title: Chronic liver disease related to hepatitis C virus: age of patients seems to be a determinant of severity independently of viral genotype.
abstract: BACKGROUND
  Hepatitis C virus infection accounts for varying severity of chronic liver disease. Clinical manifestations of infection have been related to different virus genotypes, with conflicting results.
  
  
  METHODS
  We performed a cross-sectional study on a Northern-Italian group of patients with chronic hepatitis, cirrhosis and hepatocellular carcinoma related to hepatitis C virus infection in order to verify the association of different viral strains and the outcomes of viral disease.
  
  
  METHODS
  Two hundred and seventy-one patients referred to our unit for liver disease were studied and clinical, biochemical, histological, and functional parameters were investigated.
  
  
  RESULTS
  Different viral genotypes were not associated with peculiar findings in any of the degrees of liver disease. However, a progressive age increase was associated with disease severity, although clinical and functional staging of cirrhotic patients with hepatocellular carcinoma was better compared to tumour-free cirrhotic patients. There was an increased prevalence of genotype 1b related to the age of the patients. In multivariate regression analysis the patients' age and apparent duration of infection were independently associated with the presence of cirrhosis and only the age of patients was associated to hepatocellular carcinoma.
  
  
  CONCLUSIONS
  In the population we studied age of the patients seemed to be a determinant conditioning disease severity, likely reflecting older infections and long-standing liver disease. The prevalence of certain genotypes in varying degrees of liver disease could be an epiphenomenon which might also be explained by the changing prevalence of infecting strains over the past decades.
authors.affiliation: Department of Internal Medicine, University of Genoa, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Giannini
authors.forename: F
authors.initials: F
authors.lastname: Botta
authors.forename: S
authors.initials: S
authors.lastname: Caglieris
authors.forename: A
authors.initials: A
authors.lastname: Fasoli
authors.forename: D
authors.initials: D
authors.lastname: Risso
authors.forename: P
authors.initials: P
authors.lastname: Ceppa
authors.forename: E
authors.initials: E
authors.lastname: Cresta
authors.forename: V
authors.initials: V
authors.lastname: Venturino
authors.forename: G
authors.initials: G
authors.lastname: Icardi
authors.forename: P B
authors.initials: PB
authors.lastname: Lantieri
authors.forename: G
authors.initials: G
authors.lastname: Celle
authors.forename: R
authors.initials: R
authors.lastname: Testa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification*; D019698:Hepatitis C, Chronic / Q000821:virology*; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology*; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index