日本急性病毒性肝炎的动态流行病学。

Dynamic epidemiology of acute viral hepatitis in Japan.

机构信息

Research Center for Hepatitis and Immunology, International Medical Center of Japan, Kohnodai Hospital, Ichikawa, Chiba, Japan.

出版信息

Intervirology. 2010;53(1):70-5. doi: 10.1159/000252788. Epub 2010 Jan 5.

DOI:10.1159/000252788

PMID:20068345

Abstract

The epidemiology of acute viral hepatitis (AVH) is dynamic and affected by many factors including hygiene, socioeconomic status and vaccination coverage. A total of 4,302 cases of AVH were sequentially enrolled in this nationwide study between 1980 and 2008. Of the cases of AVH, acute hepatitis A (AHA) accounted for 1,583 (36.8%), acute hepatitis B (AHB) for 1,197 (27.8%), acute hepatitis C (AHC) for 359 (8.3%), and non-A, non-B and non-C (non-ABC) for 1,163 (27.0%). Between 1980 and 1995, the proportions of AHA, AHB, AHC and non-ABC were approximately 40, 25, 10 and 25%; between 1996 and 2003, they were approximately 30, 30, 10 and 30%, and this shifted to approximately 10, 40, 10 and 40% in the last 5 years. The number of AHB caused by genotype A, which is not indigenous to Japan, was 6.0% between 1991 and 1996 but has been markedly increasing since 2000, to reach 52% in 2008. Autochthonous acute hepatitis E (AHE) accounted for 10-15% of non-ABC hepatitis after 2002. The etiology of AVH in Japan has been drastically changing. A marked increase of AHB genotype A and constant occurrence of autochthonous AHE require attention, and necessary measures should be taken.

摘要

1980 年至 2008 年，在这项全国性研究中，共连续纳入了 4302 例急性病毒性肝炎（AVH）病例。在这些 AVH 病例中，急性甲型肝炎（AHA）占 1583 例（36.8%），急性乙型肝炎（AHB）占 1197 例（27.8%），急性丙型肝炎（AHC）占 359 例（8.3%），非甲-非乙-非丙（非 ABC）占 1163 例（27.0%）。1980 年至 1995 年，AHA、AHB、AHC 和非 ABC 的比例约为 40%、25%、10%和 25%；1996 年至 2003 年，这一比例约为 30%、30%、10%和 30%，在过去 5 年中，这一比例转变为约 10%、40%、10%和 40%。1991 年至 1996 年，非日本起源的基因型 A 引起的 AHB 占 6.0%，但自 2000 年以来，这一比例显著增加，2008 年达到 52%。自 2002 年以来，本土性急性戊型肝炎（AHE）占非 ABC 肝炎的 10-15%。日本的 AVH 病因已发生巨大变化。A 型乙型肝炎基因型 A 的显著增加和本土性 AHE 的持续发生需要引起重视，并应采取必要措施。