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            significant in the group of men although there was    with the branched-DNA assay. J Med Virol 2008;80:254-60.
            a worse response after 50 years. This suggested the   7.   Elbeik  T, Surtihadi J,  Destree M,  Gorlin J,  Holodniy M,  Jortani
            lost of the advantage in female gender after 50 years   SA, Kuramoto K, Ng V, Valdes R Jr, Valsamakis A, Terrault NA.
                                                                  Multicenter  evaluation of the  performance  characteristics  of the
            without having a worsening in both genders with age.  bayer VERSANT HCV RNA 3.0 assay (bDNA). J Clin Microbiol
                                                                  2004;42:563-9.
            In summary, even if affected by limitations related   8.   Sizmann D, Boeck C, Boelter J, Fischer D, Miethke M, Nicolaus
                                                                  S, Zadak M, Babiel R. Fully automated quantification of hepatitis C
            to retrospective and in subgroups analysis, the       virus (HCV) RNA in human plasma and human serum by the COBAS
            outcomes  we  obtained  reveal  not meaningful        AmpliPrep/COBAS TaqMan system. J Clin Virol 2007;38:326-33.
            differences between men and women when the         9.   Nolte FS,  Green  AM,  Fiebelkorn KR,  Caliendo  AM,  Sturchio
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            divided in two groups younger or elder than 50        DD, Rowe IA, Hazlehurst JM, Brown R, Hübscher SG, Mutimer D.
                                                                  Operator training requirements and diagnostic accuracy of Fibroscan
            years. Despite the grade of influence of gender on    in routine clinical practice. Postgrad Med J 2013; 89:685-92.
            standard treatment is still debated, we noticed as   11.  Codes L, Asselah T, Cazals-Hatem D, Tubach F, Vidaud D, Paraná R,
            the female gender may be considered a positive        Bedossa P, Valla D, Marcellin P. Liver fibrosis in women with chronic
                                                                  hepatitis  C: evidence for the  negative  role  of the  menopause  and
            predictor of response to therapy, taking into account   steatosis and the potential benefit of hormone replacement therapy.
            its  strong  interaction with  age  and inserting  in  a   Gut 2007;56:390-5.
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                                                                  SM, Creţoiu D, Usvat R, Ioniţă L. Hepatocyte steatosis in patients
            non-modifiable predictive factors related to the      infected  with  genotype  1  hepatitis  C  virus.  Romanian  J  Morphol
            host and virus. Considering both high efficacy and    Embryol 2010;51:235-42.
            costs of new antiviral drugs therapy protocols, the   13.  Villa E, Karampatou A, Cammà C, Di Leo A, Luongo M, Ferrari A,
                                                                  Petta S, Losi L, Taliani G, Trande P, Lei B, Graziosi A, Bernabucci V,
            evidence of a gender- and age- different response to   Critelli R, Pazienza P, Rendina M, Antonelli A, Francavilla A. Early
            the standard treatment may play a role in changing    menopause is associated with lack of response to antiviral therapy in
                                                                  women with chronic hepatitis C. Gastroenterology 2011;140:818-29.
            epidemiologic characteristics of eligible patients and   14.  Rigamonti C, Andorno S, Maduli E, Capelli F, Boldorini R, Sartori
            asks the question if certain groups of patients should   M.  Gender  and  liver  fibrosis  in  chronichepatitis:  the  role  of  iron
            be primarily treated.                                 status. Aliment Pharmacol Ther 2005;21:1445-51.
                                                               15.  Lao XQ, Thompson A, McHutchison JG, McCarthy JJ. Sex and age
            Financial support and sponsorship                     differences in lipid response to chronic infection with the hepatitis C
                                                                  virus in the United States National Health and Nutrition Examination
            Nil.                                                  Surveys. J Viral Hepat 2011;18:571-9.
                                                               16.  Bakr  I,  Rekacewicz  C,  El  Hosseiny  M, Ismail  S, El  Daly  M, El-
            Conflicts of interest                                 Kafrawy S, Esmat  G, Hamid MA, Mohamed  MK, Fontanet  A.
            There are no conflicts of interest.                   Higher clearance of hepatitis C virus infection in females compared
                                                                  with males. Gut 2006;55:1183-7.
                                                               17.  Aziz H, Gil ML, Waheed Y, Adeeb U, Raza A, Bilal I, Athar MA.
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