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Epidemiologic Investigation
An outbreak of hepatitis A associated with salted clams in Busan, Korea
Hyunjin Son, Miyoung Lee, Youngduck Eun, Wonseo Park, Kyounghee Park, Sora Kwon, Seungjin Kim, Changhoon Kim
Epidemiol Health. 2022;44:e2022003.   Published online December 29, 2021
DOI: https://doi.org/10.4178/epih.e2022003
  • 11,282 View
  • 567 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Busan. The current study presents the results of an epidemiological investigation and outlines the supplementary measures that would help with hepatitis A control.
METHODS
A cohort study was conducted for all 2,865 customers who visited restaurant A from June to July. Using a standardized questionnaire, participants reported the presence of hepatitis A symptoms and whether they had consumed any of 19 food items. As for participants who had visited public health centers, their specimens were collected.
RESULTS
From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The epidemic curve was unimodal, and the median number of days from the restaurant visit to symptom onset was 31 days. A genotype analysis indicated that 89 of 90 tested patients had hepatitis A virus (HAV) genotype 1A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times (95% confidence interval [CI], 9.22 to 510.87). In an unopened package of salted clams found and secured through traceback investigation, HAV genotype 1A was detected.
CONCLUSIONS
To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams; the food sampling test standards for salted clams should also be expanded. Furthermore, a laboratory surveillance system based on molecular genetics should be established to detect outbreaks earlier.
Summary
Korean summary
2019년 7월, 부산시의 한 식당을 방문한 사람에서 다수의 A형간염 환자가 신고되었다. 2019년 6월 1일부터 7월 28일까지 해당 식당을 방문하여 카드 결제를 한 사람과 동반자 2,865명 전체를 대상으로 코호트 조사를 수행하였다. A형간염에 확진 된 사람은 총 155명으로 발병률은 5.4%였다. 다변량 로지스틱 회귀분석 결과 조개젓 섭취는 A형간염 발병 위험을 68.62배(95% CI, 9.22 to 510.87) 증가시키는 것으로 나타났다. 익히지 않은 조개류를 섭취하지 않도록 더욱 홍보를 강화해야 한다.
Key Message
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Bu¬san. A cohort study was conducted for all 2,865 customers who visited the restaurant from June to July. From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times. To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams.

Citations

Citations to this article as recorded by  
  • Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model
    Jaehong Jeong, Mijeong Kim, Jungsoon Choi
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • A Study on the Detection Rate of Hepatitis A from Gastroenteritis Patients and the Genotype Analysis of Hepatitis A Virus in Busan
    Sun Hee Park, Chanhee Kim, Summi Lee, Jihye Jeong, Junghye Choi, Seung Ju Lee
    Journal of Bacteriology and Virology.2023; 53(2): 74.     CrossRef
  • Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model
    Kiook Baek, Jonghyuk Choi, Jong-Tae Park, Kyeongmin Kwak
    International Journal of Biometeorology.2022; 66(9): 1725.     CrossRef
Original Article
Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID
Kyung-Ah Kim, Gwang Hyun Choi, Eun Sun Jang, Young Seok Kim, Youn Jae Lee, In Hee Kim, Sung Bum Cho, Moran Ki, Hwa Young Choi, Dahye Paik, Sook-Hyang Jeong
Epidemiol Health. 2021;43:e2021077.   Published online October 6, 2021
DOI: https://doi.org/10.4178/epih.e2021077
  • 8,734 View
  • 250 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Injection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).
METHODS
We used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).
RESULTS
Among the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.
CONCLUSIONS
As of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.
Summary
Korean summary
1. 국내 C형간염 환자 중 정맥주사 사용자의 비율은 6.7%로 서구에 비하면 낮은 편이며, 지역별로 차이가 있다. 2. C형간염 환자 중 정맥주사 사용자는 비사용자에 비하여 연령, 성별 및 C형간염 위험 요인 노출 등에서 상이한 역학적 특성을 보인다. 3. 정맥주사 사용자의 C형간염 치료 수용률이나 치료 성공률은 비사용자와 비슷하다.
Key Message
As of 2019, PWID comprised a minority (6.7%) of all HCV-infected people in South Korea. The epidemiological features of the PWID group were different from those of the non-PWID group in terms of age, sex and exposure to risk factors of HCV infection. However, the treatment uptake and outcomes were not significantly different between these 2 groups in DAA era. Therefore, considering the global and national increase in the number of PWID and the contribution of PWID to new cases of HCV infection, active screening and treatment should be offered to PWID in Korea.

