[Features of the course of chronic liver disease in the elderly patients].

Chronic liver disease (CLD), often occurring with blurred symptomatic occupy not the last place in the morbidity of the elderly patients. We systematized the available literature data on the peculiarities of the morphological structure of the liver and its functional status in persons over age group, presented results of their research. Established that the incidence of CLD in patients with elderly reaches 2%, while long-term asymptomatic disease in 15.4% of patients with minimal clinical manifestations--in 46% of cases. The high (29.9%), the frequency of infection of hepatotropic viruses in the elderly. During 4 years of observation of the natural history of HCV-infection in elderly formation of CP was observed in 7.3% of patients, hepatocellular carcinoma (HCC)--in 5.1% of cases. Monotherapy with interferon-alpha (IFN-alpha) within 3 months older accompanied by a decrease of biochemical activity in 60% of cases, the development of early virological response--in 33.3% of sustained virological response--in 6.7%. The incidence of side effects (depressed mood--40%, depression--20% change in hematological parameters--26.7-40%) was higher than in young patients. The use of ursodeoxycholic acid (UDCA) at a dose of 12-15 mg/kg/day for 3 months in elderly patients (n = 25) with chronic HCV-infection in the 70.6-80% of the cases resulted in significant reduction in biochemical activity, as well as asthenic severity, pain and dyspeptic syndromes.

[Polyvirus hepatitides (prevalence, diagnosis, characteristics of virusological process)].

AIM: To ascertain prevalence of chronic hepatitides (CH) of polyvirus etiology and to characterize a course of such polyvirus CH. MATERIAL AND METHODS: A total of 15000 patients with chronic diseases of the liver (CDL) of different etiology were examined for markers of hepatotropic viruses, 312 patients with CH aged 18-59 years were examined clinically, biochemically, virusologically and morphologically. RESULTS: CH of polyvirus etiology are rather prevalent. A replicative form of HBV has a significant effect on the activity of the pathological process in mixed hepatitis. Incidence of chronic HBV and HCV infection rises with age. Viral hepatitis A in drug addicts runs an atypical course. CONCLUSION: Adequate epidemiological analysis, diagnosis and antiviral treatment, follow-up of CDL of mixed viral etiology, monitoring of drug addiction, healthy life style are able to reduce prevalence of mixed hepatitis.

[HCV infection in the elderly].

AIM: To investigate prevalence, clinical picture and course of hepatitis C virus (HCV) infection in elderly patients. MATERIAL AND METHODS: A total of 1045 patients aged 60- 74 years with chronic diseases of the liver (CDL) were examined for hepatitis. RESULTS: HCV monoinfection was detected in 210 (20.1%) patients. Alcohol-viral etiology of HCV was revealed in 22% cases. HCV RNA was identified in 117 (76%) out of 154 elderly patients. All the HCV infected patients had 1b genotype, high viremia. Pain and asthenic syndromes were main clinical manifestations of HCV infection. Most often the activity of HCV infection in the elderly patients was low (88.6%), progression was slow (94.7%). The latter was registered in 22.8% patients. HCV infection in the elderly entails higher inflammation activity and incidence of HCV RNA. CONCLUSION: Complex examination of elderly patients for early detection of HCV, early diagnosis and treatment slows down progression of CDL, reduces the rate of development of severe complications and lethality.