Rodríguez-Osorio, IriaMena, ÁlvaroMeijide, HéctorMorano, LuisDelgado, ManuelCid-Silva, PurificaciónMargusino-Framiñán, LuisPedreira Andrade, José DomingoCastro-Iglesias, Ángeles2019-06-172019-06-172019-06-03Rodríguez-Osorio I, Mena A, Meijide H, Morano L, Delgado M, Cid P, Margusino L, Pedreira JD, Castro Á. Liver-related events and mortality among elderly patients with advanced chronic hepatitis C treated with direct-acting antivirals. PLoS One. 2019 Jun 3;14(6):e0217052.1932-6203http://hdl.handle.net/2183/23228Research article[Abstract] BACKGROUND: Direct-acting antivirals (DAAs) are effective in patients aged ≥65 years. However, little is known about the effects of DAAs on survival, liver decompensation and development of hepatocellular carcinoma (HCC). OBJECTIVE: To compare the incidence of liver-related events and mortality between patients aged ≥65 and <65 years. METHODS: Prospective study comparing patients aged ≥65 and <65 years treated with DAAs. The incidence of liver-related events and mortality, and HCC was compared between age groups. RESULTS: Five hundred patients (120 aged ≥65 and 380 aged <65 years) were included. The incidence of liver-related events was 2.62 per 100 patient-years (py) in older and 1.41/100 py in younger patients. All-cause mortality was 3.89 and 1.27/100 py in older and younger patients, respectively. The respective liver-related mortality rates were 1.12 and 0.31/100 py. In patients with cirrhosis (stage F4), all-cause mortality (P = 0.283) and liver-related mortality (P = 0.254) did not differ between groups. All five liver-related deaths were related to multifocal HCC. The incidence of HCC was 1.91 and 1.43 per 100 py in the older and younger groups, respectively (P = 0.747). The diagnosis of HCC was 8 months after the end of treatment. CONCLUSIONS: The incidence of liver-related events and liver-related mortality was low in older people treated with DAAs and was similar to that in younger patients. The extra mortality in people aged ≥65 years treated with DAAs seems to be secondary to non-liver-related causes. These results support the utilization of DAAs in patients aged ≥65 years.engCreative Commons Attribution 4.0 International LIcense (CC-BY 4.0)http://creativecommons.org/licenses/by/4.0/journal articleopen access