Higher elimination rate of hepatitis C virus among women

The mortality rate from liver disease in H town of the Fukuoka prefecture in Japan is significantly higher in men than in women. To clarify the gender-related difference, we evaluated subjects with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the S area of this town. A total of 824 adults participated in this study, 332 men and 492 women. The incidence of positivity for hepatitis B surface antigen (HBsAg) in serum did not differ significantly between the subjects in the S area (1.9%) and Japanese blood donors (1.5%); however, the incidence of positivity for serum antibody to hepatitis C virus (HCVAb) in the subjects (31.8%) greatly exceeded that in Japanese blood donors (1.3%). The rate of positivity for HCVAb did not differ significantly between men (28.3%) and women (34.1%), but the proportion of serum HCV RNA-positive to HCVAb-positive subjects was significantly higher in men (78.2% in men vs 67.3% in women). The incidence of elevated serum alanine aminotransferase (ALT) in subjects positive for serum HCV RNA was also significantly higher in men (77.0% in men vs 55.5% in women). These results suggest that a more frequent elimination of HCV from serum in women may explain the observed lower mortality from liver disease.