Elderly Veterans with HCV Have Higher Risk of Cirrhosis, HCC

Elderly veterans with chronic hepatitis C virus (HCV) have a higher risk of cirrhosis, hepatocellular carcinoma (HCC), and death and receive less antiviral treatment than younger veterans, according to new research.

As the HCV population in the US ages, their risk of developing comorbidities such as cirrhosis and hepatocellular carcinoma increases, which also affects their ability to respond to treatment.
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To investigate the epidemiology and outcomes among US veterans with HCV, the researchers conducted a retrospective cohort study of 161,744 patients with HCV who were listed in the Veterans Health Administration Hepatitis C Clinical Case Registry.

The veterans were divided into 3 age groups—20 to 49 years, 50 to 64 years, and 65 to 85 years—to determine whether age was associated with the risk of cirrhosis, HCC, or death and to determine how treatment affected each age group.

About 37% of the cohort was aged 20 to 49 years, 58% was aged 50 to 64 years, and 6% was aged 65 to 85 years.

Veterans aged 65 to 85 years had the highest risk of cirrhosis, HCC, and death and were the least likely to receive antiviral treatment compared with their younger counterparts.

However, 33.5% of the veterans aged 20 to 49 years, 33.2% of those aged 50 to 64 years, and 32.1% of those aged 65 to 85 years who received treatment had a sustained viral response.

“Elderly patients with chronic hepatitis C are more likely to develop hepatocellular carcinoma than younger patients but have traditionally received less antiviral treatment than younger patients,” the researchers concluded. “However, receipt of curative treatment is associated with a benefit in reducing cirrhosis, hepatocellular carcinoma, and overall mortality, irrespective of age.”

—Amanda Balbi

Reference:
El-Serag HB, Kramer J, Duan Z, Kanwal F. Epidemiology and outcomes of hepatitis C infection in elderly US veterans [published online April 3, 2016]. J Viral Hepat. doi:10.1111/jvh.12533.