Hepatitis C virus infection and related chronic liver disease in a resident elderly population: the Silea study

Abstract

The prevalence of hepatitis C virus (HCV) infection increases with advancing age, but the disease has been poorly studied in the elderly. A population-based study was therefore carried out to investigate the prevalence of HCV infection and the severity of HCV-related chronic liver disease in the elderly. One thousand and sixty-three people (> or = 60 years of age) were screened for antibodies to HCV (anti-HCV) and for possible abnormalities of common liver function tests. Positive subjects and sex and age-matched anti-HCV-negative controls were recalled 12 months later for measurements of liver enzymes, confirmatory testing of anti-HCV, HCV RNA analysis and HCV genotyping. All subjects answered a specific questionnaire concerning medical history and possible risk factors. Forty-four subjects were positive for anit-HCV, the prevalence being 4.1%. Thirty-five positive subjects and 35 controls were investigated further. Risk factors for acquiring HCV were found to be: blood transfusion, surgical intervention and the use of non-disposable syringes. Abnormal alanine aminotransferase levels were found in 13 patients (37.1%). HCV RNA genotyping showed type 1b in three (15.8%), type 2a in 13 (68.4%) and not classified in three (15.8%) patients. There was no relationship between abnormalities of serum aminotransferase, the rate of HCV RNA positivity and HCV genotypes. Ultrasound abnormalities were present in 13 (37.1%) patients. In this elderly population the relatively high prevalence of HCV infection was thought to be caused by previous parenteral exposure. The low incidence of liver disease could be related to the prevalence of HCV genotype 2a in the majority of these patients, and hints at the possibility of an HCV carrier state in elderly individuals.

Prevalence of Antibodies against Hepatitis C Virus in the Elderly: A Seroepidemiological Study in a Nursing Home and in an Open Population

“…Using a first-generation enzyme-linked immunosorbent assay, we found a surprisingly low prevalence of anti-HCV in institutionalized aged subjects [5]. More recently, comparable findings have been reported in a seroepidemiological study carried out in a nursing home in northeast Italy [6].…”

Hepatitis C in the Elderly: Epidemiology, Natural History, and Treatment

“…In another Italian study, the prevalence of positive HCV antibody was reported to be 3.3% among 1063 people aged 60 years or older (5). From those who were positive for HCV antibody, 19 subjects (54.3%) had detectable HCV RNA (5).…”

“…From those who were positive for HCV antibody, 19 subjects (54.3%) had detectable HCV RNA (5). HCV genotype 2a was the most common genotype among those who had positive HCV RNA with a prevalence of 68.4% (5).…”

Predictive Factors for Response to Peginterferon-Alpha and Ribavirin Treatment of Chronic HCV Infection in Patients Aged 65 Years and More

“…Prevalence of chronic HCV infection among patients aged 60 years in Italy and Japan reportedly ranges between 3.3 and 13.1% [19,20], and these patients often have advanced liver disease [6]. Patients aged C65 years were excluded from therapeutic trials evaluating the safety and efficacy of the current standard-of-care for the treatment of HCV-PEG-IFN and ribavirin-and in clinical practice, elderly patients are also often deemed not eligible for antiviral therapy [8,9].…”