Tomoyuki Akita

Total numbers of undiagnosed carriers of hepatitis C and B viruses in Japan estimated by age- and area-specific prevalence on the national scale.

Objective: To estimate total numbers of undiagnosed carriers of hepatitis C virus (HCV) and hepatitis B virus (HBV) in Japan. Methods: Area- and age-specific prevalence of HCV as well as HBV was determined in the first-time blood donors [20–39 years (n = 2,429,364)] and examinees of periodical health check-ups [40–74 years (6,204,968 for HCV and 6,228,967 for HBV)] in Japan. Prevalence in adolescents [5–19 years (79,256 for HCV and 68,792 for HBV)] was determined in a single prefecture, and that of HCV in the elderly (≧75 years) was estimated by the exponential model. HBV infection was determined by the detection of hepatitis B surface antigen, and HCV infection by either the algorithm or assuming persistent infection in 70% of the individuals with antibody to HCV. Results: Of the total population of 127,285,653 in 2005, 807,903 (95% CI 679,886–974,292) were estimated to be infected with HCV at a carrier rate of 0.63%, and 903,145 (837,189–969,572) with HBV at that of 0.71%. Conclusion: Accurate estimation of undiagnosed HCV and HBV carriers in the general population would help to predict the future burden of liver disease, and take appropriate measures for improving healthcare.

The applicability of ganglion cell complex parameters determined from SD-OCT images to detect glaucomatous eyes.

Purpose:To determine whether the thicknesses of the different parameters of the ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer can be used to differentiate eyes with glaucoma from normal eyes. Methods:Two hundred sixty-one eyes, including 68 normal eyes and 32 preperimetric glaucoma, 81 early glaucoma, and 80 advanced glaucoma were analyzed in the present study. The thicknesses of the GCC and retinal nerve fiber layer were measured using RTVue spectral-domain optical coherence tomographic (SD-OCT) images. The area under the receiver operating characteristic (AUROC) curve and sensitivities at fixed specificities were calculated for each parameter. A logistic regression analysis was used to determine the risk factors for glaucoma. Results:The 2 largest AUROC curves for all glaucoma stages were those for the GCC parameters. The global loss volume (GLV) was always one of the 2 highest values of the AUROC curve. The GLV also had the highest sensitivity at a fixed specificity to identify glaucoma at early and advanced stage. The focal loss volume (FLV) had the largest AUROC curve value and the highest sensitivity at a fixed specificity for advanced glaucoma. The logistic regression analysis showed that the GLV was one of the factors that predicted preperimetric glaucoma [odds ratio (OR)=1.74] and early glaucoma (OR=1.22), whereas the FLV was useful for detecting advanced glaucoma (OR=2.32). Conclusions:The SD-OCT-derived macular GCC parameters can be used to detect preperimetric and perimetric glaucoma. The new GCC parameters, GLV and FLV, performed well in discriminating glaucomatous eyes from normal eyes.

Prognosis of chronic spontaneous urticaria in 117 patients not controlled by a standard dose of antihistamine

Chronic spontaneous urticaria (CSU) is a common skin disorder, but its clinical course reported so far is largely variable, probably due to the heterogeneity of the clinical background of patients and pathogenesis of this disease.

Seroprevalence, genotypic distribution and potential risk factors of hepatitis B and C virus infections among adults in Siem Reap, Cambodia

We investigated hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among adults in Siem Reap, Cambodia, to consider the prevention strategy in cooperation with the Ministry of Health in Cambodia.

High prevalences of hepatitis B and C virus infections among adults living in Binh Thuan province, Vietnam.

Vietnam is one of the countries with the highest mortality from liver cancer, which is mostly attributed to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. For planning preventive strategies against these infections, we investigated prevalences of HBV and HCV infections among adults living in Binh Thuan, Vietnam.

Hepatitis E Virus in Cambodia: Prevalence among the General Population and Complete Genome Sequence of Genotype 4

