HEPATITIS-C VIRUS-INFECTION AND RELATED CHRONIC LIVER-DISEASE IN A RESIDENT ELDERLY POPULATION - THE SILEA STUDY

The prevalence of hepatitis C virus (HCV) infection increases with adv ancing age, but the disease has been poorly studied in the elderly A p opulation-based study was therefore carried out to investigate the pre valence of HCV infection and the severity of HCV-related chronic liver disease in the elderly One thousand and sixty-three people (greater t han or equal to 60 years of age) were screened for antibodies to HCV ( anti-HCV) and for possible abnormalities of common liver function test s. Positive subjects and sex and age-matched anti-HCV-negative control s were recalled 12 months later for measurements of liver enzymes, con firmatory testing of anti-HCV, HCV RNA analysis and HCV genotyping. Al l subjects answered a specific questionnaire concerning medical histor y and possible risk factors, Forty-four subjects were positive for ant i-HCV. the prevalence being 4.1%. Thirty-five positive subjects and 35 controls were investigated further. Risk factors for acquiring HCV we re found to be: blood transfusion, surgical intervention and the use o f non-disposable syringes. Abnormal alanine aminotransferase levels we re found in 13 patients (37.1%), HCV RNA genotyping showed type 1b in three (15.8%), type 2a in 13 (68.4%) and not classified in three (15.8 %) patients. There was no relationship between abnormalities of serum aminotransferase, the rate of HCV RNA positivity and HCV genotypes. Ul trasound abnormalities were present in 13 (37.1%) patients. In this el derly population the relatively high prevalence of HCV infection was t hought to be caused by previous parenteral exposure. The low incidence of liver disease could be related to the prevalence of HCV genotype 2 a in the majority of these patients, and hints at the possibility of a n HCV carrier state in elderly individuals.