scholarly journals Hepatitis Action Plan and Changing Trend of Liver Disease in Japan: Viral Hepatitis and Nonalcoholic Fatty Liver Disease

2017 ◽  
Vol 7 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Tatsuya Kanto ◽  
Sachiyo Yoshio
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis B ◽  
Fatty Liver ◽  
Viral Hepatitis ◽  
Nonalcoholic Fatty Liver Disease ◽  
Local Governments ◽  
Fatty Liver Disease ◽  
Action Plan ◽  
Nonalcoholic Fatty Liver

ABSTRACT 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. How to cite this article: 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.

Depression in Patients with Nonalcoholic Fatty Liver Disease and Chronic Viral Hepatitis B and C

2011 ◽  
Vol 52 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Ali A. Weinstein ◽  
Jillian Kallman Price ◽  
Maria Stepanova ◽  
Laura W. Poms ◽  
Yun Fang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis B ◽  
Fatty Liver ◽  
Viral Hepatitis ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Chronic Viral Hepatitis ◽  
Nonalcoholic Fatty Liver ◽  
Viral Hepatitis B

scholarly journals The FIB-4 Index Is a Useful Predictor for the Development of Hepatocellular Carcinoma in Patients with Coexisting Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2301
Author(s):  
Minah Kim ◽  
Yeonju Lee ◽  
Jun Sik Yoon ◽  
Minjong Lee ◽  
So Shin Kye ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis B ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Chronic Hepatitis B ◽  
Fatty Liver Disease ◽  
Youden Index ◽  
Nonalcoholic Fatty Liver

Background: The FIB-4 index, a noninvasive tool (FIB-4 index = age × aspartate transaminase (AST)/(platelet count × √alanine aminotransferase (ALT)), is a useful assessment for liver fibrosis. Patients with a high FIB-4 index were reported to have a high risk of developing hepatocellular carcinoma (HCC). This study analyzed the clinical association of the FIB-4 index with HCC development in patients with coexisting nonalcoholic fatty liver disease and chronic hepatitis B (NAFLD–CHB). Methods: This retrospective study analyzed 237 consecutive patients with NAFLD–CHB between January 2006 and December 2010 at the National Police Hospital in Korea. Patients with HCC at baseline and those diagnosed with HCC within 6 months from baseline were excluded. Propensity score matching analysis (PSM) was adopted to balance the baseline characteristics between patients with low and high FIB-4 index values. The cumulative rates of HCC development were compared between the two groups using the Kaplan–Meier method in the matched population. Results: The median follow-up duration was 13 years (interquartile range, 8.2–15.7). The optimal cutoff for the FIB-4 index of 1.77 was calculated based on the maximum Youden index value, with an AUC of 0.70. Among a total of 237 patients with NAFLD–CHB, HCC developed in 20 patients (8.4%) (14 of the 90 patients with a high FIB-4 index vs. 6 of the 147 patients (4.1%) with a low FIB-4 index; log-rank p = 0.003). Patients with a high FIB-4 index had a significantly and independently higher risk of HCC than those with a low FIB-4 index (adjusted hazard ratio, 4.35; 95%; confidence interval, 1.42–13.24; log-rank test, p = 0.006). Conclusion: A high FIB-4 index (≥1.77) might be a useful marker for predicting the development of HCC in patients with NAFLD–CHB.

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