RESEARCH FOR PREVENTION OF HEPATOCELLULAR CARCINOMA CAUSED BY HCV INFECTION

1.健康人群中丙型肝炎病毒携带者人数的估计：根据丙型肝炎病毒阳性者中丙型肝炎病毒RNA的流行率和日本估计人口中的丙型肝炎病毒携带者人数(94)，我们估计我县1,731,000人中有24,000人为丙型肝炎病毒携带者-。健康人群中丙型肝炎病毒携带者的临床分期分析：我们分析了8月以来在献血中发现的1050名丙型肝炎病毒携带者中920名丙型肝炎病毒携带者的临床分期。92年至97.3年11月。对1993年和1997年两次确诊的211例丙型肝炎病毒携带者的临床分期变化进行了分析。在1993年诊断为慢性肝炎的154名携带者中，2名携带者(1.3%)进展为HOC，4名携带者(2.6%)进展为肝炎。在54名转氨酶水平持续正常的携带者中，16人(29.6%)进展为慢性肝炎。并对献血时发现的218例丙型肝炎病毒携带者进行了丙型肝炎病毒定量分析。II/1b型丙型肝炎病毒核心蛋白滴度范围较大，III/2a型滴度较低，IV/2b型滴度较高。这些数据将有助于研究丙型肝炎病毒携带者干扰素治疗的有效率。我们研究了高流行地区丙型肝炎病毒感染的流行情况。对1992~1997年我州17个乡镇10,754名40岁以上居民丙型肝炎病毒抗体水平和抗-HCVPHA效价进行了分析。抗-HCV总感染率为10.1%(9.5-10.7%)，其中74.2%为抗-HCVPHA>2^1^3的携带者。提示40岁以上人群中抗-HCVPHA高滴度者占70%以上，尤其是老年男性抗-HCVPHA阳性人群中存在较多的丙型肝炎病毒携带者。在此基础上，建立了筛选出完美的丙型肝炎病毒携带者的筛选体系。

1. Estimation of HCV carrier populations among healthy people : we estimated 24,000 people as HCV carriers among 1,731,000 people at the age of 20 - 64 in our prefectue on the base of the prevalence of HCV RNA among HCV positives and Japanese estimated population ('94).2. Analysis of clinical stages of HCV carriers among healthy people : we analyzed the clinical stages of 920 HCV carriers among 1,050 HCV carriers found at blood donation fromAug. '92 to Nov. '97.3. We analyzed the change of clinical stages of 211 HCV carriers who were diagnosed at 2 points ; in 1993 and 1997. Of 154 carriers who were diagnosed as chronic hepatitis in 1993, 2 carriers(1.3%) have progressed to HOC and 4 carriers(2.6%) have progressed to liver chirrhosis. Of 54 carriers with persistently normal aminotransferase levels, 16 (29.6%) have progressed to chronic hepatitis. And we analyzed quantity of HCV among 218 HCV carriers who were found at blood donation. The titer of HCV core protein whose genotypes were II/1b showed wide range, that of genotype III/2a showed low range, and that of genotype IV/2b showed high range. These data will be useful in the study on the effective ratio for IFN therapy among HCV carriers.4. We studied prevalence of HCV infection in high endemic areas. From 1992 to 1997, we analyzed prevalence of HCV antibody and ratio of anti HCV PHA high titer among 10,754 residents over 40 years old in 17 towns in our prefecture. Prevalence of anti-HCV was 10.1% (9.5-.10.7%) in total, and 74.2% of these were HCV carriers who were detected over 2^1^3 anti HCV PHA.This data indicated that the rate of anti HCV PHA high titer was more than 70 % among over 40 years old, and especially many HCV carriers were found among anti HCV positives in older male groups.5. On the base of these results, we established the screening system of finding perfectly HCV carriers.