EPIDEMIOLOGY AND LONG-TERM PROGNOSIS OF HEPATITIS-C VIRUS-INFECTION IN JAPAN
EPIDEMIOLOGY AND LONG-TERM PROGNOSIS OF HEPATITIS-C VIRUS-INFECTION IN JAPAN
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DOI：
10.1136/gut.34.2_suppl.s13
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发表时间：
1993-04-01
期刊：
影响因子：
24.5
通讯作者：
KOGA, M
中科院分区：
文献类型：
--
作者：
YANO, M;YATSUHASHI, H;KOGA, M
在日本献血者中，丙型肝炎病毒（HCV）抗体阳性率范围为20岁以下受试者的0.2%至50岁以上受试者的3.9%。据估计，至少有230万日本人通过受污染的血液感染了HCV。HCV携带者状态通过聚合酶链反应在对一种以上病毒蛋白的抗体阳性的受试者（70%的病例）中确认HCV-RNA。然而，单独核心抗体阳性的受试者被发现为HCV-RNA阴性，肝功能正常，并且被认为仅具有HCV感染的既往史（30%的病例）。急性丙型肝炎在大约90%的病例中进展为慢性感染。与B型肝炎相比，慢性丙型肝炎更容易导致肝硬化和肝癌，而且很少自发缓解。在典型的HCV感染中，转氨酶活性在早期阶段明显波动，然后变得相对稳定10年或更长时间，组织学检查显示慢性持续性肝炎。此后，转氨酶活性可能发生显著变化，进展为慢性活动性肝炎，并迅速发展为肝硬化和肝细胞癌。平均而言，慢性丙型肝炎从最初感染进展到肝硬化和癌症需要大约30年，但老年患者的疾病进展更快。
In Japanese blood donors, positivity for antibodies to hepatitis C virus (HCV) ranges from 0.2% in subjects under 20 to 3.9% in those over 50 years. It is estimated that at least 2.3 million Japanese have contracted HCV infection through contaminated blood. HCV carrier state was confirmed by polymerase chain reaction for HCV-RNA in subjects positive for antibodies to more than one viral protein (70% of cases). Subjects positive for core antibody alone, however, were found to be HCV-RNA negative with normal liver function, and are considered to have only a past history of HCV infection (30% of cases). Acute hepatitis C progresses to chronic infection in about 90% of cases. In comparison with hepatitis B, chronic hepatitis C leads more frequently to cirrhosis and liver cancer, and rarely remits spontaneously. In typical HCV infection, aminotransferase activities fluctuate markedly in the early stages, then become relatively stable for 10 years or more, with chronic persistent hepatitis shown by histological examination. Thereafter, aminotransferase activities may change dramatically, with progression to chronic active hepatitis and rapid development of cirrhosis and hepatocellular carcinoma. On average, it takes about 30 years for chronic hepatitis C to progress from initial infection to cirrhosis and cancer, but the disease progresses much more rapidly in elderly patients.