<Case report>A Study of Patient with Chronic Non-B, Non-C Hepatitis who Developed Liver Cirrhosis and Hepatocellular Carcinoma Over 14 Years Observation

In 1986, a 58-year-old male was diagnosed as having chronic non-A, non-B hepatitis by a liver biopsy showing fibrous enlargement and lymphocyte infiltration in the periportal area. Since then, he continued to be followed at our outpatient clinics as a case of chronic hepatitis of unknown etiology and was found to be negative for the antibody to hepatitis C virus. During the follow-up, elevation of alanine aminotransferase (ALT) levels continued and his plasma albumin levels gradually decreased, leading to a diagnosis of liver cirrhosis. In 2000, multiple nodular lesions developed in his liver and a biopsy revealed well differentiated hepatocellular carcinoma with cirrhosis. We could not identify any etiological agent which might have caused his disease progression and the occurrence of hepatocellular carcinoma. However, the histological findings and the similarity of the clinical course to chronic hepatitis B and hepatitis C suggested that his disease might be due to chronic infection with another, as yet unidentified, virus.