Vol. 53, No. 1, 2010
Issue release date: January 2010
Intervirology 2010;53:39–43
(DOI:10.1159/000252782)
Review Article
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Changing Trends in Hepatitis C Infection over the Past 50 Years in Japan

Chung H. · Ueda T. · Kudo M.
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan
email Corresponding Author


 goto top of outline Key Words

  • Chronic hepatitis
  • Hepatitis C virus
  • Hepatocellular carcinoma
  • Injecting drug user
  • Mortality rate
  • Post-transfusion hepatitis

 goto top of outline Abstract

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. ≧ 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.

Copyright © 2010 S. Karger AG, Basel


 goto top of outline References
  1. Ikai I, Arii S, Okazaki M, Okita K, Omata M, Kojiro M, Takayasu K, Nakanuma Y, Makuuchi M, Matsuyama Y, Monden M, Kudo M: Report of the 17th nationwide follow-up survey of primary liver cancer in Japan. Hepatol Res 2007;37:676–691.
  2. Yu MC, Yuan JM, Govindarajan S, Ross RK: Epidemiology of hepatocellular carcinoma. Can J Gastroenterol 2000;14:703–709.
  3. El-Serag HB: Hepatocellular carcinoma: recent trends in the United States. Gastroenterology 2004;127:27–34.

    External Resources

  4. Tanaka J, Kumagai J, Katayama K, Komiya Y, Mizui M, Yamanaka R, Suzuki K, Miyakawa Y, Yoshizawa H: Sex- and age-specific carriers of hepatitis B and C viruses in Japan estimated by the prevalence in the 3,485,648 first-time blood donors during 1995–2000. Intervirology 2004;47:32–40.
  5. Mizokami M, Tanaka Y, Miyakawa Y: Spread times of hepatitis C virus estimated by the molecular clock differ among Japan, the United States and Egypt in reflection of their distinct socioeconomic backgrounds. Intervirology 2006;49:28–36.
  6. Sasaki F, Tanaka J, Moriya T, Katayama K, Hiraoka M, Ohishi K, Nagakami H, Mishiro S, Yoshizawa H: Very low incidence rates of community-acquired hepatitis C virus infection in company employees, long-term inpatients, and blood donors in Japan. J Epidemiol 1996;6:198–203.
  7. Tanaka J, Mizui M, Nagakami H, Katayama K, Tabuchi A, Komiya Y, Miyakawa Y, Yoshizawa H: Incidence rates of hepatitis B and C virus infections among blood donors in Hiroshima, Japan, during 10 years from 1994 to 2004. Intervirology 2008;51:33–41.
  8. Yoshizawa H: Hepatocellular carcinoma associated with hepatitis C virus infection in Japan: projection to other countries in the foreseeable future. Oncology 2002;62(suppl 1):8–17.
  9. Sy T, Jamal MM: Epidemiology of hepatitis C virus (HCV) infection. Int J Med Sci 2006;3:41–46.

