A questionnaire survey was performed for 391 patients and medical check-up examinees with positive hepatitis C virus (HCV) antibody. Regarding the questions about HCV, the subjects (aware group) who were aware about HCV infection achieved significantly higher scores than those (unaware group) who were unaware of it. When asked about when they became aware about HCV infection, approximately half the respondents (48.5%) responded that it was during a consultation at a medical institution for a different illness. Television was the best-recognized medium of education, recognized by 81.9% of those in the aware group and by 66.0% of those in the unaware group. In 123 hospital-clinic coordinating facilities, when the HCV antibodies were detected and the ALT and/or AST value was abnormally high, direct acting antivirals (DAA) were provided at their facility in 13% of the cases. Meanwhile, 17% of the facilities provided other treatments, and 6% followed up with observations. Therefore, promotion of reference to gastroenterologists and educational activities should be encouraged for HCV antibody-positive patients.

At the request of the national government, the Hepatitis Information Center has been holding educational workshops for laboratory technicians, nurses, physicians, and social workers at the liver disease information centers of the linked regional core centers since 2011. The workshop participants (n = 190) between fiscal years 2011 and 2014 submitted, in advance, a report on their needs, as a requirement of the application. By qualitative and text mining analyses, the following three "needs" were similarly selected: (1) opportunities to acquire the latest information and knowledge, (2) opportunities to learn special consultation skills for hepatitis patients and their families, and (3) networks: a human network and a network system. It should be emphasized, in particular, that "formation of networks to exchange informations" was selected as unmet "needs" of the workshop participants. Based on this study, it would be indispensable to satisfy these "needs" to improve and strengthen consultation support systems at liver disease information centers.

In 1998, a 61-year-old female was found to have multiple liver tumors. She was admitted to our hospital for further evaluation of the tumors in 2001. Based on histological examination, the tumors were diagnosed as epithelioid hemangioendothelioma (EHE) because the tumor cells were positive for markers of vascular endothelium, including CD31, factor VIII, and CD34. The tumors were located in both hepatic lobes, and multiple lung metastases were suspected. Furthermore, the tumors had no indication of partial hepatectomy and liver transplantation. In addition, specific chemotherapy and molecular-targeted agents were not available then. Thus, we carefully monitored the patient without administering any specific treatment. During the observation period, the tumor size and number remained unchanged. Follow-up CT revealed a ring enhancement noted in 2001 that disappeared by 2005. Remarkably, the patient survived for >20 years after being diagnosed with hepatic HEE and without being given any specific treatments for hepatic EHE.

We found three pairs of six sporadic acute hepatitis E cases infected with three different genotype 3b hepatitis E virus (HEV) strains, which were 99.7%-100% identical between two cases in each pair within the partial nucleotide sequences of ORF1 and ORF2 regions of the HEV genome. While no common source of infection was recognized within each pair, HEV infections in these cases occurred within the same economic bloc in the central region of Japan. Moreover, nucleotide sequences of the HEV strains from one pair were 99.8% identical to those obtained from pig liver sold in the same economic bloc. These results suggest the importance of continued molecular epidemiologic studies on HEV strains from humans and food products.