ALT、AST、GGT、CHE在肝病中的诊断价值

目的探讨肝脏疾病时肝脏酶的变化关系.方法采用速率法,测定113例肝病患者空腹血清丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰基转移酶(GGT)、胆碱酯酶(CHE),并与32例正常体检者作对照组比较.结果各型肝病患者的血清ALT、急性黄疸肝炎组的血清GGT及慢性肝炎重度组血清AST活性均显著升高(p＜0.01),慢性肝炎重度、肝硬化患者CHE活性均明显降低(p＜0.01).结论血清ALT、AST、GGT、CHE是肝病较为敏感指标,作为肝功能检测组合.有助于肝病的鉴别诊断和判断预后.     

ALT、AST、GGT、CHE在肝病中的诊断价值

目的 探讨肝脏疾病时肝脏酶的变化关系，方法 采用速率法，测定113例肝病患者空腹血清丙氨酸氨基转移酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰基转移酶（GGT）、胆碱酯酶（CHE），并与32例正常体检者作对照组比较。结果 各型肝病患者的血清ALT、急性黄疸肝炎组的血清GGT及慢性肝炎重度组血清AST活性均显著升高（p〈0．01），慢性肝炎重度、肝硬化患者CHE活性均明显降低（P〈0．01）。结论 血清ALT、AST、GGT、CHE是肝病较为敏感指标，作为肝功能检测组合。有助于肝病的鉴别诊断和判断预后。     

41例女性慢性输血后丙型肝炎10～15年后的感染状态

目的　了解我国女性输血后丙型肝炎病毒 (HCV)感染的慢性化规律和影响因素。方法　对河北省固安县 1989～ 1993年 4 1例女性慢性输血后丙型肝炎患者的现状进行调查 ,包括临床表现 ,血清生物化学指标 ,病毒学标志检测及B型超声检查。其中 ,HCVRNA的测定采用荧光定量PCR方法 ,抗 HIV ,抗 HCV和HBsAg测定采用酶联免疫吸附试验。结果　 4 1例女性丙型肝炎患者平均年龄 (40± 7)岁 ,随访时间 10～ 15年 ,HCVRNA间隔半年两次检测 ,自然阴转率为 19 5 1% (8 4 1)。 30例(73% )现在有症状 ,以乏力最为常见 (77% )。总的丙氨酸转氨酶 (ALT)和 (或 )天冬氨酸转氨酶 (AST)异常率为 32 % (13 4 1) ,均为轻度异常 ,无中度和重度。B超轻度慢性肝炎占 83% (34 4 1) ,中度占 17%(7 4 1) ,无重度。结论　平均感染 (13± 1)年的女性输血后慢性丙型肝炎患者多数肝脏炎症轻微慢性感染进程中有部分感染者出现HCVRNA自发阴转。     

291例HIV感染者合并HCV及HSV-2感染状况及相应免疫特征分析

目的了解HIV感染者中HCV及HSV-2合并感染的情况及CD4＋T细胞免疫特征。方法用ELISA方法检测291例HIV感染者的抗HCV及HSV-2抗体,对HIV感染者进行CD4＋T淋巴细胞绝对计数和其占T淋巴细胞的百分比分析。结果 HIV合并HCV感染43例,合并HSV-2感染99例,合并HCV和HSV-2感染31例。CD4＋T淋巴细胞百分比以合并感染HCV组最高（78.4%）,合并感染HSV-2组和无合并感染次之,合并感染HCV和HSV-2组最低,组间差异无统计学意义。CD4＋T淋巴细胞绝对数以合并感染HCV和HSV-2组最低,合并感染HCV组、合并感染HSV-2组居中,无合并感染组最高,组间差异无统计学意义。结论 HIV感染者合并HCV、HSV-2感染率较高,HIV合并HCV和HSV-2感染时,CD4＋T细胞绝对数和CD4＋T淋巴细胞百分比下降,加重损害机体的免疫系统。     

生化检验在诊断肝硬化疾病中的临床价值分析

目的：分析生化检验在诊断肝硬化疾病中的临床价值。方法选取2013年8月~2014年5月我院收治的肝硬化患者83例,另取同期健康体检人员83例为对照组,通过速率法对两组血清CHE浓度进行测定,同时测定GGT、AST与ALT的活性。结果与急性肝炎、慢性肝炎与对照组相比,肝硬化组的血清CHE均值明显较低,有统计学意义(<0.05);慢性肝炎、急性肝炎组相较于对照组差异无无统计学意义(>0.05)。结论血清CHE可以准确反映患者肝硬化程度,能够为肝硬化疾病诊断提供重要依据,值得临床广泛应用。     

379例HCV感染者丙型肝炎病毒载量与抗HCV及肝功能指标的相关性分析

目的 探讨丙型肝炎患者HCV RNA载量与抗HCV及肝功能指标的相关性.方法 回顾分析2011年1月至2013年12月间在本院门诊,住院,体检中丙型肝炎抗体阳性病人,男150人,女229人,年龄32-87岁,应用实时荧光定量PCR检测HCV RNA病毒,全自动生化分析仪检测肝功能8项指标,按HCV RNA病毒载量数分HCV RNA阴性组,HCV RNA低中水平组,HCV RNA高水平组.结果 三组年龄分布比例经统计学检验无明显差异（P＞0.05）,但低中水平女性比例比男性略高;三组肝功能生化指标检测结果不完全相同（P ＜0.05或P＜0.01）,其中HCV RNA低中水平组和高水平组血清ALT、AST、GGT、ALP、TBIL与阴性组比较均有差异（P＜0.05或P＜0.01）;TP、ALB、DBIL三组间比较虽无明显统计学差异,但低中水平组和高水平组结果呈下降趋势,低中水平组和高水平组比较ALT、AST、TBIL也有明显差异（P＜0.05）,病毒载量越高ALT、AST的结果越高,经干扰素治疗后随载量的下降肝功能酶类指标也随之下降.结论 不论病毒载量的高低只要HCV RNA持续阳性,都可导致肝细胞的损害和肝功能的异常,临床应尽早进行抗病毒治疗.PCR实时荧光探针技术方法先进,技术成熟,结果稳定,能早期诊断HCV感染者,有助于临床早期抗病毒治疗,防止HCV传播和发展.     

丙肝抗原的检测与抗-HCV及HCV-RNA定量的关系探讨

丙型肝炎呈世界性分布，各国丙型肝炎病毒（HCV）感染率为0.1%~10%，平均为3%，1.7亿~2亿人感染了 HCV。我国一般人群 HCV感染率为3.2%[1]。成人感染 HCV后，50%~80%发展成慢性肝炎，其中约20%可发展为肝硬化。肝硬化患者中，每年1%~4%可发展为肝癌[2]。由于目前对丙型肝炎已有有效的治疗方法，因此对 HCV感染者的病毒检测，既有利于控制丙肝的传播和预防，又有利于丙肝患者的治疗。     

游离丙型肝炎病毒核心抗原检测的临床价值探讨

目的:探讨游离丙型肝炎病毒(HCV)核心抗原检测在HCV感染诊断中的价值。方法:采用荧光定量PCR法检测HCV-RNA、ELISA法同步检测抗-HCV和游离HCV核心抗原。结果:191例HCV感染者HCV-RNA的检出率为71·2%(136/191);抗-HCV的检出率为97·4%(186/191);游离HCV核心抗原的检出率为33·0%(63/191)。其中有2例经抗病毒治疗的患者HCV-RNA和抗-HCV检测均阴性,但游离HCV核心抗原检测阳性;另有1例患者抗-HCV阴性,而游离HCV核心抗原阳性,经HCV-RNA证实为HCV感染。27例非HCV感染者HCV-RNA、抗-HCV和游离HCV核心抗原检测结果均为阴性。结论:HCV核心抗原检测作为抗-HCV检验的补充试验对HCV感染的诊断具有重要价值。     

HCV RNA载量与ALT和AST检测

我国丙型肝炎（hepatitisCvirus，HCV）感染人数约3800万，60％-85％的感染者发展为慢性肝炎，其中约20％并发肝纤维化、肝硬化等严重肝脏疾病。丙氨酸氨基转移酶（ALT）浓度，和谷草转氨酶（AST）存在于肝细胞的胞质中，在肝细胞损伤时通过细胞膜释放入血中，造成血清AfJT升高，血清ALT水平是反映肝脏组织损伤最敏感的指标之一，ALT水平越高肝脏组织损伤越重。丙肝治疗达到病毒学应答时，ALT多数都能恢复正常，停药后ALT再升高可反应病毒的复发。本文对119例病毒阳性的丙肝患者，按病毒拷贝数的对数值分为低水平≤3．00和高水平≥3.01两组，并进行了HCVRNA拷贝数和AIJT、AST结果比较分析，现报道如下。     

丙肝病毒感染者血清抗核抗体与IL-21的检测

目的:检测丙肝病毒(HCV)感染者血清抗核抗体(ANA)、白细胞介素-21(IL-21)水平,探讨两者对HCV感染者肝功能的影响.方法:应用酶联免疫吸附法(ELISA)分别检测96例HCV-IgG阳性血清以及30例健康者血清的ANA与IL-21水平;用日立7600生化仪检测所有样本丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和白蛋白(ALB)的含量.结果:HCV感染者肝功能明显异常,IL-21水平较对照组低.ANA阳性患者大部分肝功能较好.ALT≤40 U/L ALT40 U/L感染组均低于对照组IL-21水平.结论:ANA、IL-21的产生有助于HCV感染者控制肝炎的发展,降低肝细胞的受损程度.     

乙型肝炎病毒基因分型及临床应用研究

目的了解常州地区乙型肝炎病毒基因型分布特征,探讨其基因型与肝功能损伤、病毒复制水平及对拉米夫定疗效的关系. 方法采用巢式聚合酶链反应 (nest-PCR), 扩增乙型肝炎病毒S基因区, 用末端标记方法对PCR产物标记并直接测序, 测序结果和GenBank中登录的标准基因型序列相比较. 结果对该地区146份不同HBV感染者血清HBV DNA进行了基因分型,B型51份 (34.9%),C型95份(65.1%),未发现B、C以外其他基因型;丙氨酸转氨酶(ALT)水平分别为383.8±335.7IU和364.3±333.7 IU,(t=0.335,P>0.05)、HBV DNA含量分别为107.795±1.22和107.69±1.19拷贝/毫升(t=0.138,P>0.05)、HBeAg 阳性数分别为36/51和64/95,(χ2=0.159,P>0.05);104例慢性乙型肝炎中B型为43例、C型为61例,28例肝硬化和肝癌患者检出B型4例、C型24例,二组比较χ2=7.65,P<0.01;23例B基因型患者和45例C基因型患者接受48周以上拉米夫定治疗,48周后反跳者B型为18例,C型为14例,χ2=13.49,P<0.001.结论本地区HBV DNA基因型为B型和C型;二种基因型丙氨酸转氨酶水平、病毒复制水平和HBeAg表达水平差异均无显著性;C基因型与肝硬化和肝癌关系密切;拉米夫定对C基因型患者的疗效强于B型.     

Impact of nationwide hepatocellular carcinoma surveillance on the prognosis in patients with chronic liver disease

Background/AimsThis study aimed to investigate the effect of hepatocellular carcinoma (HCC) surveillance using the Korea National Liver Cancer Screening Program on the receipt of curative treatment for HCC and mortality in patients with chronic liver disease.MethodsThis population-based cohort study from the Korean National Health Insurance Service included 2003 to 2015 claims data collected from 1,209,825 patients aged ≥40 years with chronic hepatitis B, chronic hepatitis C, and liver cirrhosis. Patients were divided according to HCC surveillance using ultrasonography and serum alpha-fetoprotein every 6–12 months. The study outcomes were the receipt of curative treatment (surgical resection, radiofrequency ablation, or liver transplantation) and all-cause mortality.ResultsThe study population consisted of 1,209,825 patients with chronic hepatitis B, chronic hepatitis C, and liver cirrhosis (median age, 52.0 years; interquartile range, 46–55 years; 683,902 men [56.5%]). The proportion of participants who underwent HCC surveillance was 52.7% (n=657,889). During 10,522,940 person-years of follow-up, 74,433 HCC cases developed, including 36,006 patients who underwent curative treatment. The surveillance group had a significantly higher proportion of curative treatment for HCC than the non-surveillance group after adjusting for confounding factors (adjusted hazard ratio [HR], 5.64; 95% confidence interval [CI], 5.48–5.81). The surveillance group had a significantly lower mortality rate than the non-surveillance group (adjusted HR, 0.56; 95% CI, 0.55–0.56).ConclusionsHCC surveillance using the national screening program in patients with chronic viral hepatitis or liver cirrhosis provides better opportunity for curative treatment for HCC and improves overall survival.     

慢性重型肝炎分类的研究

目的 探讨慢性重型肝炎、肝硬化失代偿的临床特点及更合理的分型标准.方法 应用SPASS软件,回顾分析了肝硬化失代偿患者106例、单纯慢性重型肝炎患者（以下简称重型Ⅰ组）124例及肝硬化合并慢性重型肝炎患者（以下简称重型Ⅱ组）100例临床资料.结果 （1）三组患者年龄以重型Ⅰ组年龄偏小,为30岁左右,肝炎肝硬化失代偿组患者年龄偏大,为50岁左右;（2）肝硬化失代偿组、重型Ⅰ型及重型Ⅱ型患者的临床生化指标：白蛋白、球蛋白、转氨酶、凝血功能、血糖、血脂及胆碱酯酶统计学均有差异;（3）三组患者并发的上消化道出血、肝肾综合征在本次分析中差异无统计学意义,而腹水、肝性脑病两种并发症不论在数量上还是等级上均有差异,其严重程度分别为：重型Ⅱ组＞重型Ⅰ组＞肝硬化失代偿组;（4）对三组患者的预后分析发现,肝硬化失代偿患者预后明显优于重型Ⅰ、Ⅱ组的患者.结论 三组患者各有其临床特点及预后,故考虑慢性重型肝炎可分为二个亚型,在慢性肝炎基础上发生的肝衰竭为慢性重型肝炎Ⅰ型,在肝硬化基础上发生的肝衰竭为慢性重型肝炎Ⅱ型.肝硬化失代偿独立命名.     

Clinical usefulness of alpha-1-antitrypsin in the diagnosis of hepatocellular carcinoma.

Serum levels of alpha-1-Antitrypsin(AAT) were determined in 42 patients with hepatocellular carcinoma(HCC), 5 patients with metastatic liver cancer from stomach adenocarcinoma, 10 patients with liver cirrhosis, 10 patients with chronic hepatitis, and 66 controls by rocket immunoelectrophoresis using rabbit antiserum. The mean level of serum AAT was 225.5 +/- 73.0 mg/dl in 66 controls. The serum AAT in patients with HCC was 428.7 +/- 123.3 mg/dl, which was significantly higher than those in the controls and in patients with liver cirrhosis or chronic hepatitis(p less than 0.02). The level of AAT in metastatic liver cancer was similar to that in HCC. The positive cut-off value for elevation of serum AAT in this study was determined as above 445 mg/dl, the mean plus 3 standard deviations in the controls. Elevations of serum AAT were observed in 54.8%, 60.0%, and 10.0% of patients with HCC, metastatic liver cancer, and liver cirrhosis, respectively, while none of the patients with chronic hepatitis or the controls was positive. The serum AAT levels in 42 patients with HCC were analyzed with regard to sex, age, serum albumin, HBsAg, alpha-fetoprotein(AFP), and diameter of HCC, with no significant differences being observed between these factors and the serum AAT levels except for the diameter of the HCC. The positive rate in the HCC with a diameter of 10 cm or more was 74.1%, which was a significantly higher rate compared with 20.0% in the HCC with diameters less than 10cm. The positive rate of AFP for HCC was 61.9%, when 500 ng/ml of AFP was used as the cut-off value.(ABSTRACT TRUNCATED AT 250 WORDS)     

The natural history of hepatitis C virus (HCV) infection

Hepatitis C virus (HCV) is a leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma, as well as the most common indication for liver transplantation in many countries. Although the incidence of hepatitis C infection has dramatically decreased during the past decade, the worldwide reservoir of chronically infected persons is estimated at 170 million, or 3% of the global population. There is much controversy surrounding the natural history of hepatitis C infection. The rate of chronic HCV infection is affected by a person's age, gender, race, and viral immune response. Approximately 75%-85% of HCV-infected persons will progress to chronic HCV infection, and are at risk for the development of extrahepatic manifestations, compensated and decompensated cirrhosis, and hepatocellular carcinoma (HCC). The rate of progression to cirrhosis is highly variable, and is influenced by several factors, including the amount of alcohol consumption, age of initial HCV infection, degree of inflammation and fibrosis on liver biopsy, HIV and HBV coinfection, and comordid conditions. An estimated 10%-15% of HCV-infected persons will advance to cirrhosis within the first 20 years. Persons with cirrhosis are at increased risk of developing HCC. An understanding of the natural history of hepatitis C is essential to effectively manage, treat, and counsel individuals with HCV infection.     

Hepatitis C: epidemiology and therapy--with special reference to long-term prognosis after IFN therapy

Blood transfusion or blood products are a important route for transmission of hepatitis C virus(HCV) infection. Routes of infection other than blood transfusion are medical treatments including hemodialysis, exposure of hospital employees to needles contaminated with blood, drug abusers, acupuncture, tattooing, certain types of sexual behavior and mother-to-infant infection. The prevalence of anti-HCV antibodies in blood donors in Kumamoto Prefecture was 1.30%(1,704 of 131,376) between February and October 1992 and 0.46%(622 of 132,847) between April 1998 and May 1999, respectively. Also, the prevalence of anti-HCV was 22.9%(126 of 550) in the highly endemic area. The prevalence of HCV infection was evaluated in 548 patients undergoing hemodialysis, and 216 members of the hospital dialysis staff. Of 548 hemodialysis patients, 166(30.3%) were positive and significantly higher than those for either hospital staff members(2.3%; p < 0.01) or healthy blood donors(1.3%; p < 0.01). Patients with a history of blood transfusion tended to have a higher positivity rate for anti-HCV than did the non-transfused group. Positivity for anti-HCV was related to the duration fo hemodialysis. Although hemodialysis patients remain a high-risk group for HCV infection, the prevalence of anti-HCV antibodies has decreased recently thanks to the use of erythropoietin for renal anemia, the universal screening of blood donors for anti-HCV antibodies, and improvements in infection control measures for this virus. To evaluate the effect of interferon(IFN) therapy on the incidence of hepatocellular carcinoma(HCC) or decompensated liver cirrhosis, 490 patients with chronic hepatitis or liver cirrhosis type C who had undergone liver biopsy since 1987, were followed periodically. Of these patients, 411 received IFN and 79 were untreated. The degree of liver fibrosis was assessed from stage F0(no fibrosis) to stage F4(cirrhosis). Response to IFN was determined virologically and biochemically. HCC developed in IFN-treated patients and in 17 untreated patients with stage F3 or F4 fibrosis. In multivariate analysis, IFN therapy was associated with a reduced risk of HCC, especially among patients with sustained virological response(CR), among those with persistently normal serum ALT levels, and among those with ALT levels less than two times the upper limit of normal(PR). Also, the cumulative incidence of decompensated liver cirrhosis and cumulative survival in treated and untreated patients differed significantly. None of the patients with CR or PR progressed to the decompensated state and all patients with CR or PR have survived to date. In conclusion, IFN therapy significantly reduces the risk for HCC or decompensated cirrhotic stage, especially among virological or biochemical responders.     

Alpha 1-antitrypsin deficiency and liver cirrhosis in adults. An analysis of 35 Swedish autopsied cases

alpha 1-Antitrypsin (AAT) deficiency in adults predisposes to lung and liver disease, but its natural history is incompletely known. To better characterize the liver disease, all known deceased adult Swedish patients known to us with homozygous (PiZZ) AAT-deficiency, who had undergone autopsy during the 20-year period 1963-82 were reviewed. Of 94 such patients, 35 had cirrhosis (27 males and eight females) with a mean age at death of 65.5 +/- 10.5 (SD) years compared to 53.6 +/- 12.8 years (p less than 0.01) for the 59 non-cirrhotic patients. The longer survival suggests less severe lung disease in the cirrhotic group. Clinically these patients most frequently presented with ascites or other signs of portal hypertension. Evidence of alcohol overconsumption, chronic viral hepatitis, or autoimmune disease was rare. Aside from low plasma AAT levels, laboratory and other clinical features were indistinguishable from those of decompensated cirrhosis of any etiology. The prognosis was generally grave with a mean survival of two years after diagnosis. Fourteen of the 35 cirrhotics (10 males and four females) had primary liver cancer (PLC) at autopsy. We conclude that cirrhosis and PLC are more frequent complications in elderly patients with AAT-deficiency than was previously known. These complications had a marked male predominance.     

HBV核心启动子突变与临床表现及病毒复制的关系

目的探讨HBV核心启动子nt 1 762～1 764突变与肝病严重性的关系以及对e系统状态和病毒复制的影响.方法采用半套式突变特异PCR(msPCR)技术检测97例各型肝病患者血清nt 1 762～1 764突变株的感染状况.结果经测序和扩增产物电泳证实,采用我们设计的引物建立的msPCR方法检测HBV感染者血清nt 1 762～1 764突变株和野生株的特异性强,方法可靠.急性肝炎、慢性肝炎轻度、中度、重度及肝硬化患者nt 1 762～1 764突变株感染比例分别为2/5、7/43、10/31、1/3和7/15,肝硬化患者nt 1 762～1 764突变株感染率显著高于慢性肝炎轻度患者(P＜0.025).在92例慢性HBV感染者中,野生株(25/92)、突变株(42/92)和混合感染者(25/92)血清HBeAg阳性率分别为80.0%、56.0%和64.3%;HBV DNA含量分别为(4.4±8.5)×10 8、(1.1±1.6)×10 9和(1.4±1.8)×10 9拷贝/ml;ALT异常率分别为44.0%、52.0%和42.6%;ALT水平分别为(58.6±79.0)、(57.1±75.2)和(62.6±90.3)IU/L,以上各组之间比较差异无统计学意义.结论msPCR技术检测nt 1 762～1 764突变灵敏特异.nt 1 762～1 764突变与肝病严重性有密切关系,这种相关性与突变株的e系统状态、高病毒复制无任何关系.     

Risk stratification of HBV infection in Asia-Pacific region

Hepatitis B virus (HBV) infection is the major etiology of chronic liver disease worldwide and thus a global health problem, especially in Asia-Pacific region. The long-term outcomes of Asian HBV carriers vary widely; however, a significant proportion of them will finally develop end-stage liver disease. Over the past decade, several host and HBV factors predictive of clinical outcomes in Asian HBV carriers have been identified. The community-based REVEAL-HBV study illustrated the strong association between HBV-DNA level at study entry and risk of HCC over time, and male gender, older age, high serum alanine aminotransferase (ALT) level, positive HBeAg, higher HBV-DNA level, HBV genotype C infection and core promoter mutation are independently associated with a higher hepatocellular carcinoma (HCC) risk. Another hospital-based ERADICATE-B cohort further validated the HCC risk started to increase when HBV-DNA level was higher than 2,000 IU/mL. Of particular note, in patients with low viral load (HBV-DNA level <2,000 IU/mL), HBsAg level ≥1,000 IU/mL was a new independent risk factor for HCC. With the results from REVEAL-HBV study, a risk calculator for predicting HCC in adult non-cirrhotic patients has been developed and validated by independent international cohorts (REACH-B). With the combination of HBV-DNA, HBsAg, and ALT levels, ERADICATE-B study proposed an algorithm to predict disease progression and categorize risk levels of HCC as well as corresponding management in Asian HBV carriers. The introduction of transient elastography may further enhance the predictive power. In conclusion, HBsAg level can complement HBV-DNA level for the risk stratification of disease progression in Asian adult patients with chronic HBV infection.     

Non-B hepatocellular carcinoma: influence of age, sex, alcohol, family clustering, blood transfusion and chronic liver disease

In 144 cases of hepatocellular carcinoma (HCC), 166 cases of cirrhosis without HCC and 142 cases of chronic hepatitis, we examined HBsAg, anti-HBs and anti-HBc in sera and compared the following factors between hepatitis B virus marker-negative and -positive patients: age, sex, alcohol consumption, family clustering of liver diseases, and histories of blood transfusion and post-transfusion hepatitis. Results of this study demonstrated several distinct differences in clinical backgrounds between non-B (negative for HBsAg, anti-HBs and anti-HBc) and B (positive for HBsAg) patients with HCC. Non-B patients were significantly older, had a lower frequency of familial tendencies for liver diseases, and more frequently had cancers other than HCC in their families. Some of these differences were also observed between non-B and B patients with cirrhosis and chronic hepatitis. Among patients with chronic hepatitis, the non-B patients had received blood transfusion or had post-transfusion hepatitis more frequently than the B patients. However, this difference was not apparent in patients with liver cirrhosis or HCC, suggesting that progression of non-A, non-B post-transfusion hepatitis to cirrhosis and HCC may not be as frequent as progression to chronic hepatitis.