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Here, we define impact of comorbidities, concomitant medication and drug\u2013drug interactions in elder patients with HCV related disease before starting DAAs regimen. We analyzed data of 814 patients prospectively enrolled at our Unit within the web based model HCV Sicily Network. Out of 814, 590 were treated with DAAs and 414 of them were older than 65\u00a0years. We divided those 414 in two groups, one including 215 patients, aged between 65 and 74\u00a0years, and another with 199 patients, aged of 75\u00a0years and over. Charlson Comorbidity Index (CCI) was assessed for each patient; drug\u2013drug interactions (DDI) and de-prescribing process were carried out appropriately. Within 414 patients included, percentage rates of women treated was higher than males, BMI was lower and cirrhosis was frequently reported in patients older than 75\u00a0years. Hypertension, diabetes mellitus, dyslipidemia (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), prostatic pathologies, kidney disease, gastrointestinal disease (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), osteoporosis (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and depression were most common co-morbidities. CCI showed lower scores in the first group as compared with the second one (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Among drugs, statins were frequently suspended and anti-hypertensive often replaced. DAAs are useful and effective regardless of disease severity, comorbidities, medications and age. De-prescribing allows a stable reduction of number of medications taken with real improvement of quality of life.<\/jats:p>","DOI":"10.1007\/s11739-021-02741-9","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T06:04:30Z","timestamp":1619589870000},"page":"43-51","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comorbidities impact and de-prescribing in elderly with HCV-related liver disease: analysis of a prospective cohort"],"prefix":"10.1007","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0383-6121","authenticated-orcid":false,"given":"Anna","family":"Licata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-7349","authenticated-orcid":false,"given":"Maria Giovanna","family":"Minissale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Giannitrapani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo A.","family":"Montalto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clelia","family":"Lombardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Mirarchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Amodeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Soresi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Montalto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"2741_CR1","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jhep.2018.03.026","volume":"69","author":"EASL","year":"2018","unstructured":"EASL (2018) EASL recommendations on treatment of hepatitis C 2018. 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