臨牀消化器内科 Vol.27 No.11(1)


特集名 C型肝炎治療の最前線
題名 わが国におけるC型肝炎の疫学
発刊年月 2012年 10月
著者 田中 純子 広島大学大学院医歯薬保健学研究院疫学・疾病制御学
【 要旨 】 厚生労働省研究班(肝炎の疫学研究班)が行ってきた調査研究を中心に,C型肝炎に関する疫学調査成績を紹介した.わが国の一般集団におけるC型肝炎ウイルス持続感染率(HCVキャリア率)の分布は,若い世代から順に少なくとも1922年出生の集団(2005年時点83歳)にまでさかのぼり高くなること,近畿以西,とくに肝がん好発年齢集団で高い値を示すこと,1986年以後に出生した世代ではきわめて低い値を示すこと,一般集団においてはHCV感染の新規発生はごくまれであること,しかし,観血的処置を行う頻度の多い医療施設や感染のハイリスク集団における感染は,102倍程度リスクが高くなることを示した.全国推計で80.8万人と推計された潜在しているHCVキャリアへの検査の推進と,治療導入に至っていない要精検HCVキャリアへの方策が緊急課題としてあげられる.
Theme The Forefront of Hepatitis C Treatment
Title Epidemiological Topics Concerning Hepatitis C in Japan
Author Junko Tanaka Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University
[ Summary ] Epidemiological studies concerning HCV derived from large research studies conducted after 2000 are examined. These studies were conducted by the Hepatitis Epidemiological Research Group (Chairman : J. Tanaka) with the support of the Ministry of Health, Labor and Welfare. According to the results obtained HCV carrier rates in the Japanese general population exhibit various features. The farther back we check to the birth of the group in 1922 (83 years as of 2005), the higher HCV carrier rates are. High HCV carrier rates were observed in the Kinki region and further west. There was a high HCV carrier rate, especially in the peak age HCC onset group. Very low HCV carrier rates were observed in the generations born after 1986. An extremely low incidence rate of HCV infection was seen in the general population. A 102 fold greater risk of HCV infection was noted in medical institutions which provided frequent invasive treatment, as well as in the high risk infection group. In conclusion, there are two urgent countermeasures to combat HCV. One is to promote examinations for undetected HCV carriers who are estimated to number 808,000. The other is to take measures to detect HCV carriers who are not receiving treatment, giving them detailed examinations and providing them with appropriate therapy.
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