Kimio Nakanishi

Interferon therapy for patients more than 60 years of age with chronic hepatitis C

Abstract Nineteen patients aged > 60 years with chronic hepatitis C (CHC) received interferon (IFN) therapy and a complete response (CR) was achieved by five of them (26%). The incidence of CH with severe fibrosis in this elderly group was significantly higher than in another 52 patients with CHC who were < 60 years of age (the younger group; P < 0.05). There was no significant difference in the hepatitis C virus (HCV) genotype distribution between the elderly group and the younger group. However, the HCV‐RNA titre was significantly higher in the elderly group than in the younger group (P < 0.05). There was no significant difference in the efficacy rate of IFN in the elderly and younger groups after standardization of the background factors. In the elderly group, the HCV‐RNA titre was significantly lower in the patients achieving CR than in those with no response (P < 0.05). These data suggest that elderly patients with a low HCV‐RNA titre can still respond well to IFN therapy.

Significance of sublobular hepatic necrosis in the progression of chronic hepatitis C

Abstract The clinical characteristics of hepatitis C virus associated chronic liver diseases (C‐LD) in 17 patients were compared with hepatitis B virus associated diseases (B‐LD) in 47 patients, by analysing the histological findings of the liver and the change in serum alanine aminotransferase (ALT) level. The persistence of the moderate abnormality in ALT (> 100 IU/L) for longer than 1 year was more frequently seen in the C‐LD group (P < 0.01), although the severe exacerbation of the disease with ALT higher than 500 IU/L was more frequent in the B‐LD group (P < 0.01). The patients with the histological finding of sublobular hepatic necrosis (SN) in the C‐LD group progressed to advanced stages more frequently than those with SN in the B‐LD group (P < 0.05). Furthermore, nine of 10 patients with SN in C‐LD finally progressed to hepatocellular carcinoma (HCC) in 52 ± 23 months, whereas three of 16 with SN in B‐LD developed HCC in 81 ± 34 months. Although the morphological features of SN in C‐LD and B‐LD were almost the same, SN in C‐LD seemed to be a more significant diagnostic condition for the progression to liver cirrhosis or HCC. The patients with SN in the C‐LD group should be closely followed for the early detection of HCC, although further study with a greater number of patients is necessary.

Characteristic Laparoscopic Findings of Chronic Hepatitis C: A Comparison with Hepatitis B.

Abstract: We performed laparoscopy on 72 patients with chronic hepatitis C (CH‐C) to elucidate its morphological features and characteristics relating to its progressive clinical course. We then compared these findings with those of 188 patients with chronic hepatitis B (CH‐B).