title: Progression to cirrhosis in hepatitis C patients: an age-dependent process.
abstract: BACKGROUND
  Age at infection is known to be associated with disease progression rate in hepatitis C virus (HCV) infected patients. The aim of this study was to assess when cirrhosis is expected to occur according to host and viral factors.
  
  
  METHODS
  Fibrosis progression was studied in 247 naive HCV patients using multiple regression analysis. The expected age at cirrhosis was calculated for each patient.
  
  
  RESULTS
  Progression rate was 0.13, 0.14, 0.27, and 0.36 U of fibrosis/year for patients with age at infection <or=19, 20-24, 25-36 and >or=37 years, respectively. Age at infection above 37 years was independently associated with fast progression (rate>0.13; P=0.001). Body mass index >25 kg/m2 and alanine aminotransferase>3 x ULN are also possibly associated with faster progression. Based on progression rates, the expected age at cirrhosis is 65.4, 64.6, 64.8 and 69.4 years for age at infection <or=19, 20-24, 25-36, >or=37 years, respectively.
  
  
  CONCLUSIONS
  Most HCV patients, if untreated, are expected to develop cirrhosis at about 65 years, irrespective of the age at infection. Thus, age itself seems even more important than age at infection for predicting the occurrence of liver cirrhosis. A specific active monitoring and therapeutic approach should be adopted in older patients to prevent progression to cirrhosis and its complications.
authors.affiliation: Department of Hepatogastroenterology, Hôtel-Dieu, Lyon, France. pradat@univ-lyon1.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Pradat
authors.forename: Nicolas
authors.initials: N
authors.lastname: Voirin
authors.forename: Hans Ludger
authors.initials: HL
authors.lastname: Tillmann
authors.forename: Michèle
authors.initials: M
authors.lastname: Chevallier
authors.forename: Christian
authors.initials: C
authors.lastname: Trépo
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking; D015992:Body Mass Index; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged
chemical_list: D000410:Alanine Transaminase