Citations

Citations to this article as recorded by  
  • Prevalence and factors associated with hepatitis C among pregnant women in China: a cross-sectional study
    Sun He, Gao Shuang, Wu Yinglan, Wang Lan, Wang Wei, Wang Ailing, Wang Changhe, Wang Xiaoyan, Gao Qun, Lu Zechun, Huang Dongxu, Wang Yu, Mo Phoenix Kit Han, Chen Zhongdan, Polin Chan, Wang Qian
    Scientific Reports.2023;[Epub]     CrossRef
  • Hepatitis C Virus Seroprevalence in Persons Who Inject Drugs in Korea, 2012–2022: A Multicenter, Retrospective Study
    Jihye Kim, Gwang Hyeon Choi, Og-Jin Jang, Younghoon Chon, Sung Nam Cho, Dohoon Kwon, Sook-Hyang Jeong
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
COVID-19: Perspective
Air filtration and SARS-CoV-2
Yevgen Nazarenko
Epidemiol Health. 2020;42:e2020049.   Published online July 4, 2020
DOI: https://doi.org/10.4178/epih.e2020049
  • 16,289 View
  • 823 Download
  • 38 Web of Science
  • 24 Crossref
AbstractAbstract PDF
Abstract
Air filtration in various implementations has become a critical intervention in managing the spread of coronavirus disease 2019 (COVID-19). However, the proper deployment of air filtration has been hampered by an insufficient understanding of its principles. These misconceptions have led to uncertainty about the effectiveness of air filtration at arresting potentially infectious aerosol particles. A correct understanding of how air filtration works is critical for further decision-making regarding its use in managing the spread of COVID-19. The issue is significant because recent evidence has shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can remain airborne longer and travel farther than anticipated earlier in the COVID-19 pandemic, albeit with diminishing concentrations and viability. While SARS-CoV-2 virions are around 60-140 nm in diameter, larger respiratory droplets and air pollution particles (>1 µm) have been found to harbor the virions. Removing particles that could carry SARS-CoV-2 from the air is possible using air filtration, which relies on the natural or mechanical movement of air. Among various types of air filters, high-efficiency particle arrestance (HEPA) filters have been recommended. Other types of filters are less or more effective and, correspondingly, are easier or harder to move air through. The use of masks, respirators, air filtration modules, and other dedicated equipment is an essential intervention in the management of COVID-19 spread. It is critical to consider the mechanisms of air filtration and to understand how aerosol particles containing SARS-CoV-2 virions interact with filter materials to determine the best practices for the use of air filtration to reduce the spread of COVID-19.
Summary

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Special Article
Causes and countermeasures for repeated outbreaks of hepatitis A among adults in Korea
Moran Ki, Hyunjin Son, Bo Youl Choi
Epidemiol Health. 2019;41:e2019038.   Published online September 22, 2019
DOI: https://doi.org/10.4178/epih.e2019038
  • 12,312 View
  • 240 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The 2019 hepatitis A outbreak has become increasingly prevalent among adults in Korea and is the largest outbreak since that in 2009-2010. The incidence in the current outbreak is highest among adults aged 35-44 years, corresponding to the peak incidence among those aged 25-34 years 10 years ago. This may indicate a cohort effect in the corresponding age group. Causes of these repeated outbreaks of hepatitis A in Korea are low level of immunity among adults, Korean food culture that consumes raw seafood such as salted clam and inadequate public health system. Among countermeasures, along with general infectious disease control measures including control of the infectious agent, infection spread, and host, urgent actions are needed to review the vaccination policy and establish an adequate public health system.
Summary
Korean summary
2019년 한국 성인의 A형 간염 유행은 10년전 대규모 유행 이후 가장 큰 규모로발생하고 있다. 주 발생 연령이 10년전 유행보다 10세가 증가한 35-44세로 나타나 연령 코호트 효과라 볼 수 있다. 우리나라의 A형 간염 반복 유행의 원인은 성인의 낮은 집단면역수준, 어패류 생식문화, 공중보건의료체계 미비 등으로 보인다. 이에 대한 대책은 일반적인 감염관리대책인 감염원관리, 전파관리, 숙주관리와 함께 효율적인 백신접종정책, 공고한 공중보건관리체계 마련 등의 근본적 대책이 시급하다.

