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Hepatitis C virus infection in the elderly

A M Brind1, J P Watson, O F James

  • 1Liver Unit, Freeman Hospital, Newcastle-upon-Tyne, UK.

QJM : Monthly Journal of the Association of Physicians
|April 1, 1996
PubMed
Summary

Hepatitis C virus (HCV) infection in older adults often presents with advanced liver disease, including cirrhosis and cancer. Many patients had no clear risk factors, highlighting the need for broader screening and understanding of HCV transmission.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Geriatrics

Background:

  • Hepatitis C virus (HCV) treatment decisions for younger patients rely on understanding long-term outcomes.
  • Older populations represent a growing demographic with significant HCV-related morbidity and mortality.
  • Limited data exists on the clinical presentation and prognosis of HCV in individuals over 65 years old.

Purpose of the Study:

  • To investigate the clinical characteristics, risk factors, and outcomes of hepatitis C virus infection in patients aged 65 and older.
  • To assess the spectrum of liver disease, including hepatocellular carcinoma, in this elderly cohort.
  • To determine mortality causes and associated factors in older adults with HCV.

Main Methods:

  • Retrospective analysis of HCV-antibody-positive patients aged over 65, treated between 1990 and 1994.

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  • Review of patient demographics, clinical presentations, identified risk factors, and liver biopsy results.
  • HCV genotyping and survival data analysis, including causes of death.

    • Main Results:

    • Twenty-five patients (>65 years) were identified, predominantly Caucasian, with a median age of 67.
    • Common presentations included asymptomatic infection, esophageal varices, malaise, and abdominal pain.
    • Liver biopsies revealed significant fibrosis, with 12 showing cirrhosis and six developing hepatocellular carcinoma; three additional patients also developed cancer.
    • HCV genotype 1 was prevalent in all genotyped patients.
    • Eleven patients died, with five deaths attributed to liver disease and two to HCV-associated non-hepatic conditions.

    Conclusions:

    • Hepatitis C virus infection in older adults is frequently associated with advanced liver disease at presentation.
    • A significant proportion of cases lacked identifiable risk factors, suggesting potential underdiagnosis or unrecognized transmission routes.
    • HCV infection in the elderly carries a substantial risk of mortality, both from liver-related complications and non-hepatic disorders.