A study on clarifying the clinical natural course of Hepatitis C Virus carriers

我们的目的是澄清在献血或健康检查中发现的无症状HCV携带者的临床自然病程。我们评估了1019名在献血时发现HCV感染的人的肝脏疾病，并对他们进行了5-10年的随访，无论是否接受干扰素（IFN）。我们称之为“基于人群的研究”。另一方面，我们从文献中的“基于医院的案例研究”中检查HCC的累积率。这些研究结果可为日本预防HCC提供基础和有价值的数据。1)基线时，慢性肝炎在529名（51.9%）HCV携带者中检测到，男性比女性更频繁（62.6%比42.5%,p < 0.01）；5例（0.5%）诊断为肝硬化，1例诊断为肝细胞癌。2)在随访5年或更长时间的携带者中，197例接受干扰素（IFN）治疗的患者中有61例（31.0%）血清中HCV RNA丢失，211例未接受干扰素治疗的患者中只有1例（0.5%）血清中HCV RNA丢失（p < 0.0001）。3)有14名携带者发生HCC，其中211名无IFN的有6名（2.8%），197名有IFN的有8名（4.1%）（包括6名无应答者）。对949名携带者的随访发现，年龄（p < 0.002）、男性性别（p < 0.01）和基线时的肝硬化是导致HCC发展的因素。4)慢性肝炎携带者10年内HCC的累积发病率与基线时的年龄平行增加。也就是说，60岁及以上携带者在献血时出现慢性肝炎的10年累积HCC风险估计为18.7% (95% CI: 1.9-35.5%)， 50岁携带者为8.7%(0-17.5%)，40岁携带者为7.2%（0-15.5%）。

Our aim is to clarify the clinical natural course of HCV carriers without symptoms who were found at the occasion of donation of their blood or at their health check. We evaluated liver disease of 1019 individuals who were found with HCV infection at blood donation, and they were followed for 5-10 years with or without receiving interferon (IFN). This study we called is a "population based study". And the other hand, we check the cumulative rate for HCC from "hospital based case study" in the literatures. These results of this research can lead to basis and valuable data for preventing HCC in Japan.1) At the baseline, chronic hepatitis was detected in 529 (51.9%) HCV carriers and more frequently in men than women (62.6% vs. 42.5%, p < 0.01); cirrhosis was diagnosed in five (0.5%) and hepatocellular carcinoma (HCC) in one.2) Of the carriers who were followed for 5 years or longer, loss of HCV RNA from serum was achieved in 61 (31.0%) of the 197 treated with interferon (IFN) and only one of the 211 (0.5%) without IFN (p < 0.0001).3) HCC developed in 14 carriers including 6 of the 211 (2.8%) without IFN and 8 of the 197 (4.1%) with IFN (6 non-responders included). Follow-ups of the 949 carriers identified age (p < 0.002), male gender (p < 0.01) and cirrhosis at the baseline as factors contributing to the development of HCC.4) Cumulative incidence rates of HCC during 10 years among carriers found with chronic hepatitis increased in parallel with the age at the baseline. That is, cumulative HCC risk during 10 years was estimated at 18.7% (95% CI : 1.9-35.5%) for carriers aged 60 years or older, 8.7% (0-17.5%) for those in the fifties and 7.2% (0-15.5%) for those in the forties when they presented with chronic hepatitis at blood donation.