[Anti-HCV treatment for older patients]

The prevalence of older patients has been increasing in Japan, and this is an impending problem in other countries where viral spread has occurred more recently. The risk for hepatocellular carcinoma (HCC) depended on age, and increased after 65 years of age. Even when stratified by stage of fibrosis, the cumulative and annual incidences of HCC were significantly higher in older patients than in younger patients (p < 0.001) at the same stage of fibrosis. The impact of hepatitis C viral (HCV) eradication on HCC prevention was less significant in older patients than in younger patients. Patients should therefore be identified at an earlier age and treatment should be initiated. Treatment strategy for older patients with HCV should be decided in consideration with interferon eligibility, response to interferon therapy, presence of resistant-associated variant in the NS5A, and risk of HCC.