Liver cirrhosis in Japan: Future global trends in the era of progressive antiviral therapy

Abstract

In Japan, viral hepatitis is the main cause of chronic liver diseases, including liver cirrhosis. Due to the availability of highly effective antiviral drugs in combination with antihepatitis measures, Japan has become one of the most successful countries in the world with regard to hepatitis virus elimination. In Japan, there are many elderly patients who have been infected with hepatitis C virus for a long time, and antihepatitis measures have been in place since the 2000s. Thus, the medical situation in Japan is expected to reflect the future situation in other countries where hepatitis countermeasures have been recently initiated and the infected population is aging. Our nationwide survey clarified the changes in the etiologies of liver cirrhosis in Japan. Although viral hepatitis remains a major cause of liver cirrhosis in Japan, nonviral cirrhosis is suggested to increasingly contribute to the etiologies of liver cirrhosis, as opposed to viral hepatitis‐related liver cirrhosis. The changing etiology of liver cirrhosis in Japan may help to predict future global trends in chronic liver diseases.

Etiological changes of liver cirrhosis and hepatocellular carcinoma‐complicated liver cirrhosis in Japan: Updated nationwide survey from 2018 to 2021

“…In Japan, viral hepatitis is a major health concern due to its high prevalence. Various antiviral measures have been officially implemented since 2008, 5,6 and Japan has been regarded as having one of the most successful antiviral strategies 7,8 . In addition, due to lifestyle changes in recent years, nonviral CLDs, including ALD and NASH, have been suggested to be increasing worldwide, including in Japan 9–12 …”