Hepatitis E virus (HEV) is a growing public health problem in many countries. In this study, we investigated HEV seroprevalence among the general population in the Siem Reap province, Cambodia, and performed HEV genetic analysis with the aim to develop an HEV prevention strategy. This seroepidemiological cross-sectional study conducted from 2010 to 2014 included 868 participants from four different locations in Siem Reap province, Cambodia. They answered questionnaires and provided blood samples for the analysis of hepatitis virus infections. Among the participants (360 men and 508 women; age range, 7–90 years), the prevalence of anti-HEV IgG was 18.4% (95% confidence interval: 15.9–21.0); HEV RNA was detected in two participants (0.23%) and was classified as genotype 3 and 4. Full-length genome of the genotype 4 isolate, CVS-Sie10, was sequenced; it contained 7,222 nucleotides and three ORFs and demonstrated high sequence identity with the swine China isolates swGX40 (95.57%), SS19 (94.37%), and swDQ (91.94%). Multivariate logistic regression analysis revealed that men, elderly people, and house workers were risk groups significantly associated with the positivity for anti-HEV IgG. This is the first report on the detection of HEV genotype 4 in humans in Cambodia and on the complete genome sequence of HEV genotype 4 from this country. Our study demonstrates that new HEV infection cases occur frequently among the general population in Cambodia, and effective preventive measures are required.

Predicting future blood supply and demand in Japan with a Markov model: application to the sex- and age-specific probability of blood donation

Simulation studies were performed to predict the future supply and demand for blood donations, and future shortfalls.

Estimated numbers of patients with liver disease related to hepatitis B or C virus infection based on the database reconstructed from medical claims from 2008 to 2010 in Japan

To estimate the number of patients with liver‐related diseases classified by hepatitis viruses (HBV, HCV) based on the information from re‐coded medical claims including several diagnosed diseases.

Using the early postoperative intraocular pressure to predict pressure control after a trabeculectomy.

Purpose:The goal of this study was to identify the early postoperative intraocular pressure (IOP) that predicts low pressure control after a trabeculectomy with mitomycin C. Materials and Methods:This study retrospectively analyzed the medical records of the initial trabeculectomy with mitomycin C in patients with primary open-angle glaucoma. We established 2 target postoperative IOPs, ⩽11 and ⩽15 mm Hg. The preoperative and early postoperative factors contributing to the success and failure of postoperative IOP control were studied by multiple regression analyses. These factors included the sex and age of patients, record of cataract surgery, number of preoperative medications, preoperative IOP, IOP recorded 2 weeks after surgery, laser suture lysis after surgery, and the presence of a shallow anterior chamber and choroidal detachment during the first month after surgery. The optimal IOP levels 2 weeks after surgery for long-term IOP control were examined using the Kaplan-Meier survival analyses. Results:Sixty-six patients (66 eyes) with open-angle glaucoma participated in the study. The age and IOP 2 weeks after surgery were selected as the confounding factors affecting the probability of successfully satisfying both target IOPs;⩽11 and⩽15 mmHg postoperatively. An IOP under 8 mm Hg at 2 weeks after surgery was found to be associated with maintaining the postoperative IOP at either ⩽11 and ⩽15 mm Hg for an extended period. Conclusions:An IOP of 8 mm Hg was associated with successful outcomes in patients undergoing trabeculectomy. Also, younger age was found to be a risk factor for surgical failure.

Systematic review and meta-analysis of hepatitis C virus infection in the Democratic Republic of Congo

OBJECTIVES Hepatitis C virus (HCV) infection is endemic in the Democratic Republic of the Congo (DRC), where the prevalence of HCV antibodies (anti-HCV) is reported to range from 0.2% to 13.7%. However, the reported prevalence rates have been inconsistent. Therefore, a meta-analysis of observational studies was conducted to provide updates on the prevalence of HCV infection in the DRC. STUDY DESIGN Systematic review and meta-analysis. METHODS Medline, EMBASE and Google Scholar were searched for publications reporting on HCV infection in the DRC up to autumn 2015. In addition, a manual search was undertaken to detect relevant papers. Studies performed in groups at low risk of HCV (blood donors and pregnant women) were used for the meta-analysis. The random effects model was used to estimate the pooled prevalence of anti-HCV. RESULTS Sixteen studies with 13,799 participants (aged 6 months-71 years) met the inclusion criteria. The studies were performed in blood donors, pregnant women, military personnel, individuals with human immunodeficiency virus, children, commercial sex workers, Congolese patients living in Canada, patients with sickle cell disease and hospitalized patients. The reviewed studies revealed the presence of anti-HCV in almost all studied age groups and did not differ between sexes. The pooled prevalence of anti-HCV was 2.9% [95% confidence interval 1.5-4.3%]. Subgroup analyses revealed that the prevalence rates of anti-HCV in blood donors and pregnant women were 2.7% (95% confidence interval: 1.1-4.4%) and 3.3% (1.4-5.1%), respectively. CONCLUSIONS HCV infection remains an issue of public concern in the DRC, demonstrating a need for adequate hepatitis control programmes. Efforts must be made to virtually eliminate transfusion-transmitted HCV throughout the country.