Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
Intervirology. 2010;53(1):39-43. doi: 10.1159/000252782. Epub 2010 Jan 5.
In Japan, hepatocellular carcinoma (HCC) is the fourth leading cause of death in males and the fifth in females. Hepatitis C virus (HCV) is a major cause of HCC in Japan, with 70% of cases being HCV related. HCV genotype 1b, the most prevalent subtype in Japan, started to spread in the 1930s among injecting drug users (IDUs) during and after World War II or through medical procedures such as blood transfusion and use of contaminated syringes. The prevalence of HCV infection is much lower in the current younger generation compared with that in the older generation, particularly those aged >55 years (0.1-0.2% vs. > or = 2%). Therefore, the total number of patients with HCV infection is estimated to decrease, even though sporadic HCV transmission is mainly seen among young IDUs. Of note, HCV genotype 2 seems to be spreading among IDUs, but the response to antiviral therapy in these patients seems to be better than that in older patients, irrespective of the genotype. Although the number of patients who die because of HCC has steadily increased over the last 50 years, the incidence of HCC is now decreasing, mainly because of the decreased prevalence of HCV-related HCC.
在日本，肝细胞癌（HCC）是男性的第四大死因，女性的第五大死因。丙型肝炎病毒（HCV）是日本 HCC 的主要病因，其中 70%与 HCV 相关。HCV 基因型 1b 是日本最流行的亚型，它于二战期间及之后在注射吸毒者（IDU）中开始传播，或者通过输血和使用污染的注射器等医疗程序传播。与老年人群（>55 岁，0.1-0.2%）相比，当前年轻一代 HCV 感染的流行率要低得多。因此，尽管散发性 HCV 传播主要发生在年轻 IDU 中，但预计 HCV 感染患者的总数将会减少。值得注意的是，HCV 基因型 2 似乎在 IDU 中传播，但这些患者对抗病毒治疗的反应似乎比老年患者更好，而与基因型无关。尽管过去 50 年来因 HCC 死亡的患者人数稳步增加，但 HCC 的发病率现在正在下降，主要是因为与 HCV 相关的 HCC 的流行率降低。
