Chronic liver disease related to hepatitis C virus: age of patients seems to be a determinant of severity independently of viral genotype

Background Hepatitis C virus infection accounts for varying severity of chr onic liver disease, Clinical manifestations of infection have been related to different virus genotypes, with conflicting results, Design We performed a cross-sectional study on a Northern-Italian group of patients with chronic hepatitis, cirrhosis and hepatocellular carcinoma rel ated to hepatitis C virus infection in order to verify the association of d ifferent viral strains and the outcomes of viral disease. Methods Two hundred and seventy-one patients referred to our unit for liver disease were studied and clinical, biochemical, histological, and function al parameters were investigated. Results Different viral genotypes were not associated with peculiar finding s in any of the degrees of liver disease. However, a progressive age increa se was associated with disease severity, although clinical and functional s taging of cirrhotic patients with hepatocellular carcinoma was better compa red to tumour-free cirrhotic patients. There was an increased prevalence of genotype 1b related to the age of the patients. In multivariate regression analysis the patients' age and apparent duration of infection were indepen dently associated with the presence of cirrhosis and only the age of patien ts was associated to hepatocellular carcinoma, Conclusions In the population we studied age of the patients seemed to be a determinant conditioning disease severity, likely reflecting older infecti ons and long-standing liver disease. The prevalence of certain genotypes in varying degrees of liver disease could be an epiphenomenon which might als o be explained by the changing prevalence of infecting strains over the pas t decades, fur I Gastroenterol Hepatol 11:553-558 (C) 1999 Lippincott Willi ams & Wilkins.