《国际肝病》：目前在印度尼西亚，哪种病毒性肝炎发病率最高？乙型肝炎还是丙型肝炎？

 

　　: Professor Muljono，which hepatitis have the higher incidence in Indonesia currently? HBV or HCV？

 

　　David H. Muljono教授：在印度尼西亚，乙型肝炎发病率比丙型肝炎高，不同地区的发病率从4%至15%不等，某些地区的发病率甚至＞5%。据2007年的相关统计数据显示，全国平均发病率为9.4%。经过近几年的努力后，于2013年对印度尼西亚33个省，超过八万人进行的再次普查显示，乙型肝炎发病率暂时为7.1%，因为仍然有很多的数据需要分析。

 

　　Prof. Muljono: Hepatitis B. The prevalence rate of hepatitis B is known to be very high in Indonesia and there is a range of rates from 4% to >15% depending on location. The average prevalence in 2007 was 9.4% and efforts were made to impact those rates and a repeat survey in 2013 covering 33 provinces in Indonesia and with >80000 people showed a prevalence rate of 7.1% provisionally, as there are still more data to review. This means that Indonesia is currently categorized as having intermediate endemicity.

 

　　《国际肝病》：在印度尼西亚，哪种肝炎病毒感染更容易进展为肝癌？

 

　　: Chronic infection of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) is a major risk factor in the development of the HCC, so what is the primary cause of HCC currently in Indonesia, HBV or HCV?

 

　　David H. Muljono教授：HBV或HCV感染是诱发肝细胞肝癌（HCC）的重要原因，在印度尼西亚。关于肝炎病毒感染进展为HCC的研究多为单中心，没有多中心的研究。从雅加达的癌症在册数据看，乙型肝炎进展为HCC的发生率最高，其次是丙型肝炎。

 

　　Prof. Muljono: There are only sporadic studies from Indonesia but the data from the cancer registry located in Jakarta shows the highest prevalence is from hepatitis B followed by hepatitis C.

 

　　《国际肝病》：从亚洲研究看，病毒性肝炎进展为肝癌的平均时间是多少？

 

　　: According to the research in Asian population, what is the average time from hepatitis virus infection to HCC?

 

　　David H. Muljono教授：从肝炎病毒感染进展为HCC的时间，取决于疾病的活动状态。总体而言，乙型肝炎患者可能处于活动或非活动状态。患者可能处于免疫耐受期、非活动或低复制期，可能表明看起来处于健康状态，但实际上已经发展为慢性乙型肝炎。如果他们未接受治疗，经过5～15年，可能进展为HCC。对于丙型肝炎，数据更加明了。从慢性丙型肝炎确诊到进展为肝硬化的时间为8～10年，其中部分患者经过15～20年将形成HCC。

 

　　Prof. Muljono: That depends on the activity of the disease. In general, people can have hepatitis B in an active or inactive state. They can be in the immune tolerant phase or inactive or lower replicative phase. Patients can remain outwardly healthy, but for chronic hepatitis B, if they are not treated, the onset of HCC may take 5-15 years. For hepatitis C, the data is clearer. The time from diagnosis of chronic hepatitis C to progression to liver cirrhosis is 8-10 years, and by 15-20 years, some of those patients will develop liver cancer.

 

　　专家简介：

 

　　David Handojo Muljono教授，印度尼西亚生命科学院教授（院士），印度尼西亚雅加达Eijkman分子生物学研究所转化研究副主任、肝炎和新型疾病科主任，澳大利亚悉尼大学悉尼医学院荣誉教授，印度尼西亚孟加锡Hasanuddin大学医学教授，Journal of Hepatology、Journal of Medical Virology、Medical Journal of Indonesia等多部学术期刊审稿人，World Journal of Gastroenterology和Current Pharmacogenomics and Personalized Medicine杂志编辑委员。