PGI36 THE RECENT CHANGE IN EPIDEMIOLOGY OF CHRONIC LIVER DISEASE IN JAPAN: AN ANALYSIS OF CLAIMS DATABASE

Abstract

Hepatitis B or C infection has been major cause of chronic liver disease (CLD) in Japan. Actions to control infection have been performed such as hepatitis B immunization program to prevent vertical infection. Also, innovative medicines for hepatitis C were recently introduced. However, little is understood about nationwide epidemiological changes in the etiology of CLD. Our objective was to chronologically visualize the landscape of CLD. The hospital-based commercial claim database (N=25 million) was used (April 2008-August 2018). Patients with any diagnosis of CLD (defined by disease name) were included and classified into following nine categories with mutually exclusive criteria; hepatitis B, hepatitis C, hepatitis B and C, viral hepatitis, autoimmune, toxic/drug induced, alcoholic, Non-alcoholic fatty liver disease (NAFLD) and others. Patients distribution, demographics, and comorbidities were calculated by disease category and calendar year. A total of 1,790,449 individuals were extracted and their mean age was 66.4. Female patients account for 45.8%. The percentages of patients of hepatitis B (8.7%, to 21.3%), alcoholic (0.3% to 5.9%) or NAFLD (0.1% and 2.9%) were increased, whereas that of hepatitis C was decreased (45.5% to 33.7%) from 2008 to 2018. The mean age of patients with hepatitis B (57.9 to 63.6), hepatitis C (65.5 to 70.0) hepatitis B and C (62.8 to 66.6) autoimmune (62.6 to 66.4) or alcoholic (59.2 to 64.4) was getting older from 2008 to 2018. 30-50% of patients in every category had GERD, hypertension and hyperlipidemia and the percentage was higher especially in alcoholic and NAFLD. Hepatitis C still accounts for a large percentage of the population but has decreased over time. Other types of CLD have relatively grown overtime, but the change in prevalence is still unknown. Additional research is needed to understand whether the prevalence of them is increasing and if increasing why that happens.