Okayama A, Stuver S O, Tabor E, Tachibana N, Kohara M, Mueller N E, Tsubouchi H
Department of Internal Medicine II, Miyazaki Medical College, Kiyotake, Miyazaki, Japan.
J Viral Hepat. 2002 Jan;9(1):43-51. doi: 10.1046/j.1365-2893.2002.00331.x.
Hepatitis C virus (HCV) is an important cause of liver disease throughout the world. However, the natural history and pathogenesis of this infection is still not completely understood. The aim of this study was to characterize the evolution of incident, asymptomatic HCV infection in a community-based population in Japan. The Miyazaki Cohort Study is a prospective study of adult residents in two villages, one of which has a very high prevalence of HCV. Nine hundred and seventy-three people from this village were enrolled in the cohort between 1984 and 1995, with antibodies to HCV (anti-HCV) found in 23%. During subsequent visits to annual health screens, new HCV seroconverters were identified among susceptible individuals, and their sequential samples were tested for anti-HCV, HCV-RNA, and HCV core antigen. Fourteen participants (six males, eight females) acquired anti-HCV during the first 11 years of study follow-up, at an incidence rate of 362 per 100 000 person-years. Detectable HCV-RNA and high anti-HCV titres (> 1:2048) were observed for more than 5 years following seroconversion in 80% (8/10) of seroconverters with sufficient information, indicating the development of persistent infection in these subjects. Three (37.5%) of the eight sero converters with persistent infection had fairly consistent, albeit mild, alanine aminotransferase elevations (30-130 IU/L) during the study. Anti-HCV seroconversions occurred at a very high rate in this community-based population in Japan, in which this infection is endemic. Persistence also developed at a high frequency among the cases of newly acquired infection, although the associated liver enzyme abnormalities were mild.
丙型肝炎病毒（HCV）是全球肝病的一个重要病因。然而，这种感染的自然史和发病机制仍未完全明了。本研究的目的是描述日本一个社区人群中初发无症状HCV感染的演变情况。宫崎队列研究是一项针对两个村庄成年居民的前瞻性研究，其中一个村庄HCV患病率非常高。1984年至1995年间，该村庄的973人被纳入队列，其中23%的人检测出抗丙型肝炎病毒（抗-HCV）抗体。在随后的年度健康筛查中，在易感个体中识别出新的HCV血清转化者，并对他们的连续样本进行抗-HCV、HCV-RNA和HCV核心抗原检测。在研究随访的前11年中，14名参与者（6名男性，8名女性）获得了抗-HCV抗体，发病率为每10万人年362例。在有足够信息的血清转化者中，80%（8/10）在血清转化后5年以上检测到可检测的HCV-RNA和高抗-HCV滴度（>1:2048），表明这些受试者发生了持续感染。在8名持续感染的血清转化者中，有3名（37.5%）在研究期间丙氨酸转氨酶有相当一致但轻微的升高（30-130 IU/L）。在日本这个以社区为基础的人群中，抗-HCV血清转化发生率非常高，而这种感染在该人群中呈地方性流行。新感染病例中也有很高比例出现持续感染，尽管相关的肝酶异常较轻。
