Generation Gap for Screening and Treatment of Hepatitis C Virus in Saga Prefecture, Japan: An Administrative Database Study of 35,625 Subjects

Abstract

Objective Despite recent advances in hepatitis C virus (HCV) treatment, some HCV-positive individuals are unaware of their infection. The present study aimed to assess the rate and age distribution in Saga Prefecture regarding i) HCV infection and HCV screening and ii) direct acting anti-viral (DAA) treatment. Methods HCV screening data collected at a medical institution or in the workplace were obtained from the administrative database in Saga Prefecture between April 1, 2008 and March 31, 2014. DAA treatment data from Saga Prefecture were obtained from the DAA treatment reimbursement recipient database between October 2014 and March 2017. Results There were 35,625 individuals who underwent HCV screening, and the HCV positive rate was 1.18% (421 individuals), which increased in an age-related manner. The screening rate in the screened populations peaked at 45-74 years of age (approximately 6%) and decreased in the younger and older generations. The estimated percentage of DAA treatment peaked at 65-74 years old (65.8%) and significantly decreased inversely with age in the younger generations; only 9.4% of HCV carriers received DAA treatment in the 20to 34-year age group. The proportion of subjects who received a complete physical examination for DAA treatment was higher in the subjects who were screened at a medical institution than in those screened at the workplace. ConclusionThe rate of subjects who underwent HCV screening and DAA treatment was not high, especially in the younger generation, in Saga Prefecture. This group should be targeted for HCV screening and treatment.

<p>Management of Hepatitis B Surface Antigen and Hepatitis C Antibody-Positive Patients by Departments Not Specializing in Hepatology at a Suburban University Hospital in Japan: A Single-Center Observational Study</p>

“…17 In addition, we have shown the prevalence of HBs-Agpositive patients according to age in Japan in S1 Table, and the prevalences of presumptive HCV carriers according to age in both Saga prefecture and Japan in S1 and S2 Tables. 17,18 HBs-Ag positivity was defined as ≥0.05 IU/mL. HCV-Ab positivity was defined as ≥1.0 S/CO, but titers were further divided into three categories-low (≥1.0, <4.0 S/ CO), medium (≥4.0, <12.0 S/CO), and high (≥12.0 S/ CO) 19 -and only patients in the medium and high groups were considered positive for the purposes of subsequent analyses.…”

Decline incidence in upper gastrointestinal bleeding in several recent years: data of the Japan claims database of 13 million accumulated patients

“…(39)(40)(41) The incidence of bleeding induced by gastroesophageal varices has decreased during the most recent decade in Japan because the prevalence of portal hypertension due to liver cirrhosis and/or hepatocellular carcinoma has decreased with the reduction in the prevalence of viral hepatitis and progress in therapeutic approaches to viral hepatitis. (42)(43)(44)(45) Upper GI bleeding is a complication of GERD. The prevalence of GERD increased during the study period as shown in Fig.…”