Poor Response to Pegylated Interferon and Ribavirin in Older Women Infected with Hepatitis C Virus of Genotype 1b in High Viral Loads

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Abstract
Background Response to treatment in patients with chronic hepatitis C, with reference to age and gender, has not been examined fully. Aim The influence of gender and age on treatment with pegylated interferon (PEG-IFN) and ribavirin was evaluated in a retrospective study. Methods PEG-IFN and ribavirin were given for 48 weeks to 179 men and 121 women infected with hepatitis C virus (HCV) of genotype 1b in high viral loads (>100 kIU/ml). Results Sustained virological response at 24 weeks after treatment was poorer in women than men who were aged ≥50 years (22% vs 53%, P < 0.001). Among the patients aged ≥50 years who had received ≥80% of the doses of PEG-IFN, ribavirin, or both, women responded less often than men (26% vs 64%, P < 0.001; 33% vs 61%, P = 0.022; and 32% vs 63%, P = 0.016; respectively). In multivariate analysis, male gender, retention of indocyanine green, ribavirin dose and compliance with therapy increased sustained virological response. Conclusions Response to combined PEG-IFN and ribavirin is poorer in female than male patients with hepatitis C who are aged ≥50 years, irrespective of compliance with treatment. Low estrogen levels in older women could be responsible for their impaired response to PEG-IFN and ribavirin.

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