Citations

Citations to this article as recorded by  
  • Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model
    Jaehong Jeong, Mijeong Kim, Jungsoon Choi
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Antiviral Efficacy of Dielectric Barrier Discharge Plasma against Hepatitis A Virus in Fresh Oyster Using PMA/RT-qPCR
    Min Gyu Song, Ji Yoon Kim, Eun Bi Jeon, So Hee Kim, Min Soo Heu, Jung-Suck Lee, Jin-Soo Kim, Shin Young Park
    Applied Sciences.2023; 13(6): 3513.     CrossRef
  • Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model
    Kiook Baek, Jonghyuk Choi, Jong-Tae Park, Kyeongmin Kwak
    International Journal of Biometeorology.2022; 66(9): 1725.     CrossRef
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    Jung Hee Hyun, Ju Young Yoon, Sang Hyuk Lee
    Osong Public Health and Research Perspectives.2022; 13(5): 352.     CrossRef
  • An outbreak of hepatitis A associated with salted clams in Busan, Korea
    Hyunjin Son, Miyoung Lee, Youngduck Eun, Wonseo Park, Kyounghee Park, Sora Kwon, Seungjin Kim, Changhoon Kim
    Epidemiology and Health.2021; 44: e2022003.     CrossRef
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    Li Zhang
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Editorial
Current status of hepatitis C virus infection and countermeasures in South Korea
Sook-Hyang Jeong, Eun Sun Jang, Hwa Young Choi, Kyung-Ah Kim, Wankyo Chung, Moran Ki
Epidemiol Health. 2017;39:e2017017.   Published online April 13, 2017
DOI: https://doi.org/10.4178/epih.e2017017
  • 23,814 View
  • 366 Download
  • 16 Web of Science
  • 26 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Hepatitis C virus (HCV) infection is a major cause of liver cirrhosis, hepatocellular carcinoma, and liver-related mortality. The new antiviral drugs against HCV, direct acting antivirals, result in >90% cure rate. This review aimed to summarize the current prevalence, clinical characteristics, outcomes, and treatment response associated with HCV infection, and countermeasures for optimal HCV control in South Korea. Based on a literature review, the current anti-HCV prevalence in the Korean population is 0.6 to 0.8%, with increasing prevalence according to age. The major HCV genotypes in Korean patients were genotype 1b and genotype 2. Successful antiviral treatment leads to significantly reduced liver related complications and mortality. However, only about one third of the individuals with HCV infection seem to be managed under the current national health insurance system, suggesting a remarkable rate of underdiagnoses and subsequent loss of opportunity to cure. A recent study in South Korea showed that targeted population screening for HCV infection is cost-effective. To prevent recently developed clusters of HCV infection in some clinics, mandatory surveillance rather than sentinel surveillance for HCV infection is required and governmental countermeasures to prevent reuse of syringes or other medical devises, and public education should be maintained. Moreover, one-time screening for a targeted population should be considered and a cost-effectiveness study supporting an optimal screening strategy is warranted.
Summary
Korean summary
우리나라 C형간염 유병률은 1% 미만(0.6-0.8%)이며, 수혈에 의한 C형간염은 더 이상 발생하지 않을 것으로 보인다. 그러나 최근 의료기관에서 C형간염 집단감염이 발생하여 국가적 대응이 필요한 공중보건의 문제로 떠올랐다. 2016년 부터는 C형간염을 완치할 수 있는 효과적이고 안전한 약제가 건강보험급여로 인정되어 이미 진단된 환자들에서는 효과적인 치료가 시작되었다. 그러나 진단되지 않은 상태에서 간질환이 진행되고 있는 환자들을 발굴하기 위해 국가 검진체계와 연계하여 선별검사를 시행한다면, 단기적으로는 진단과 치료비용 부담이 커지겠지만 장기적으로 사망률을 감소시키고, 삶의 질을 높이는 비용효과적인 C형간염 퇴치 전략이 될 것이다.

