RESEARCH FOR PREVENTION OF HEPATOCELLULAR CARCINOMA CAUSED BY HCV INFECTION

1.健康人群中HCV携带者人群的估计：根据HCV阳性人群中HCV RNA的流行率和日本估计人群（'94），我们估计在我县20 - 64岁的1，731，000人中有24，000人为HCV携带者。健康人群中HCV携带者临床分期分析：我们分析了2010年8月至2011年8月献血时发现的1,050名HCV携带者中920名HCV携带者的临床分期。从92年到97.3年11月我们分析了1993年和1997年2个时间点确诊的211名丙型肝炎病毒携带者的临床分期变化。在1993年诊断为慢性肝炎的154名携带者中，2名携带者（1.3%）发展为HOC，4名携带者（2.6%）发展为肝硬化。在54例转氨酶水平持续正常的携带者中，16例（29.6%）进展为慢性肝炎。并对218例献血时发现的HCV携带者进行HCV定量分析。HCV基因型II/1b的核心蛋白滴度变化幅度较大，III/2a的核心蛋白滴度变化幅度较小，IV/2b的核心蛋白滴度变化幅度较大。这些数据将有助于研究干扰素治疗丙型肝炎病毒携带者的有效率.我们研究了高流行区HCV感染的流行情况。1992 ~ 1997年，对我州17个乡镇10,754名40岁以上居民的HCV抗体阳性率和抗-HCV PHA高滴度率进行了分析。抗-HCV阳性率为9.5-.10.7%，其中抗-HCV PHA阳性率在2^1^3以上者占74.2%，提示40岁以上人群抗-HCV PHA高滴度检出率在70%以上，尤其是老年男性抗-HCV阳性者中HCV携带者较多.在此基础上，建立了HCV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.