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The course of elderly patients with persistent hepatitis C virus infection without hepatocellular carcinoma

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Little is known about the course of elderly patients with persistent hepatitis C virus (HCV) infection. We investigated the course of HCV infection in this patient population.

Methods

Among 9,126 HCV antibody-positive patients who visited our hospital between 1995 and 2015, there were 453 patients with continuous follow-up who survived to age 80. They were included in the study following the inclusion criteria: confirmed persistent detection of HCV RNA, no HCV eradication if anti-HCV therapy occurred before enrollment, and no development of hepatocellular carcinoma (HCC) before enrollment. For all study patients, baseline was defined as the date when they turned 80. Mortality rates after the age of 80 years and cause of death were analyzed.

Results

During the study period, 155 patients (34.2%) died. Median survival time (MST) after age 80 was 8.8 years, which was comparable to that of the general population (10.1 years). Among 155 deceased patients, the majority (115 patients, 74.2%) died due to non-liver-related disease, followed by HCC (28 patients, 18.1%) and liver-related disease other than HCC (12 patients, 7.7%). Patients with advanced liver fibrosis (FIB-4 index > 3.25, n = 245) had shorter MST than patients with mild liver fibrosis (FIB-4 index ≤ 3.25, n = 208) (7.1 vs. 10.2 years; p = 0.020) due to a higher mortality rate from liver-related complications, including HCC.

Conclusion

Most elderly HCV patients die from non-liver-related disease, especially those with less advanced liver fibrosis.

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Abbreviations

ALBI:

Albumin-bilirubin

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

CI:

Confidence intervals

DAAs:

Direct-acting antiviral agents

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

HRs:

Hazard ratios

IFN:

Interferon

IQR:

Interquartile range

MST:

Median survival time

SVR:

Sustained virologic response

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan

    Kazuyuki Mizuno, Hidenori Toyoda, Satoshi Yasuda, Toshifumi Tada & Takashi Kumada

  2. Department of Radiology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan

    Yasuhiro Sone

  3. Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Hiroshima, Japan

    Junko Tanaka

Authors
  1. Kazuyuki Mizuno
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  2. Hidenori Toyoda
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  3. Satoshi Yasuda
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  4. Toshifumi Tada
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  5. Takashi Kumada
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  6. Yasuhiro Sone
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  7. Junko Tanaka
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Correspondence to Kazuyuki Mizuno.

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Mizuno, K., Toyoda, H., Yasuda, S. et al. The course of elderly patients with persistent hepatitis C virus infection without hepatocellular carcinoma. J Gastroenterol 54, 829–836 (2019). https://doi.org/10.1007/s00535-019-01595-5

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  • DOI: https://doi.org/10.1007/s00535-019-01595-5

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