Hepatitis C Treatment in Elderly Patients

Abstract

The patients with chronic hepatitis C (CHC) are geting older and the demands for treatment to those patients are increasing due to the high risk of development of hepatocellular carcinoma. Elderly patients were previously deined as 60 years and over, however deinition of the elderly patients shifted to be older year to year. Interferon (IFN) and ribavirin combination therapy was signiicantly improved eicacy of treatment, however ribavirin induces anemia, resulted in lower eicacy due to reduction of ribavirin for the elderly patients. And eicacy of over 60 years old was comparable to the patients under 60 years. In the CHC patients with genotype 1, the eicacy of elderly patient was signiicantly lower than that of younger patients, especially in female. Direct-acting antivirals (DAAs) therapy makes treatment eicacy improved to over 90% and side efect of treatment was dramatically reduced compared to IFN-based therapy. The eicacy of dual oral therapy by using asunaprevir (ASV) and daclatasvir (DCA) for elderly patients with hepatitis C virus (HCV) genotype 1b has not been fully clariied. In this article we would like to show the eicacy of elderly patients with CHC, especially patients infected with genotype 1b, from the era of IFN monotherapy to the era of new DAAs.

Oral administration of branched-chain amino acids ameliorates high-fat diet-induced metabolic-associated fatty liver disease via gut microbiota-associated mechanisms

“…BCAAs supplementation in obese/diabetic mice appears to suppress hepatic de novo lipogenesis and promote adipocyte lipolysis, causing abnormal lipolysis and hyperlipidemia, and liver injury (Zhang et al, 2016;Iwao et al, 2020;Zhao et al, 2020). In contrast, research on nonalcoholic steatohepatitis mice showed that BCAAs supplementation alleviated hepatic steatosis and liver injury by suppressing the expression of lipogenesis-related genes and proteins (Honda et al, 2017). Thus, it is necessary to further clarify the effect of BCAAs on the liver and the possible mechanisms.…”

Semaglutide ameliorates metabolism and hepatic outcomes in an NAFLD mouse model

“…L-Isoleucine is a Branchedchain amino acids (BCAA). Previous studies have reported that BCAAs can promote fatty acid b-oxidation and ketone body production (19). b-oxidation is thought to be the main mechanism of hepatic lipid reduction and is involved in the upregulation of peroxisome and mitochondrial genes (20).…”