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Original Articles
Age-period-cohort analysis of hepatitis A incidence rates in Korea from 2002 to 2012
Joo Yeon Seo, Sungyong Choi, BoYoul Choi, Moran Ki
Epidemiol Health. 2016;38:e2016040.   Published online September 30, 2016
DOI: https://doi.org/10.4178/epih.e2016040
  • 14,273 View
  • 360 Download
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to evaluate the epidemiology of hepatitis A in Korea from 2002 to 2012 using age-period-cohort analyses.
METHODS
We used claims data from the Korean National Health Insurance Corporation for the entire population. Census data from 2010 were used as the standard population. The incidence of hepatitis A was assumed to have a Poisson distribution, and the models and effects were evaluated using the intrinsic estimator method, the likelihood ratio, and the Akaike information criterion.
RESULTS
The incidence of hepatitis A gradually increased until 2007 (from 17.55 to 35.72 per 100,000 population) and peaked in 2009 (177.47 per 100,000 population). The highest incidence was observed among 27-29-year-old individuals when we omitted data from 2005 to 2007. From 2005 to 2007, the peak incidence was observed among 24-26-year-old individuals, followed by 27-29-year-olds. The best model fits were observed when the age-period-cohort variables were all considered at the same time for males, females, and the whole population.
CONCLUSIONS
The incidence of hepatitis A exhibited significant age-period-cohort effects; its incidence peaked in 2009 and was especially high among Koreans 20-39 years of age. These epidemiological patterns may help predict when high incidence rates of hepatitis A may occur in developing countries during their socioeconomic development.
Summary
Korean summary
A형 간염 발생률은 서서히 증가하는 추세였으나 2009년 가파르게 증가하여 최고조에 이르렀으며, (177 명 100,000 명당) 1978–1986 년 생 (발생 당시25–35세) 사이에서 가장 높았다. 남성, 여성, 전체 인구를 통틀어 가장 적합한 모형은 연령, 기간, 코호트 변수를 모두 고려한 모형이었다. 한국의 A형 간염 발생은 고위험 양상에서 중등도 위험양상으로 변해가고 있으며, 이는 역학적 변화를 겪는 여러 나라의 향후 양상을 예측하는데 도움이 될 것이다.

Citations

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Seroprevalence and associated risk factors of hepatitis B virus among pregnant women in southern Ethiopia: a hospital-based cross-sectional study
Yeshi Metaferia, Walelign Dessie, Ibrahim Ali, Anteneh Amsalu
Epidemiol Health. 2016;38:e2016027.   Published online June 19, 2016
DOI: https://doi.org/10.4178/epih.e2016027
  • 17,936 View
  • 533 Download
  • 34 Web of Science
  • 34 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Hepatitis B virus (HBV) is a major blood-borne and sexually transmitted infectious agent that is a significant global public health issue. The aim of this study was to determine the seroprevalence and risk factors of HBV among pregnant women attending the antenatal clinic of the Hawassa University referral hospital in Ethiopia.
METHODS
A cross-sectional study was conducted from April to May, 2015. A total of 269 consecutive pregnant women attending antenatal consultations were enrolled. Sociodemographic information and data regarding possible risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) screening was performed using an enzyme-linked immunosorbent assay, and the data were analyzed.
RESULTS
The overall seroprevalence of HBsAg among the 269 participants enrolled in the study was 7.8% (n=21). The prevalence of human immunodeficiency virus (HIV) infection was 5.2% (n=14), of whom two participants (14.2%) were also positive for HBsAg. Study participants with no formal education (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.27 to 10.68; p<0.05) were more likely to be infected with HBV than those who had completed at least secondary school. Although HBsAg was detected more often in pregnant women who had multiple exposure factors (8.8%, n=13) than in pregnant women who had not experienced possible risk factors (4%, n=1), this difference was not statistically significant (OR, 2.33; 95%CI, 0.29 to 18.63).
CONCLUSIONS
A high prevalence of HBV infection was detected in the study population. Neither the type of risk factors nor exposure to multiple risk factors was significantly associated with HBV infection. Hence, screening pregnant women regardless of risk factors and improving awareness of the transmission routes of HBV within this group may reduce the risk of HBV infections.
Summary

