Epidemiological surveys suggest that majority of people are not immune to Hepatitis A virus (HAV) in developed countries and its morbidity and mortality increases with age. The current study was aimed to assess the epidemiology, manifestations, therapy, and prevention of viral hepatitis in elderly along with its prevention and management. It has been suggested that a safe and potent vaccine for hepatitis A is available and immunization should be done by health authorities early in life and for both healthy adults and potential high risk groups such as nursing home residents.in terms of acute hepatitis due to Hepatitis B virus (HBV), it is a rare disease in older people and is generally considered to be mild. Several studies documented that not all elderly patients with chronic HBV infection, who suffer from advanced liver disease can not be treated with interferon therapy as all of them do not have ongoing viral replication. However, old patients who have ongoing viral replication and compensated liver disease should be managed with interferon or should be evaluated in clinical trials with new antiviral drugs such as lamivudine. These patients require vaccines with greater immunogenicity as the response rate to hepatitis B vaccination decreases with age. Currently, combination antiviral therapy are getting researched for older patients with chronic HCV infection who do not respond to conventional interferon therapy. Although, another recently discovered RNA virus, Hepatitis G virus (HGV), is found with liver disease in older people, its role in the pathogenesis of liver injury is yet to be understood.

Source: Marcus EL, Tur-Kaspa R. Viral hepatitis in older adults. J Am Geriatr Soc. 1997 Jun;45(6):755-63.