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The risk for hepatocellular carcinoma (HCC) among asymptomatic hepatitis C virus (HCV) carriers is not well understood. A community-based prospective study was conducted for over 8 years by record linkage to the Osaka Cancer Registry. The subjects were 1,927 individuals who were positive for anti-HCV through screening for secondgeneration HCV antibody (passive hemagglutination assay: > Key words: hepatitis C virus; hepatocellular carcinoma; blood donor; alanine aminotransferase; hepatitis B virus; interaction; prospective studyApproximately 170 million persons worldwide have persistent infection with hepatitis C virus (HCV), 1 which is a risk factor for hepatocellular carcinoma (HCC). Some patients with persistent HCV infection advance through incrementally severe stages of chronic hepatitis to cirrhosis, occasionally culminating in HCC, although the majority of persons with persistent HCV infection remain asymptomatic. The incidence of HCV-associated HCC is increasing in several developed countries, including the United States, 2,3 Italy, 4 France 4 and Japan. 5 However, it is not well understood what proportion of asymptomatic HCV-positive persons will develop HCC during their lifetime.Many prospective studies have been conducted that assessed the risk of severe liver disease, including HCC, among individuals with chronic HCV infection. 6 -18 Some studies were conducted in tertiary-care treatment facilities, 6 -11 and the proportion of severe cases may have been overestimated due to referral bias. On the other hand, several follow-up studies reported that patients with chronic HCV infection have a very low risk of developing severe liver disease. [12][13][14][15][16][17] This result may have been obtained due to an insufficient length of follow-up to describe the full extent of adverse sequelae of HCV infection or because the subjects were too young to develop severe liver disease. In a cohort study of patients with non-A, non-B, transfusion-associated hepatitis over a period of almost 25 years, liver-related mortality was only 4.1%. 18 As this cohort had high all-cause mortality probably resulting from the condition that required the original transfusion, the liverrelated mortality reported in that study may have been underestimated. Studies performed in community-based settings have an advantage in clarifying the risk of HCC among asymptomatic HCV-positive persons, who comprise the majority of HCV-infected persons. However, several previous community-based prospective studies had a relatively small sample size. 19 -21 In another community-based prospective study, the subjects were persons who had been infected with HCV through injection drug use and who had high competing mortality. 22 Screening blood donors for the antibody to HCV (anti-HCV) in the early 1990s revealed that there was a large group of apparently healthy individuals who were positive for anti-HCV. We conducted a prospective study to determine the absolute risk of developing HCC among persons who were incidentally detected of having HCV at t...

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The risk of neonatal alloimmune thrombocytopenia and refractoriness to platelet transfusion induced by the antigens of the HPA-1, HPA-7W, and HPA-8W systems was extremely rare in Japanese. However, attention must be paid to the involvement of the HPA-4 and HPA-6W systems in these clinical disorders.