The whole spectrum of patients infected with hepatitis C virus (HCV) who visited hospitals has not been fully clarified. It is also unknown whether such patients have visited the hospitals regularly thereafter for a long period. We studied 844 consecutive patients with liver diseases who visited our outpatient clinic located in the southern region of Ibaraki Prefecture. Five hundred eighty-three patients were HCV-infected. Among them, three patients were HBsAg-positive and another patient was IgM anti-HAV positive. Thus, 579 patients (68.6%) were considered to have HCV solely as a hepatotropic virus.Of these HCV patients, 60 were asymptomatic carriers and 15 others were unclassified because of the absence of either biopsy or imaging test records of the liver. As to the rest of the HCV patients, acute hepatitis was diagnosed in one patients, chronic hepatitis in 332 patients, cirrhosis in 130 patients and cancer of the liver in 41 patients.About half of the patients undergoing liver biopsy showed F1 in the degree of liver fibrosis. The rate of virological response to interferon mono-therapy in patients infected with genotype 2 was worse than the national average. The poor response was considered to be due to high viral load. It was suggested that the distribution of patients with each genotype was uneven in this region. After five years, the rate of patients still visiting our clinic were 68.1% for those with chronic hepatitis, and 50% for the healthy carriers. We deemed that it was important to clarify whether patients not visiting our clinic are followed up closely in other hospitals.
Hepatitis C virus ; Liver ; Clinic ; Infection as complication of medical care ; biopsy characteristics

The liver mitochondrial redox state (the liver mitochondrial free NAD+/NADH ratio), which indicates hepatic energy charge, is known to parallel the ketone body ratio (acetoacetate/3-hydroxybutyrate) in liver tissue. Since the ketone body ratio in arterial blood was reported to correlate with that in liver tissue; the arterial ketone body ratio (AKBR) has been widely accepted as a useful measure of the liver function reserve. The liver mitochondrial redox state is known to decrease with the oxidation of ethanol in alcohol abusers. To evaluate whether AKBR reflected the effect of alcohol intake on the liver, AKBR was measured in normal controls (n=8), and patients with alcoholic liver injuries (n=14) and chronic active hepatitis (n=15). The mean AKBRs in the normal control subjects, in patients with chronic active viral hepatitis, and in those with alcoholic liver disease were 1.68±0.77, 2.22±1.02, and 1.55±0.79, respectively. Though the AKBR in patients with alcoholic liver disease tended to be lower than the other groups, there was no significant difference in AKBR among those three groups. In conclusion, this study demonstrated that AKBR was doubtful as an accurate parameter to estimate the changes in the liver mitochondrial redox state by alcoholic intake.

A cluster of insulin resistance, dyslipidemia and hypertension has been labeled as a metabolic syndrome. Asians have a lower rate of obesity than Caucasians, but have recently become increasingly prone to obesity and the metabolic syndrome, especially in rural communities in Japan. Although weight loss has been considered to be effective for improvement of the metabolic syndrome, most data are based on studies in Western countries with only limited information derived from Japanese populations. We conducted a study of 188 subjects who participated in our interventional program for obesity based on health education and self-determination in 2000-2003. The intervention induced significant decreases in caloric intakes and increases in physical activity in the participants, and then resulted in a significant 1.3kg reduction in weight on the average. Weght-loss was significantly associated with indexes of obesity, values of total cholesterol, triglyceide and HDL cholesterol levels, but was not related with blood pressure and LDL cholesterol, which were significantly decreased by our intervention. Furthermore a simple regression analysis was carried out to verify whether weight loss and metabolic syndrome parameters were related. Weight loss was determinantsexplaining less than a total of 10% of the variance in triglyceride and total cholesterol for the participants. Future studies of weight loss for metabolic syndrome should incorporate Asian ethnic factors, such as dietary habits and genetic influences.
Syndrome ; Weight Loss ; Obesity ; Health education ; Metabolic