佐賀県では2012年より佐賀県健康増進課と佐賀大学が協同で肝疾患データベース（DB）を構築してきた．このDBを用いて佐賀県のC型肝炎ウイルス（HCV）陽性者の現状を解析した．解析対象はHCV陽性者2460人，治療費助成受給者3110人．HCV陽性者の出生年は治療費助成受給者に比べ早く高齢化が進んでいた（1944±12年 vs. 1952±12年，p＜0.001）．治療費助成受給者における1939年以前出生の割合はHCV陽性者における割合に比べ低く高齢者の治療が進んでいないことが明らかとなった（11.5% vs 38.6％，p＜0.001）．治療法別では経口2剤治療登場後，1939年以前出生の割合が有意に増加しており高齢者の治療ハードルが下がっていることが読み取れた．治療の進歩に伴い未治療者のみならず既治療者も高齢化が進んでいくことが予想される．このことを踏まえた肝炎・肝がん対策が必要である．
The distribution of hepatitis C virus (HCV) serogroup and possible transmission route was investigated in 445 HCV-infected patients in a city hospital in Mito, Japan, during 2006-2014. The proportion of HCV serogroup 1 (SG1) was higher (65.2%) in the age group of ≥50 years (n=333), while the percentage of HCV serogroup 2 (SG2) was higher (65.2%) in the age group of <50 years (n=112) (p<0.0001). Blood transfusion/surgery and acupuncture as assumed transmission routes were frequent in the aged group, while tattooing, injection drug use (IDU) and piercing was frequent in the younger group. Of note, in the younger group, tattooing was associated with SG1, while IDU and piercing were frequently seen in patients with SG2. Significant changes in the distribution of HCV serogroup were observed, most likely due to the marked decrease of transfusion-transmitted HCV infection. Continued risk of HCV infections via tattooing, IDU and piercing should carefully be surveyed.
We studied intraperitoneal bleeding in laparoscopic bipolar radiofrequency ablation (RFA) for hepatocellular carcinoma and feasibility of needle tract cauterization (NTC), retrospectively. Patients treated with laparoscopic RFA divided into three groups: (1) using monopolar RFA, (2) using bipolar RFA before and (3) after modification of NTC method. Age, gender, platelet count, prothrombin time and Child-Pugh score were equal in each group. Though NTC was performed in all procedures, bleeding from needle tract was observed in 7/41 (17.1%) in monopolar group, 20/39 (51.3%) in bipolar group and 10/49 (20.4%) in bipolar with modified NTC group (P<0.002). Careful attention and appropriate treatment to intraperitoneal bleeding are required in bipolar RFA using thick and plural applicators.