CHRONIC HEPATITIS-C IN ELDERLY PATIENTS - CLINICAL, HISTOLOGICAL AND VIROLOGICAL FEATURES

Some clinical, histological and virological features, efficacy and saf ety of interferon (IFN) therapy were evaluated in elderly patients wit h chronic hepatitis C (CHC). We enrolled 22 patients aged 65 - 75 (mea n 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 afte r the therapy, and HCV sub-types were established: 15 patients underwe nt hepatobiopsy. At entry, the duration of disease was: 6 patients 1-3 years, 2 patients 4-10 years, 14 patients 11-30 years; alanine-aminot ransferase (ALT) = (3.17 +/- 1.15) x N (N = normal value); aspartate-t ransaminase (AST) = 2.28 +/- 1.6 x N; gamma-glutamil-transpeptidase (g GT) = 1.4 +/- 1.1 x N; platelets 164,000 +/- 66,000/mm(3); histologica l pattern: 2 mild chronic active hepatitis (CAH), 5 CAH, 2 severe CAH, 6 CAH with liver cirrhosis (LC); histological activity index (HAI) (1 4 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 so). Treatment was appli ed 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 w eek; 3 patients received 6 mU beta-IFN thrice per week. Therapy over 6 months was applied to 16 patients: Complete response (CR) was observe d in 8 patients (50 Oa), one of them was with long-term CR (over 12 mo nths after therapy); 5 have had relapse and 2 patients are still under treatment. Partial response (PR) was observed in 4 patients (25 %), n o response (NR) in 4 patients (25 %). Side effects were moderate and s elf-limited. Loss of HCV-RNA was shown in some patients with PR and in all patients with CR, but only temporarily.