Chronic hepatitis C in elderly patients: Clinical, histolocical and virolocical features

Summary Some clinical, histological and virological features, efficacy and safety of interferon (IFN) therapy were evaluated in elderly patients with chronic hepatitis C (CHC). We enrolled 22 patients aged 65–75 (mean age: 68.3 ± 3.17 years); 15 males and 7 females. In all cases the hepatitis C virus RNA (HCV-RNA) was determined before, during and after the therapy, and HCV sub-types were established; 15 patients underwent hepatobiopsy. At entry, the duration of disease was: 6 patients 1–3 years, 2 patients 4–10 years, 14 patients 11–30 years; alanine-aminotransferase (ALT) = (3.17 ± 1.15) x N (N = normal value); aspartatetransaminase (AST) = 2.28 ± 1.6 × N; gamma-glutamil-transpeptidase (gGT) = 1.4 ± 1.1 × N; platelets = 164,000 ± 66,000/mm 3 ; histological pattern: 2 mild chronic active hepatitis (CAH), 5 CAH, 2 severe CAM, 6 CAH with liver cirrhosis (LC); histological activity index (HAI) (14 patients) = 11.14 ± 4.5 (range 5–17); scores according to Scheuer: lobular 2.28 ± 1.13, portal 2.71 ± 0.99, fibrosis 2.35 ±1.33; HCV-RNA +ve: 20 patients, HCV-RNA −ve: 2 patients; HCV-subtypes: 1b 20/20 (100 %), 1b+1a 1/20 (5 %), 1b+ 2a 1/20 (5 %). Treatment was applied to 18 patients, for 3–12 months; 5 received alpha-IFN2a; 5 received alpha-IFN2b, 3 lymphoblastoid IFN, all at a dose of 3 mU thrice per week; 3 patients received 6 mU beta-IFN thrice per week. Therapy over 6 months was applied to 16 patients: Complete response (CR) was observed in 8 patients (50 %), one of them was with long-term CR (over 12 months after therapy); 5 have had relapse and 2 patients are still under treatment. Partial response (PR) was observed in 4 patients (25 %), no response (NR) in 4 patients (25 %). Side effects were moderate and selflimited. Loss of HCV-RNA was shown in some patients with PR and in all patients with CR, but only temporarily.