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The exposure rate to hepatitis B and C viruses among medical waste handlers in three government hospitals, southern Ethiopia
Anteneh Amsalu, Mesfin Worku, Endale Tadesse, Techalew Shimelis
Epidemiol Health. 2016;38:e2016001.   Published online January 5, 2016
DOI: https://doi.org/10.4178/epih.e2016001
  • 19,947 View
  • 261 Download
  • 15 Web of Science
  • 18 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to assess the rate of and risk factors for exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) among medical waste handlers.
METHODS
A cross-sectional study was conducted from December 2014 to January 2015. A total of 152 medical waste handlers (MWH) and 82 non-medical waste handlers (NMWH) were studied. Serum samples were collected from participants and screened for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and anti-HCV using rapid immunochromatography assay. MWH were also screened for hepatitis B surface antibody (anti-HBs).
RESULTS
The respective prevalence of HBsAg, anti-HBc and anti-HCV was 1.3%, 39.4%, and 0.7% in MWH, compared to 2.4%, 17.1%, and 1.2%, respectively, in NMWH. Among MWH, 58.6% were susceptible to HBV infection. There was a significant difference in the rate of lifetime exposure to HBV in MWH compared with NMWH (odds ratio [OR], 3.17; 95% confidence interval [CI], 1.64 to 6.13). However, there was no significant difference between participant groups with respect to current HBV infection (OR, 0.53; 95%CI, 0.07 to 3.86) or anti-HCV (OR, 0.54; 95%CI, 0.03 to 8.69). Age older than 40 years and working in a hospital laundry were independent predictors of lifetime exposure to HBV infection. Eleven (7.2%) respondents were vaccinated against HBV.
CONCLUSIONS
Lifetime exposure to HBV infection was significantly higher in MWH than in NMWH. The majority of MWH was not vaccinated against HBV and thus remains susceptible to contracting the infection. Screening upon hire followed by vaccination of MWH is recommended to reduce the transmission of HBV.
Summary

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    Belaynew Wasie Taye
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Changes in seroprevalence of hepatitis B surface antigen and epidemiologic characteristics in the Republic of Korea, 1998-2013
Hyerin Lee, Hyungmin Lee, Yumi Cho, Kyungwon Oh, Moran Ki
Epidemiol Health. 2015;37:e2015055.   Published online December 23, 2015
DOI: https://doi.org/10.4178/epih/e2015055
  • 14,518 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people.
METHODS
HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization.
RESULTS
HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people.
CONCLUSIONS
While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.
Summary
Korean summary
한국 국민건강영양조사 자료로 본 HBsAg 양성률은 1998 년 4.6%에서 2008 년에 2.9%로 감소한 이후 5 년간 증감없이 2013 년에 2.9%로 나타났다. 한국 HBsAg 양성률을 더욱 감소시키기 위해서는 예방접종사업뿐 아니라 B형 간염 환자 치료를 보다 적극적으로 해야 될 것으로 보인다. 또한 HBsAg 양성자는 간경화나 간암 예방을 위해 건강한 생활습관을 가지도록 노력하는 것이 필요하다.

