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Transition in the etiology of liver cirrhosis in Japan: a nationwide survey.

Authors
  • Enomoto, Hirayuki1
  • Ueno, Yoshiyuki2
  • Hiasa, Yoichi3
  • Nishikawa, Hiroki1, 4
  • Hige, Shuhei5
  • Takikawa, Yasuhiro6
  • Taniai, Makiko7
  • Ishikawa, Toru8
  • Yasui, Kohichiroh9
  • Takaki, Akinobu10
  • Takaguchi, Koichi11
  • Ido, Akio12
  • Kurosaki, Masayuki13
  • Kanto, Tatsuya14
  • Nishiguchi, Shuhei15, 16
  • 1 Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan. , (Japan)
  • 2 Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. , (Japan)
  • 3 Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan. , (Japan)
  • 4 Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Japan. , (Japan)
  • 5 Department of Hepatology, Sapporo Kosei General Hospital, Sapporo, Japan. , (Japan)
  • 6 Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan. , (Japan)
  • 7 Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. , (Japan)
  • 8 Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan. , (Japan)
  • 9 Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan. , (Japan)
  • 10 Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan. , (Japan)
  • 11 Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan. , (Japan)
  • 12 Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. , (Japan)
  • 13 Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino, Japan. , (Japan)
  • 14 Hepatitis Information Center, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Tokyo, Japan. , (Japan)
  • 15 Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo, 663-8501, Japan. [email protected] , (Japan)
  • 16 Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Japan. [email protected] , (Japan)
Type
Published Article
Journal
Journal of gastroenterology
Publication Date
Mar 01, 2020
Volume
55
Issue
3
Pages
353–362
Identifiers
DOI: 10.1007/s00535-019-01645-y
PMID: 31768801
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To assess the recent real-world changes in the etiologies of liver cirrhosis (LC) in Japan, we conducted a nationwide survey in the annual meeting of the Japan Society of Hepatology (JSH). We investigated the etiologies of LC patients accumulated from 68 participants in 79 institutions (N = 48,621). We next assessed changing trends in the etiologies of LC by analyzing cases in which the year of diagnosis was available (N = 45,834). We further evaluated the transition in the real number of newly identified LC patients by assessing data from 36 hospitals with complete datasets for 2008-2016 (N = 18,358). In the overall data, HCV infection (48.2%) was the leading cause of LC in Japan, and HBV infection (11.5%) was the third-most common cause. Regarding the transition in the etiologies of LC, the contribution of viral hepatitis-related LC dropped from 73.4 to 49.7%. Among the non-viral etiologies, alcoholic-related disease (ALD) and nonalcoholic steatohepatitis (NASH)-related LC showed a notable increase (from 13.7 to 24.9% and from 2.0 to 9.1%, respectively). Regarding the real numbers of newly diagnosed patients from 2008 to 2016, the numbers of patients with viral hepatitis-related LC decreased, while the numbers of patients with non-viral LC increased. HCV has remained the main cause of LC in Japan; however, the contribution of viral hepatitis as an etiology of LC is suggested to have been decreasing. In addition, non-viral LC, such as ALD-related LC and NASH-related LC, is suggested to have increased as etiologies of LC in Japan.

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