    External Resources

  10. Lavanchy D: The global burden of hepatitis C. Liver Int 2009;29(suppl 1):74–81.
  11. Villano SA, Vlahov D, Nelson KE, Lyles CM, Cohn S, Thomas DL: Incidence and risk factors for hepatitis C among injection drug users in Baltimore, Maryland. J Clin Microbiol 1997;35:3274–3277.
  12. Touzet S, Kraemer L, Colin C, Pradat P, Lanoir D, Bailly F, Coppola RC, Sauleda S, Thursz MR, Tillmann H, Alberti A, Braconier JH, Esteban JI, Hadziyannis SJ, Manns MP, Saracco G, Thomas HC, Trepo C: Epidemiology of hepatitis C virus infection in seven European Union countries: a critical analysis of the literature. Hencore group. (Hepatitis C European Network for Co-operative Research). Eur J Gastroenterol Hepatol 2000;12:667–678.
  13. Mathei C, Robaeys G, van Damme P, Buntinx F, Verrando R: Prevalence of hepatitis C in drug users in Flanders: determinants and geographic differences. Epidemiol Infect 2005;133:127–136.
  14. Wada K, Greberman SB, Konuma K, Hirai S: HIV and HCV infection among drug users in Japan. Addiction 1999;94:1063–1069.
  15. Satoh Y, Hino K, Kato T, Mizokami M, Yamashita S, Nakamura H, Okita K: Molecular epidemiologic analysis of hepatitis C virus infection in injecting drug users with acute hepatitis C in Japan. J Gastroenterol Hepatol 2004;19:1305–1311.
  16. Kato H, Maeno Y, Seko-Nakamura Y, Monma-Ohtaki J, Sugiura S, Takahashi K, Zhe LX, Matsumoto T, Kurvanov F, Mizokami M, Nagao M: Identification and phylogenetic analysis of hepatitis C virus in forensic blood samples obtained from injecting drug users. Forensic Sci Int 2007;168:27–33.
  17. Okanoue T, Itoh Y, Hashimoto H, Yasui K, Minami M, Takehara T, Tanaka E, Onji M, Toyota J, Chayama K, Yoshioka K, Izumi N, Akuta N, Kumada H: Predictive values of amino acid sequences of the core and ns5a regions in antiviral therapy for hepatitis C: a Japanese multi-center study. J Gastroenterol 2009;44:952–963.
  18. Kau A, Vermehren J, Sarrazin C: Treatment predictors of a sustained virologic response in hepatitis B and C. J Hepatol 2008;49:634–651.
  19. Chung H, Kudo M, Kumada T, Katsushima S, Okano A, Nakamura T, Osaki Y, Kohigashi K, Yamashita Y, Komori H, Nishiuma S: Risk of HCV transmission after needlestick injury, and the efficacy of short-duration interferon administration to prevent HCV transmission to medical personnel. J Gastroenterol 2003;38:877–879.
  20. Takagi H, Uehara M, Kakizaki S, Takahashi H, Takezawa J, Kabeya K, Satoh K, Kojima A, Saito S, Matsumoto T, Hashimoto Y, Abe T, Yamada T, Konaka K, Shimoda R, Takayama H, Takehara K, Nagamine T, Mori M: Accidental transmission of HCV and treatment with interferon. J Gastroenterol Hepatol 1998;13:238–243.
  21. Kiyosawa K, Sodeyama T, Tanaka E, Nakano Y, Furuta S, Nishioka K, Purcell RH, Alter HJ: Hepatitis C in hospital employees with needlestick injuries. Ann Intern Med 1991;115:367–369.
  22. Maheshwari A, Ray S, Thuluvath PJ: Acute hepatitis C. Lancet 2008;372:321–332.
  23. Manns MP, McHutchison JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R, Goodman ZD, Koury K, Ling M, Albrecht JK: Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 2001;358:958–965.
  24. Asselah T, Benhamou Y, Marcellin P: Protease and polymerase inhibitors for the treatment of hepatitis C. Liver Int 2009;29(suppl 1):57–67.
  25. Thompson A, Patel K, Tillman H, McHutchison JG: Directly acting antivirals for the treatment of patients with hepatitis C infection: a clinical development update addressing key future challenges. J Hepatol 2009;50:184–194.
  26. Umemura T, Ichijo T, Yoshizawa K, Tanaka E, Kiyosawa K: Epidemiology of hepatocellular carcinoma in Japan. J Gastroenterol 2009;44(suppl 19):102–107.
  27. Tanaka H, Imai Y, Hiramatsu N, Ito Y, Imanaka K, Oshita M, Hijioka T, Katayama K, Yabuuchi I, Yoshihara H, Inoue A, Kato M, Takehara T, Tamura S, Kasahara A, Hayashi N, Tsukuma H: Declining incidence of hepatocellular carcinoma in Osaka, Japan, from 1990 to 2003. Ann Intern Med 2008;148:820–826.
  28. Taura N, Hamasaki K, Nakao K, Ichikawa T, Nishimura D, Goto T, Fukuta M, Kawashimo H, Miyaaki H, Fujimoto M, Kusumoto K, Motoyoshi Y, Shibata H, Inokuchi K, Eguchi K: Aging of patients with hepatitis C virus-associated hepatocellular carcinoma: long-term trends in Japan. Oncol Rep 2006;16:837–843.

 goto top of outline Author Contacts

Masatoshi Kudo, MD, PhD
Department of Gastroenterology and Hepatology
Kinki University School of Medicine
377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511 (Japan)
Tel. +81 72 366 0221, Fax +81 72 367 2880, E-Mail m-kudo@med.kindai.ac.jp


 goto top of outline Article Information

Published online: January 5, 2010
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 0, Number of References : 28


 goto top of outline Publication Details

Intervirology (International Journal of Basic and Medical Virology)

Vol. 53, No. 1, Year 2010 (Cover Date: January 2010)

Journal Editor: Liebert U.G. (Leipzig)
ISSN: 0300-5526 (Print), eISSN: 1423-0100 (Online)

For additional information: http://www.karger.com/INT


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