549 Hepatitis C in 2,410 patients 65 years or older. A severe and neglected curable disease?

Natural history and predictors of disease severity in chronic hepatitis C

“…Fibroteste has the same predictive value in patients with normal or elevated transaminases [18]. In patients aged 65 years or older, extensive fibrosis and normal transaminases are frequently observed and this population is particularly at risk of high fibrosis progression rates [40].…”

Leverlijden bij oudere personen

“…26,27 Een aantal kleinere vergelijkende studies met de huidige standaardtherapie, bij hoofdzakelijk hep C genotype 1 positieve patiënten, konden een SVR van 45% bij personen boven de 65 jaar aantonen. 28,29,33 Omwille van intolerantie (vooral anemie, neutropenie, trombopenie) moest de therapie in 25% van de gevallen wel gestopt worden en in 30% van de gevallen in dosis gereduceerd worden. 28 Zie ook tabel 3.…”

“…28,29,33 Omwille van intolerantie (vooral anemie, neutropenie, trombopenie) moest de therapie in 25% van de gevallen wel gestopt worden en in 30% van de gevallen in dosis gereduceerd worden. 28 Zie ook tabel 3. Dit draagt bij tot een lagere SVR bij oudere personen.…”

Chronic Hepatitis C Virus Infection in Older Adults

“…A study in France comparing chronic HCV infection in patients у65 years of age with that in younger patients demonstrated that the older group had a significantly longer duration of infection (26 vs. 20 years), a higher age at infection ( [24]. Among persons who underwent liver biopsy, the fibrosis stage was higher for those aged у65 years, regardless of infection duration.…”

“…Studies examining the validity of the FibroTest-ActiTest versus that of liver biopsy for patients with chronic hepatitis C did not include elderly patients [40]. In a study of patients with chronic hepatitis C, the prevalence of severe fibrosis estimated by FibroTest-ActiTest was 73% (1121 of 1529) among patients aged у65 years, compared with 35% (2419 of 7011) among younger patients [24]. However, because liver biopsy was not documented, it is not clear whether the sensitivity and specificity of the FibroTest-ActiTest are similar for older and younger patients.…”