Hepatitis C virus in elderly patients with chronic liver diseases

Summary n January 1993 and July 1994, 141 consecutive patients were recruited, all above 50 years of age, affected by chronic liver diseases (CLD), in order to evaluate the prevalence of hepatitis C virus (HCV). The overall prevalence of HCV alone was 50.3 % (71 out of 141 patients) which increased to 70.1 % when considered together with the alcoholism (28 out of 141 patients). Contrastingly, the prevalence of hepatitis B and D virus (HBV and HDV) was low (17 %, 24 patients). Mean age of HCV patients was significantly higher than the mean age of HBV/HDV patients (p < 0.001). There was a significant difference (p < 0.05) between the mean age of the group of patients with only HCV and those where the disease was associated with alcoholism. Our data indicate that HCV is by far the most frequent cause of CLD in elderly patients in our geographical area. The mean age of HCV-induced CLD patients was significantly higher than the mean age of HBV/HDV patients, due to the slower evolution of HCV. The severity of liver damage increases if HCV is associated with alcoholism, as shown by the lower age of these subjects. HCV induced liver cirrhosis often develops into carcinoma (in 5 out of 51 patients in our series, 9.8 %) and may be a result of the longer duration of the disease. This seems to be the only factor aggravating the otherwise slow evolution of HCV. Our data suggest the necessity of long term monitoring of elderly patients with HCV-induced CLD.