials, 17 were prospective studies, and 28 were retrospective cohort studies.
- Primary outcome: sustained virologic response (SVR).
- Funding: None.
- Pooled SVR rates were similar with age ≥65 vs
- Non-SVR risk was comparable with age ≥65 vs 2=13%; P=.21) or publication bias.
- In subanalysis, non-SVR risk was lower among cirrhotic patients aged ≥65 years (RR=0.59; P=.044), but similar vs age
- Treatment-experienced (P=.880).
- Across genotypes (P=.24).
- Across DAA regimens (P=.14).
- Some overlapping study populations.
- Heterogeneity in adverse event reporting, regimen protocols.