The prevalence of hepatitis C virus (HCV)
infection in elderly patients has been increasing in Japan. However, there are no reports on the safety and efficacy of the triple
therapy of
telaprevir, peginterferon, and
ribavirin for elderly patients with chronic HCV
infection. This study evaluated the safety and efficacy of triple
therapy [12 weeks of
telaprevir 1,500 mg/day,
reduction dose, and 24 weeks of peginterferon and
ribavirin] in 18 elderly Japanese patients aged >65 years, with
chronic infection with HCV genotype 1b. Four patients received triple
therapy with
telaprevir 2,250 mg/day and the other 14 patients received
telaprevir 1,500 mg/day. Sustained virological response-12 (HCV
RNA negativity at 12 weeks after completion of
therapy) was 50% (9 of 18 patients); while 4 of 18 (22%) patients discontinued triple
therapy due to adverse events (skin rashes,
anemia, poor appetite). The dose of
telaprevir did not affect HCV
RNA clearance rates. Regardless of the dose, 50% of the treated patients achieved sustained virological response-12, evaluated by intention-to-treat analysis. Furthermore, the fall in
hemoglobin and the rise in serum
creatinine were significantly milder in the
telaprevir 1,500 mg group than the
telaprevir 2,250 mg/day group. Further analysis showed that 67% (6 of 9 elderly patients) with IL28B gene (rs8099917) genotype TT, treated with
telaprevir 1,500 mg, achieved sustained virological response-12. These results suggest that 24-week triple
therapy with
telaprevir 1,500 mg seems safe and efficacious for elderly Japanese patients infected with HCV genotype 1b.