Acute viral hepatitis in the elderly.

Seventy-six cases of acute viral hepatitis in the elderly (65 years old or older) were reviewed. Their clinical symptoms, biochemical pictures and clinical courses were compared with patients less than 40 years old (young) and those 40-64 years old (middle-aged). There were 51 men and 25 women with the mean age of 69 years (range 65 to 78 years). The most common etiology of acute viral hepatitis in the elderly is acute non-A, non-B hepatitis (48.7%), followed by acute hepatitis in HBsAg carrier (44.7%) and acute type B hepatitis (7.9%). Acute hepatitis in HBsAg carrier is the most common etiology in the young and middle-aged patients. Gastric flu, deep or tea colored urine and fatigue-weakness are the common clinical presentations. In conventional liver function tests, serum levels of GPT and albumin tended to be lower in the elderly patients. Overall, 25% of acute viral hepatitis in the elderly were complicated with fulminant hepatic failure or subacute hepatic failure and 18.4% died. The prevalence of fulminant or subacute hepatic failure and the mortality in the elderly were significantly higher than those in the younger patients.