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    Nguyen H. Tran
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Demographic characteristics and intravenous drug use among hepatitis C patients in the Kota Setar district, Kedah, Malaysia
Wei Leong Tan, Goh Yihui, Muhammad Radzi Abu Hassan
Epidemiol Health. 2015;37:e2015032.   Published online July 10, 2015
DOI: https://doi.org/10.4178/epih/e2015032
  • 65,535 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study explored the demographic characteristics of hepatitis C patients in the Kota Setar (KS) district, Kedah, Malaysia, the prevalence of intravenous drug use (IVDU) as a risk factor among these patients, and the associations between IVDU and demographic characteristics.
METHODS
Retrospective data pertaining to 713 patients from January 2009 to December 2013 were retrieved from hospital and disease notification records for analysis. The risk factors for hepatitis C virus (HCV) infection were grouped into IVDU and non-IVDU risk factors for analysis using multiple logistic regression.
RESULTS
Of the hepatitis C patients included in this study, the most common age group was 31 to 40 years (30.2%), and male patients (91.2%) made up the overwhelming majority. Ethnic Malays constituted approximately 80.4% of the patients, and IVDU was the main risk factor (77.8%) for HCV infection. Multiple logistic regression showed that male patients were 59 times more likely to have IVDU as a risk factor for HCV infection. Single patients were 2.5 times more likely to have IVDU as a risk factor. Patients aged ≥71 years were much less likely than patients aged ≤30 years to have IVDU as a risk factor for HCV infection.
CONCLUSIONS
IVDU was found to be an important risk factor for HCV infection among patients in the KS district. The factors associated with IVDU included age, sex, and marital status. Appropriate preventive measures should be developed to target the groups in which IVDU is most likely to be a risk factor for HCV infection.
Summary

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Health Statistics
Trends of liver cancer and its major risk factors in Korea
Eun-Young Lee, Tran Thi Xuan Mai, Yoonjung Chang, Moran Ki
Epidemiol Health. 2015;37:e2015016.   Published online March 11, 2015
DOI: https://doi.org/10.4178/epih/e2015016
  • 23,838 View
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AbstractAbstract AbstractSummary PDF
Abstract
The Republic of Korea (hereafter Korea) is one of the countries with high incidence of liver cancer and there is great difference in incidence of liver cancer between male and female. We investigated the sex-specific trends of three major risk factors of liver cancer, which are hepatitis B virus(HBV) infection, hepatitis C virus(HCV) infection, and alcoholic liver cirrhosis. The incidence of liver cancer was obtained from the Cancer Registration Statistics of the National Cancer Center of Korea. Hepatitis B surface antigen (HBsAg) seropositivity was based on data from the 2011 Korea National Health and Nutrition Examination Survey. Disease statistics from the Health Insurance Review and Assessment Service of Korea were used to evaluate trends in HCV infection and alcoholic liver cirrhosis. The prevalence of these risk factors were compared with the incidence of liver cancer. Males had a three to four times higher incidence of liver cancer than females did from 1999 to 2011. This gap between the incidence for males and females increased with age and males aged 50 to 59 showed a five times higher incidence than females of the same age did. In general, HBsAg seropositivity decreased from 1998 to 2011. The prevalence of HCV infections was 96.2 and 90.3 per 100,000 females and males, respectively in 2013. The prevalences of HCV infections from 2009 to 2013 did not substantially differ. The annual average prevalence of alcoholic liver cirrhosis from 2009 to 2013 was 77.22 and 8.90 per 100,000 males and females, respectively; the prevalence among males was 8.7 times higher than that among females. The prevalence rapidly increased with age in males, and males aged 60 to 69 peaked with a 19.2 times higher prevalence than that among females of the same age group. We found that the incidence of alcoholic liver cirrhosis, a major risk factor of liver cancer, exhibited a trend similar to that of liver cancer incidence in males, and this trend also differed remarkably by sex.
Summary
Korean summary
한국의 간암 발생 추세에서 나타나는 큰 남녀차이와 관련하여 간암의 주요 위험요소로 평가되는 만성 간염, 음주, 간경변과 관련한 B형간염, C형간염, 알코올성 간경변의 유병률 추세를 살펴본 결과 알코올성 간경변의 유병률 추세에서 간암발생에서와 유사한 큰 남녀차이가 발견되었다.

