{"created":"2023-07-27T06:53:20.183848+00:00","id":47860,"links":{},"metadata":{"_buckets":{"deposit":"b6aceec3-013a-4a1e-b7f4-b8f572af070d"},"_deposit":{"created_by":18,"id":"47860","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"47860"},"status":"published"},"_oai":{"id":"oai:kanazawa-u.repo.nii.ac.jp:00047860","sets":["1132:1133:1134"]},"author_link":["77802","85318","62","85321","550","26139"],"item_4_biblio_info_8":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"380","bibliographicPageStart":"375","bibliographicVolumeNumber":"54","bibliographic_titles":[{"bibliographic_title":"日本老年医学会雑誌"},{"bibliographic_title":"Japanese Journal of Geriatrics","bibliographic_titleLang":"en"}]}]},"item_4_creator_33":{"attribute_name":"著者別表示","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"Ishida, Kosuke"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"Shimakami, Tetsuro"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"Kaneko, Shuichi"}],"nameIdentifiers":[{},{}]}]},"item_4_description_21":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"Aim: Antiviral treatment for hepatitis C infection in elderly patients has been dramatically improved by direct-acting antivirals (DAAs). DAAs are easy to use as they are administered orally and the treatment periods are shorter. Furthermore, they are associated with fewer adverse effects. In this study, we sought to analyze the efficacy and safety of DAAs in HCV-infected elderly patients.\nMethod: We analyzed 223 HCV-infected patients who were treated with DAAs in Kanazawa University Hospital, Japan. As of August 31, 2016, all of the patients were observed to have achieved a sustained viral response by the 12th week of treatment (SVR12). We categorized patients into two groups. Group one included 79 patients (average age 75.5 years; range 70-85 years). Group two included 144 patients (average age, 58.1 years; range 27-69 years). Group one included more female patients.\nResults: The platelet count of Group one was significantly lower than that of Group two. The FIB-4 index of Group one was significantly higher than that of Group two. Group one included a greater number of patients with a history of hepatocellular carcinoma (HCC) before the administration of DAAs. The SVR12 rate and rate of drop-out due to adverse effects did not differ between the two groups to a statistically significant extent. The rate of HCC occurrence after SVR in Group one was higher than that in Group two.\nConclusion: Our study shows that DAAs can be used for older patients and that the antiviral efficacy and safety are similar to the efficacy and safety in younger patients.","subitem_description_type":"Abstract"},{"subitem_description":"目的：C型慢性肝疾患に対する抗ウイルス療法は，直接作用型抗ウイルス薬（以下DAA）の登場で高率にウイルス駆除が可能となった．今回，当院においてDAAによる抗ウイルス療法を施行したC型慢性肝疾患症例を対象として，高齢者に対するDAAの有効性，安全性を検討した．方法：金沢大学附属病院においてDAAを導入したC型慢性肝疾患症例のうち，2016年8月までに治療終了後12週間目の持続的ウイルス学的著効（Sustained Viral Response at week 12 after treatment is completed：SVR12）の判定が可能であった223例を対象とした．治療開始時の年齢が70歳以上を高齢群，70歳未満を若年群として両群の臨床背景，抗ウイルス効果，有害事象を解析した．結果：全223例中，高齢群は79例，若年群は144例であった．年齢は高齢群で75.5±4.4歳，若年群で58.1±9.8歳（平均±SD），最年長は85歳，最年少は27歳であった．性別は高齢群で有意に女性が多かった（p＜0.01）．血小板数は高齢群で13.7±6.4×104/μl，若年群で15.9±7.0×104/μl と有意に高齢群で低値であり（p=0.02），FIB-4 Indexも高齢群で5.12±3.25，若年群で3.48±2.89と有意に高齢群が高値であった（p＜0.01）．肝癌既往歴を有する症例は，高齢群で79例中39例，若年群で144例中29例であり，高齢群で有意に多かった（p＜0.01）．血清AFP値は高齢群で12.5±20.3 ng/ml，若年群で15.7±22.3 ng/mlと有意差は認めなかった．DAA導入前の前治療は高齢群で79例中49例，若年群で144例中63例に治療歴があり，高齢群で有意に前治療歴を有する症例が多かった（p=0.01）．治療効果は高齢群が79例中71例（89.9%），若年群が144例中131例（91.0%）でSVR12を達成しており，有意差は認めなかった．副作用中止は高齢群で79例中4例（5.1%），若年群で144例中4例（2.8%）に認めたが，有意差は認めなかった．SVR12達成後の肝発癌は高齢群で79例中17例，若年群で144例中12例に認め，有意に高齢群で多かった（p＜0.01）．結論：DAAの治療効果，副作用は両群間に差を認めず，高齢者においても安全に治療可能であった．しかし，高齢群では肝線維化進展例，肝癌治療歴を有する症例が多く，ウイルス駆除後の発癌に留意すべきである．","subitem_description_type":"Abstract"}]},"item_4_description_22":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"出版者の許可を得て登録","subitem_description_type":"Other"}]},"item_4_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.24517/00054183","subitem_identifier_reg_type":"JaLC"}]},"item_4_publisher_17":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本老年医学会 = The Japan Geriatrics Society"}]},"item_4_relation_12":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"10.3143/geriatrics.54.375","subitem_relation_type_select":"DOI"}}]},"item_4_relation_28":{"attribute_name":"関連URI","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"https://www.jstage.jst.go.jp/browse/geriatrics/-char/ja/"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.jstage.jst.go.jp/browse/geriatrics/-char/ja/","subitem_relation_type_select":"URI"}},{"subitem_relation_name":[{"subitem_relation_name_text":"https://www.jpn-geriat-soc.or.jp/"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://www.jpn-geriat-soc.or.jp/","subitem_relation_type_select":"URI"}}]},"item_4_rights_23":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"Copyright © 日本老年医学会 The Japan Geriatrics Society"}]},"item_4_source_id_11":{"attribute_name":"NCID","attribute_value_mlt":[{"subitem_source_identifier":"AN00199010","subitem_source_identifier_type":"NCID"}]},"item_4_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0300-9173","subitem_source_identifier_type":"ISSN"}]},"item_4_version_type_25":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"石田, 晃介"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"島上, 哲朗"}],"nameIdentifiers":[{},{},{}]},{"creatorNames":[{"creatorName":"金子, 周一"}],"nameIdentifiers":[{},{},{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-05-27"}],"displaytype":"detail","filename":"ME-PR-KANEKO-S-375.pdf","filesize":[{"value":"357.4 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"ME-PR-KANEKO-S-375.pdf","url":"https://kanazawa-u.repo.nii.ac.jp/record/47860/files/ME-PR-KANEKO-S-375.pdf"},"version_id":"d0de8df6-4fa6-4fb2-8618-aa08abda11ec"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"高齢者C型慢性肝疾患に対する直接作用型抗ウイルス薬(DAA)の使用経験","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高齢者C型慢性肝疾患に対する直接作用型抗ウイルス薬(DAA)の使用経験"},{"subitem_title":"The use of direct-acting antivirals in the treatment of elderly patients with hepatitis C Virus infection","subitem_title_language":"en"}]},"item_type_id":"4","owner":"18","path":["1134"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-05-27"},"publish_date":"2019-05-27","publish_status":"0","recid":"47860","relation_version_is_last":true,"title":["高齢者C型慢性肝疾患に対する直接作用型抗ウイルス薬(DAA)の使用経験"],"weko_creator_id":"18","weko_shared_id":-1},"updated":"2023-07-27T16:29:27.920791+00:00"}