Women With Chronic Hepatitis C Virus Infection

Recommendations for Clinical Practice

Mary Jane Burton, MD; James B. Brock, MD; Stephen A. Geraci, MD


South Med J. 2013;106(7):422-426. 

In This Article

Effect of Sex and Age on Treatment Response

The primary goal of treatment of HCV is the prevention of cirrhosis and hepatocellular carcinoma by eradicating the virus. The surrogate marker for viral eradication is a sustained virologic response (SVR), defined as an undetectable serum HCV viral load 6 months after completing therapy. Studies of hepatic C therapeutics that examined SVR rates by sex reported conflicting findings. Overall, men and women appear to have equal responses to pegylated interferon and ribavirin.[34,35] When stratified by age, however, SVR rates for women dramatically decline with older age, a phenomenon that has not been observed in men[36–38] (Table 1). Similar to their protective effects on the progression of liver disease, higher estrogen states are hypothesized to promote SVR.[37] Studies of telaprevir or boceprevir in combination with pegylated interferon and ribavirin illustrate equivalent response rates among men and women with genotype 1 HCV[39–42] (Table 2). These studies did not further stratify women by age, although in some studies older age was associated with overall lower rates of SVR.[35,43]