首都圏におけるB型急性肝炎の変遷:―Genotype Aの急増から10年を経て―  [in Japanese] Incidence of acute hepatitis B in a metropolitan area: a follow-up study after increased genotype A infection  [in Japanese]

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Author(s)

    • 山田 典栄 Yamada Norie
    • 清川病院肝臓病研究センター|国立感染症研究所ウイルス第2部 Department of Internal Medicine, Center for Liver Diseases, Seizankai Kiyokawa Hospital|Department of Virology II, National Institute of Infectious Diseases
    • 鈴木 通博 Suzuki Michihiro
    • 川崎市立多摩病院消化器・肝臓内科 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital
    • 安田 清美 Yasuda Kiyomi
    • 清川病院肝臓病研究センター Department of Internal Medicine, Center for Liver Diseases, Seizankai Kiyokawa Hospital
    • 平石 哲也 Hiraishi Tetsuya
    • 川崎市立多摩病院消化器・肝臓内科 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital
    • 小林 稔 Kobayashi Minoru
    • 聖マリアンナ医科大学消化器・肝臓内科 Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine
    • 池田 裕喜 Ikeda Hiroki
    • 聖マリアンナ医科大学消化器・肝臓内科 Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine
    • 渡邊 綱正 Watanabe Tsunamasa
    • 聖マリアンナ医科大学消化器・肝臓内科 Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine
    • 奥瀬 千晃 Okuse Chiaki
    • 川崎市立多摩病院消化器・肝臓内科 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital
    • 四柳 宏 Yotsuyanagi Hiroshi
    • 東京大学医科学研究所先端医療研究センター感染症分野 Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo

Abstract

<p>1994年から2017年の首都圏におけるB型急性肝炎(AH-B)の発生動向について246例を対象に検討を行った.観察開始以降,AH-B症例数は増加傾向であったが2004年をピークに2010年までほぼ横ばいで推移し以降は減少に転じた.Genotype(GT)の分布は2002年からGTAの増加を認め,2006年以降はGTAが常に優位となった.臨床背景は20-30歳代,男性,性感染によるものが大多数であり,経過観察可能であった165例中5例(GTA;3例,GTC;1例,GTH;1例)で慢性化を認めた.HBs抗原領域のワクチンエスケープ変異は2例に検出された.首都圏におけるAH-Bの症例数は減少傾向であるが,依然として若年男性,GTAを特徴とした性感染症として認められた.AH-Bの発生動向については今後も継続的な調査が必要であり,B型肝炎ワクチン(HBワクチン)接種のさらなる啓発も求められる.</p>

<p>We investigated the incidence of acute hepatitis B (AH-B) infection in the metropolitan area from 1994 to 2017. A total of 246 AH-B cases were recorded. The number of patients with AH-B increased between 1994 and 2004 but decreased after 2010. After initiating the observation period, the incidence of infections with genotype (GT) A gradually increased and accounted for most cases after 2006. Infections were also observed in young men; moreover, sexual transmission was frequently observed. Among 166 patients who were continuously observed, 5 developed chronic infections (GTA, 3 patients; GTC, 1 patient; and GTH, 1 patient). The evaluation of amino acid polymorphisms in the <i>a</i>-determinant region revealed that seven patients had amino acid substitutions. Continuous monitoring of the incidence and characterization of AH-B is required, and education regarding the importance of HB vaccination is necessary for controlling this viral infection.</p>

Journal

  • Kanzo

    Kanzo 60(5), 139-146, 2019

    The Japan Society of Hepatology

Codes

  • NII Article ID (NAID)
    130007650443
  • NII NACSIS-CAT ID (NCID)
    AN00047770
  • Text Lang
    JPN
  • ISSN
    0451-4203
  • NDL Article ID
    029661033
  • NDL Call No.
    Z19-130
  • Data Source
    NDL  J-STAGE 
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