NATIONAL SURVEY OF ALCOHOLIC LIVER-DISEASE IN JAPAN (1968-91)

National surveys of alcoholic liver disease (ALD) in Japan were perfor med in 1978 and 1985 by a previous Japanese study group for ALD (the T akeuchi group). In the present study, a subsequent nationwide survey o f ALD in Japan was conducted from 1986 to 1991 and the results compare d with the previous studies. In order to clarify the aetiological rela tionship between hepatitis C virus (HCV) infection and ALD, results we re also analysed according to new diagnostic criteria for ALI) propose d by the current ALD study group (the Takada group). According to the diagnostic criteria of the Takeuchi group, the incidence of ALD did no t differ significantly from 1986 to 1991. However, the incidence of he patocellular carcinoma (HCC) in alcoholic cirrhosis (AL-LC) clearly in creased during this period. The analysis, which included analysis of r esults from the previous studies, indicated that the incidence of ALD reached a plateau in 1980 and then stablized. However, HCC in AL-LC co ntinued to show a linear increase from 1976 to 1991. The new diagnosti c criteria of the Takada group were used to analyse cases from 1990 an d 1991. Approximately two out of every three cases of ALD were caused by alcohol alone, and the remainder were caused by a combination of al cohol and HCV. Cases caused only by HCV were very rare. The main aetio logy in patients with alcoholic hepatitis and fibrosis was alcohol alo ne, and in the case of chronic hepatitis, in heavy drinkers, it was a combination of alcohol and HCV In half the patients with AL-LC the aet iology was alcohol alone, and in the other half it was a combination o f both alcohol and HCV. In the majority of patients with HCC, the aeti ology was a combination of alcohol and HCV, indicating that HCV infect ion may be important in the development of HCC in alcoholics.