In living donor liver transplantation, it could be one of the key points for better prognosis that the recipients with hepatitis C should have prophylactic therapy to prevent hepatitis C recurrence. We performed a retrospective analysis in our 10 patients of hepatitis C virus (HCV)-infected LDLT recipients. Three patients had the anti-HCV therapy before LDLT. Two cases showed the decrease of HCV-RNA levels, although the therapy was obliged to stop or reduce because of side effects. Seven of ten patients had the anti-HCV therapy after LDLT, five patients before HCV recurrence, and two patients after HCV recurrence. In these five patients, HCV recurred in only one patient, even though HCV-RNA was positive in two patients. Meanwhile, two patients who had the therapy after HCV recurrence showed progressive graft damagein spite of the initiation of the therapy. Three patients were excluded because of the instability of their post-operation status. In conclusion, LDLT recipients with hepatitis C should have prophylactic therapy to prevent hepatitis C recurrence.

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The present study deals with 155 patients with more than ten years survival of hepatocellular carcinoma who are collected from 19 hospitals of Chugoku district.
1. 110 cases are male (71%) and 45 cases are female (29%) and the average age was 65.1 years old.
2. HBs-Ag positive cases were 20.6% and HCV-Ab positive cases were 56.7% and both negative cases occupied 7.8%.
3. The average age of HBs-Ag positive cases were 59.1 years old, while in HCV-Ab positive patients it was 67.2 years old.
4. Choice of treatments consist of hepatectomy in 61 cases (39.3%) and hepatectomy with combined other therapies in 59 cases (38.1%). Hepatectomy were selected in 77.4% (120 out of 155 cases).
5. TAE (transcatheter arterial embolization) were selected in 66 cases (42.6%) as monotherapy or in combination with other treatments.

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A 23 year old female was admitted to our hospital for general malaise and live function test abnormalities, and was diagnosed with acute hepatitis B. She showed grade-I coma and prothrombin time was prolonged. As for the source of infection, her male sexual partner was suspected because he had contracted acute hepatitis B 3 months before. Nucleotide sequence analyses indicated that both his and her isolates segregate to genotype Ae, and showed 99.9%-identity to each other over the entire preS/S region. The partner had had sex repeatedly with prostitutes before onset of his illness. As illustrated by the present case, merely a tip of iceberg perhaps, HBV is now spreading by sex in younger generations. Some public health measures are thus warranted.

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A 52-year-old Japanese woman with positive for HBs antigen was admitted to our hospital due to abnormal liver function test. HBe antigen was negative, anti-HBe antibody was positive, and serum HBV-DNA was undetectable. Antinuclear antibody was positive at titer 1 : 160, and anti-mitochondrial antibody was positive at titer 1 : 80. Laparoscopic examination showed coarse depression and groove-like depression. Biopsy specimen presented chronic hepatitis with plasma cells infiltration. Bile duct damage was not observed. The diagnosis of autoimmune hepatitis was made. HBV was thought to be inactive state. She had received oral corticosteroid therapy and prophylaxis of lamivudine. She had rapidly normalization of liver function tests, had taken a good course without reactivation of HBV for 2 years. Prophylactic administration of lamivudine during corticosteroid therapy may be beneficial for preventing reactivation of HBV.

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We experienced a case of primary biliary cirrhosis (PBC) seronegative for anti-nuclear and anti-mitochondrial antibodies but positive for anti-smooth muscle antibody. She was a middle-aged woman and asymptomatic. Although laboratory data showed high titer of γ-globurin and IgG and modified AIH score (by International Autoimmune Hepatitis Group, 1999) was 14 which corresponded to probable AIH, she was histologically diagnosed as PBC by typical chronic non-suppurative destructive cholangitis and bile duct injury and lack of interface hepatitis. We think that measurement of anti-smooth muscle antibody may be useful to diagnose PBC in some cases but further studies will be needed to explain the significance of anti-smooth muscle antibody in PBC patients.

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