APASL Daily：The first time APASL conference came to Japan was in 2000 in Fukuoka with your teacher, Dr. Michitami Yano, as the president. Now it's the third time APASL holding in Japan and as was the student, today you have become the vice-president and member of committee. What's your feeling about the development of APASL, also about the development of hepatology in Japan?
Prof. Yatsuhashi：Since many of the virus hepatitis patients present in the Asian region, while I will perform the clinical and research of viral hepatitis under the guidance of Dr. Yano who is a my teacher, I had a great interest for the epidemiology, patients background, natural course and anti-viral effect. I have a great interest what is the difference or what is the same between Japan and Asian countries, The APASL that has been brought an answer to my concern till now, I am very pleased that was able to hold this third APASL in Japan.
APASL Daily：HBV genotypes differ in their clinical manifestations and responses to therapy. The Japanese have been infected with genotypes B and C mainly. However, an article published in J Gastroenterol Hepatol by you and your colleagues mentioned that the distribution of genotype A had also increased. Will current therapy need adjustments?
Prof. Yatsuhashi：Indeed, the main genotypes of hepatitis B virus in Japan are genotype B and C until now. As we have reported in GUT 2011, genotype A infection is increasing in Japan. This is due to globalization or personnel exchanges with overseas. This phenomenon is expected to further accelerate. Of course, I also think that it is necessary that treatment guidelines adapt to the Japan of the genotype A.
APASL Daily： Non-invasive diagnosis of liver fibrosis has been widely used in these years. Do we still need liver biopsy to stage and score the disease in liver? When the liver biopsy is unavoidable in your opinion?
Prof. Yatsuhashi：Non-invasive examination of the liver such as FibroScan or several kinds of simple blood tests (FIB-4, APRI-score and M2BPGi etc.), are located while penetration in Japan. Among such circumstances, I also think that liver biopsy is needed for the patients such as AIH, PBC, a NASH, because such liver disease need histological findings as diagnostic criteria. However, I have a special thought with respect to the hepatitis B. I think a liver biopsy is needed for the patients with chronic hepatitis B, because it is difficult to decide prognosis and treatment policy in the patients whose complete viral clearance is difficult, In contrast, the significance of liver biopsy from the fact that can be viral clearance in almost all cases to establish would day become smaller in patients with chronic hepatitis C patients.
APASL Daily：Standard and normalization will be helpful and perhaps is necessary to improve the diagnosis performance of non-invasive diagnosis method. But the related guideline seems scarce. Will APASL develop a guideline on noninvasive diagnosis?
Prof. Yatsuhashi： I feel there may be a difficulty in that to establish guidelines on noninvasive diagnosis in APASL at this time. Not limited to guidelines on noninvasive diagnosis, medical care, economy, society, and the culture, there is a large variation in Asia Pacific Ocean countries. 燭he features of the Asia Pacific Ocean countries, is that they have a diversity that is not uniform. By to develop while in the future repeatedly APASL, consensus among the countries with such diversity will be established in near future.
(Professor Hiroshi Yatsuhashi, vice-president of APASL 2016, Nagasaki Medical Center, Japan, will give two lectures at APASL2016: i. ”Various Hepatitis in Japan” on 22nd, Feburary,and ii.”Non-Invasive Diagnosis ofFibrosis: APASL Clinical PracticeGuidelines and Future Directions”.)