Kanto Tatsuya, Yoshio Sachiyo
The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan.
Euroasian J Hepatogastroenterol. 2017 Jan-Jun;7(1):60-64. doi: 10.5005/jp-journals-10018-1213. Epub 2017 May 5.
In Japan, the estimated number of chronic hepatitis B virus infections was 1.1 to 1.4 million, and that of chronic hepatitis C virus was 1.9 to 2.3 million in 2000. The mortality of hepatocellular carcinoma had been increasing and hit the peak at around 2002, which subsequently started to decrease. Japan has a national action plan for addressing viral hepatitis called Basic Act on Hepatitis Measures, established in 2009. In 2011, basic guidelines for promotion of control measures for hepatitis were issued, comprising nine principles in order to promote measures to prevent hepatitis B and C. According to these guidelines, national and local governments share screening costs for testing hepatitis B and C in residents who are over 40 years old. Thus, out-of-pocket expenses from examinees are nil or reduced to the minimum. In addition, for patients with chronic hepatitis B or C and on treatment, drug prices of nucleotide analogs, interferon (IFN) treatment, or IFN-free direct antiviral agents along with examination expenses should be covered by special programs for viral hepatitis. The national and local governments cover the amount in excess of 100 to 200 USD of the cost of treatment. The proportion of liver cancer with nonviral etiology has been increasing in Japan. For the screening and follow-up of patients with nonalcoholic fatty liver disease, we demonstrated that interleukin 34 is a feasible fibrosis marker. Several advantages have prevailed in the Japanese health care systems for patients with viral liver disease compared with those in countries in the Western Pacific region. Therefore, Japan should take a lead in helping the implementation of practical hepatitis action plans in every country when in need. Kanto T, Yoshio S. Hepatitis Action Plan and Changing Trend of Liver Disease in Japan: Viral Hepatitis and Nonalcoholic Fatty Liver Disease. Euroasian J Hepato-Gastroenterol 2017;7(1):60-64.
在日本，2000年估计慢性乙型肝炎病毒感染人数为110万至140万，慢性丙型肝炎病毒感染人数为190万至230万。肝细胞癌的死亡率一直在上升，并在2002年左右达到峰值，随后开始下降。日本有一项应对病毒性肝炎的国家行动计划，即2009年制定的《肝炎对策基本法》。2011年，发布了促进肝炎控制措施的基本指南，包括九条原则，以推动预防乙型和丙型肝炎的措施。根据这些指南，国家和地方政府分担对40岁以上居民进行乙型和丙型肝炎检测的筛查费用。因此，受检者的自付费用为零或降至最低。此外，对于慢性乙型或丙型肝炎患者及正在接受治疗的患者，核苷酸类似物、干扰素（IFN）治疗或无干扰素直接抗病毒药物的药价以及检查费用应由病毒性肝炎专项计划支付。国家和地方政府支付超过100至200美元的治疗费用。在日本，非病毒病因导致的肝癌比例一直在上升。对于非酒精性脂肪性肝病患者的筛查和随访，我们证明白细胞介素34是一种可行的纤维化标志物。与西太平洋地区国家相比，日本的医疗保健系统在病毒性肝病患者方面具有若干优势。因此，日本应在需要时率先帮助各国实施切实可行的肝炎行动计划。 关东T，吉尾S。日本的肝炎行动计划和肝病变化趋势：病毒性肝炎和非酒精性脂肪性肝病。《欧亚肝脏胃肠病学杂志》2017；7（1）：60 - 64。