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Original Articles
The costs of hepatitis A infections in South Korea
Kyohyun Kim, Baek-Geun Jeong, Moran Ki, Mira Park, Jin Kyung Park, Bo Youl Choi, Weon-Seob Yoo
Epidemiol Health. 2014;36:e2014011.   Published online August 18, 2014
DOI: https://doi.org/10.4178/epih/e2014011
  • 18,948 View
  • 141 Download
  • 4 Web of Science
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AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
The incidence of hepatitis A infections among young adults has recently increased in South Korea. Although universal vaccination has often been suggested to mitigate the problem, its rationale has not been well-understood. Estimating the societal costs of hepatitis A infections might support the development of intervention strategies.
METHODS
We classified hepatitis A infections into eight clinical pathways and estimated the number of occurrences and cost per case for each clinical pathway using claim data from National Health Insurance and several national surveys as well as assumptions based on previous studies. To determine the total costs of a hepatitis A infection, both direct and indirect costs were estimated. Indirect costs were estimated using the human-capital approach. All costs are adjusted to the year 2008.
RESULTS
There were 30,240 identified cases of hepatitis A infections in 2008 for a total cost of 80,873 million won (2.7 million won per case). Direct and indirect costs constituted 56.2% and 43.8% of the total costs, respectively. People aged 20-39 accounted for 71.3% of total cases and 74.6% of total costs. Medical costs per capita were the lowest in the 0-4 age group and highest in the 20-29 age group.
CONCLUSIONS
This study could provide evidence for development of cost-effective interventions to control hepatitis A infections. But the true costs including uncaptured and intangible costs of hepatitis A infections might be higher than our results indicate.
Summary

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  • The chronological changes in the seroprevalence of anti-hepatitis A virus IgG from 2005 to 2019: Experience at four centers in the capital area of South Korea
    Dae Hyun Lim, Won Sohn, Jae Yoon Jeong, Hyunwoo Oh, Jae Gon Lee, Eileen L. Yoon, Tae Yeob Kim, Seungwoo Nam, Joo Hyun Sohn
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Hepatitis A Vaccination Rates and Related Factors in a 2005 Population-based Study in Nonsan, Korea
Eun Young Kim, Baeg Ju Na, Moo Sik Lee, Keon Yeop Kim, Moran Ki
Epidemiol Health. 2009;31:e2009003.   Published online October 12, 2009
DOI: https://doi.org/10.4178/epih/e2009003
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>The incidence of clinical hepatitis A has increased in young Korean adults since the mid-1990s. Although hepatitis A vaccinations have been administered in private clinics over the past 10 yr, no data exist on the vaccination rate and relating factors.</p></sec><sec><title>METHODS</title><p>In 2005, a population-based survey of 12-35-month-old children was carried out in Nonsan, Korea. An interview survey was completed for 71.3% of the children. All data came from a vaccination card or confirmation from a provider.</p></sec><sec><title>RESULTS</title><p>The hepatitis A vaccination rate was 42.3% for ≥1 dose and 24.7% for 2-dose. The results of the multivariate regression analysis for the hepatitis A vaccination showed that the second (OR=1.6) and third and successive children (OR=3.3) were less often immunized than the first child. Low economic status (OR=1.6), rural area (OR=1.5) and employed mother (OR=1.5) were also correlated with a lower vaccination rate. The hepatitis A vaccination rate was significantly lower in children who had no other vaccinations: measlesmumps-rubella (OR=2.8 for ≥1 dose and 7.3 for 2-dose), varicella (OR=20.2 and 22.0, respectively) and <italic>Haemophilus influenza</italic> type b (OR=14.3 and 13.3, respectively).</p></sec><sec><title>CONCLUSION</title><p>To prevent outbreaks of clinical hepatitis A by enough herd immunity, a vaccination should be included in the National Immunization Program and a vaccination policy developed and implemented that can overcome the barriers to immunization such as late birth order and a mother's employment.</p></sec>
Summary

