摘要老年患者是丙型肝炎治疗管理中需要特别关注的群体,其HCV暴露时间长,肝脏本身病变和肝外并发症进展风险高.随着直接抗病毒药物(DAA)的问世,慢性丙型肝炎治疗疗效明显提高,老年患者也能获得＞90%的病毒学治愈率,且用药安全.但老年患者往往基础疾病多伴随用药复杂,由此产生的药物相互作用(DDI)更增加了治疗管理的挑战性.本文重点综述了DAA治疗前老年患者全面评估的要求,包括肝肾功能、合并用药以及潜在的DDI,在此基础上制定合适的治疗方案.治疗期间需要密切监测可能出现的不良事件和DDI以便采取积极干预措施.

abstractsElderly patients have become a special concern in the management of hepatitis C .Their HCV exposure time is long and the risk of liver disease and extrahepatic complications is high .With the advent of direct antiviral drugs (DAA), the treatment of chronic hepatitis C has been significantly improved , and the cure rate of virology can be more than 90% in the elderly patients , with a high safety.However, elderly patients often have more underlying diseases and the drug use will be more complicated , resulting in drug interaction ( DDI) and increasing the challenge of treatment management.This article reviews the requirements for comprehensive evaluation of elderly patients before DAA treatment , including liver and kidney function, combined drug use and potential DDI.The monitoring of adverse events and DDI , and the countermeasures are also discussed in the article.