| セッション情報 | パネルディスカッション8(肝臓学会・消化器病学会合同)東アジアにおける肝疾患の問題点と治療の特色 |
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| タイトル | 肝PD8-3指：Characteristics of Liver Disease and its Treatment in East Asia |
| 演者 | J. D. Sollano（University of Santo Tomas） |
| 共同演者 | |
| 抄録 | While the spectrum of liver diseases in East and Southeast Asia is wide and varied, the most common disorders are largely related to infections. Up to 8,980,000 cases of viral hepatitis with 585,800 deaths occur annually in the region, and distributed as follows; hepatitis A: 400 000 cases with 800 deaths annually, hepatitis B :1,380,000 cases with 300,000 deaths annually, hepatitis C: 500,000 cases with 120,000 deaths annually, and hepatitis E: 6,500,000 cases with 160,000 deaths and 2700 stillborns annually. Acute hepatitis of unknown etiology contributes 200,000 cases with 5000 deaths. Hepatitis B virus infection is highly prevalent and is the major etiology of hepatocellular carcinoma (HCC) in 55-65% of cases. Other causes of HCC are hepatitis C virus infection and aflatoxin exposure. In the world, the East and Southeast Asian regions have the highest incidence rates for HCC, i.e., age-standardized incidence rate is 35.5 and 21.4 for males and 12.7 and 9.0 for females, respectively. HCC has a high fatality rate and most cases are diagnosed late. Universal vaccination programs against HBV being implemented today will surely duplicate the dramatic decrease of HBV infection and HCC achieved previously in other regions, however, these gains will not come in the short term. The WHO reports that as of 2010, approximately 130M infants have been admnistered HBV vaccination. Improvements in social and medical care services, as well as, introduction of novel treatments against hepatitis C to East Asia will invariably help reduce the burden of the disease. Liver fluke infestation with Clonorchis sinensis and Opistorchis viverrini continue to contribute to recurrent pyogenic cholangitis, pancreatitis, cholangiocacinoma and oriental hepatolithiasis in certain areas of the region. Schistosomiasis results in severe portal hypertension and deaths due to esophageal variceal haemorrhage. Hepatobiliary (and pancreatic) ascariasis is remains a frequent source of biliary sepsis and emergencies. On the other hand, improved sanitation has resulted in a decrease in amoebic liver abscess incidence. Tuberculosis (TB) is a re-emerging problem which may cause hepatobiliary TB and cholestasis. Currently, infection with MDR-M tuberculosis is a major concern. Despite the disparity in socioeconomic conditions within the region metabolic syndrome and non-alcoholic fatty liver disease (NAFLD) are fairly common. With an overall prevalence that is broadly similar to that of North America, i.e., affecting between 10% and 45% of community subgroups, NAFLD and its long-term sequelae is predicted to be a dominant health issue for the East and Southeast Asian regions in the future. |
| 索引用語 | Hepatitis B, East Asia |