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  • Very low prevalence of anti-HAV in Japan: high potential for future outbreak
    Chikako Yamamoto, Ko Ko, Shintaro Nagashima, Takayuki Harakawa, Toshiko Fujii, Masayuki Ohisa, Keiko Katayama, Kazuaki Takahashi, Hiroaki Okamoto, Junko Tanaka
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Epidemiological Comparison of viral hepatitis-hepatocellular carcinoma(HCC) and non viral hepatitis-hepatocellular carcinoma(HCC).
Pae Gun Park, Song Gyu Yoon, Hee Sup Lee, Jin Kun Jang, Ju Hee Maeng, Gee Hyun Lee, Jong Soo Choi
Korean J Epidemiol. 2003;25(1):32-38.
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AbstractAbstract PDF
Abstract
BACKGROUND
Korea is one of high incidence areas of Hepatocellular carcinoma (HCC) and major etiologic factor is hepatitis B virus (HBV). In future incidence of HBV related HCC may decrease and non viral hepatitis HCC (Non-B,C HCC) relatively increase because of widely used vaccination for HBV. To evaluate epidemiological characters of Non-B,C HCC, We divided HCC by viral or non-viral feature and compared each others.
METHODS
185 patients firstly diagnosed HCC and 455 normal subjects included from January 1997 to December 2000 and divided into 3 groups, HBV group (positive HBsAg), HCV group (positive anti-HCV Ab) and Non-B,C group (both negative HBsAg and anti-HCV Ab).
RESULTS
136 cases were HBV group (73.5%), 19 cases were HCV group (10.3%) and 27 cases were Non-B,C group (14.6%). Mean age of Non-B,C group at diagnosis was higher than HBV group (64.1+/-7.1 vs 55.6+/-7.7). Non-B,C HCC were more associated with alcohol abuse and rural residence (p<0.01). There was no difference of family history of liver disease, coexistence rate of liver cirrhosis and occupation.
CONCLUSION
Non-B,C HCC tended to be older in mean age than HBV HCC and more associated with alcohol abuse and rural residence. This characteristics of Non-B,C HCC supposed to be from difference in alcohol consumption and environment.
Summary
Sero-prevalence of Hepatitis B Virus Surface Antigen and Antibody in High School Students in Chungju-city.
Hyeongsu Kim, Kun Sei Lee, Soung Hoon Chang, Suekyung Park, Cheongsik Kim, Chang Hee Lee, Hyuk Jung Kweon, Soon Sup Chung
Korean J Epidemiol. 2002;24(2):107-112.
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AbstractAbstract PDF
Abstract
OBJECTIVES
Since Korea has been known to be one of the endemic area for hepatitis B virus(HBV) infection, vaccination for HBV has been recommended for all neonates in Korea. After starting vaccination in 1983, the change of sero-positivity of HBsAg and HBsAb is expected. This study was carried out to investigate the seropositive rate of hepatitis B virus surface antigen and antibody in high school freshmen students in Chungju-city.
METHODS
AND MATERIALS: From 1998 to 2001, a total of 11,735 who were born in 1982 to 1986, were enrolled in this study. HBsAg and anti-HBs were tested by reversed passive hemagglutination and passive hemagglutination, respectively. PESULTS: The study population was 11,735 students who were composed of 5,813 males (49.6%) and 5,914 females (50.4%). The HBsAg sero-positivity of male and female students was 3.25% (n=381) and 2.59% (n=153) respectively. The anti-HBs sero-positivity of male and female students was 62.2% (n=3,154) and 64.1% (n=2,969) respectively. There are significant difference observed in comparison of HBsAg and anti-HBs seropositivity according to sex (p<0.05). From 1982 to 1986 on birth year, anti-HBs sero-positivity has been increased significantly from 63.3% to 73.3%. But the change of HBsAg sero-positivity has not been changed significantly.
CONCLUSIONS
As compared with previous studies of HBsAg and anti-HBs, the sero-positive rate of HBsAg has not been changed but that of HBsAb has been increased significantly. This result revealed that the effect of HBV vaccination program was successful.
Summary

Epidemiol Health : Epidemiology and Health