title: Hepatitis C in the elderly: a multicentre cross-sectional study by the Italian Association for the Study of the Liver.
abstract: BACKGROUND
  The prevalence of hepatitis C virus infection increases with advancing age, but elderly hepatitis C virus patients remain an understudied population.
  
  
  OBJECTIVE
  To define the virological, epidemiological and clinical profiles of Italian outpatients aged 65 years and over infected by hepatitis C virus.
  
  
  METHODS
  We evaluated 1544 anti-hepatitis C virus positive patients aged ≥65 years referred to 34 Italian outpatient specialty clinics over a two-year period.
  
  
  RESULTS
  The study population included 1134 (73%) early elderly (65-74 years) and 410 (27%) late elderly patients (≥75 years). Late elderly subjects were less likely to have their virus genotyped, their viral load assessed or a histological evaluation of liver disease. Overall, 30% of patients had advanced liver disease whose prevalence increased with increasing age. In both age groups, about 40% of patients had normal transaminase levels. Excluding patients with past infection, 51% had not received any antiviral treatment and only 25% were treated after the age of 65. Late elderly patients, women and patients with advanced liver diseases had been less frequently treated. The main reason for exclusion from treatment was age followed by the presence of comorbid conditions.
  
  
  CONCLUSIONS
  Elderly hepatitis C virus patients referred to Italian specialty clinics have advanced and underestimated liver disease. Nevertheless, they are progressively understudied in parallel with increasing age.
authors.affiliation: Department of Clinical Medicine, University of Bologna, Via Massarenti 9, Bologna, Italy.
authors.forename: Annagiulia
authors.initials: A
authors.lastname: Gramenzi
authors.forename: Fabio
authors.initials: F
authors.lastname: Conti
authors.forename: Calogero
authors.initials: C
authors.lastname: Cammà
authors.forename: Antonio
authors.initials: A
authors.lastname: Grieco
authors.forename: Antonino
authors.initials: A
authors.lastname: Picciotto
authors.forename: Caterina
authors.initials: C
authors.lastname: Furlan
authors.forename: Domenico
authors.initials: D
authors.lastname: Romagno
authors.forename: Paolo
authors.initials: P
authors.lastname: Costa
authors.forename: Maria
authors.initials: M
authors.lastname: Rendina
authors.forename: Fausto
authors.initials: F
authors.lastname: Ancarani
authors.forename: Maria
authors.initials: M
authors.lastname: Chiaramonte
authors.forename: Gabriella
authors.initials: G
authors.lastname: Verucchi
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxì
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology; D008297:Male; D015995:Prevalence; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase