[National survey of alcoholic liver disease in Japan]

Recently, the incidence of alcoholic liver disease (ALD) has been increasing in Japan in association with increased alcoholic beverage consumption. The objectives of this study were 1) to investigate the incidence of ALD in Japan from 1998 to 2002, and 2) to determine whether hepatitis virus affects its prevalence.

A nation-wide survey of hospitals qualified by the Japanese Society of Gastroenterology was conducted to determine the status of ALD in-patients since 1998. The prevalence of hepatitis virus infection in each kind of ALD patient was also investigated.

Of all ALD patients, 73% did not have viral hepatitis. Except for the hepatocellular carcinomas (HCC) in heavy drinkers and chronic alcoholic hepatitis types, the percentage of ALD with negative viral hepatitis markers constituted more than 80%. However, the percentage of HCC patients without viral hepatitis was 34% of all heavy drinkers with HCC, and the percentage of chronic alcohol hepatitis patients without viral hepatitis was 24%. The percentage of individuals with viral hepatitis has significantly decreased among the alcoholic liver cirrhosis patients.

In conclusion, ethanol intake per se plays an important role in the pathogenesis of ALD, except with the HCC in heavy drinkers and chronic alcoholic hepatitis types. Hepatitis virus continues to play a crucial role in the pathogenesis of HCC in heavy drinkers and chronic alcohol hepatitis, although it is less involved in the pathogenesis of alcoholic liver cirrhosis, which contributes to the pathogenesis of most HCCs.