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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
  • 9,311 View
  • 252 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
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
  • 24,292 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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  • Changing trends in the incidence and spectrum of cancers between 1990 and 2021 among HIV-infected patients in Busan, Korea
    Soon Ok Lee, Jeong Eun Lee, Yong Ki Sim, Shinwon Lee, Woo Seog Ko, Jinmi Kim, Jin Suk Kang, Hyunjin Son, Sun Hee Lee
    Journal of Infection and Chemotherapy.2023; 29(6): 571.     CrossRef
  • Next-generation sequencing analysis of hepatitis C virus resistance–associated substitutions in direct-acting antiviral failure in South Korea
    Kyung-Ah Kim, Sejoon Lee, Hye Jung Park, Eun Sun Jang, Youn Jae Lee, Sung Bum Cho, Young Suk Kim, In Hee Kim, Byung Seok Lee, Woo Jin Chung, Sang Hoon Ahn, Seungtaek Kim, Sook Hyang Jeong
    Clinical and Molecular Hepatology.2023; 29(2): 496.     CrossRef
  • Treatment of Chronic Hepatitis C in Older Adults
    Jong Eun Yeon
    Korean Journal of Clinical Geriatrics.2023; 24(3): 93.     CrossRef
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    Hoo Jeung CHO, Euna PARK
    THE JOURNAL OF FISHERIES AND MARINE SCIENCES EDUCATION.2022; 34(2): 219.     CrossRef
  • Assessing the Effectiveness and Safety of Direct-acting Antiviral Treatment in Korean Patients with Hepatitis C Virus Genotype 1b or 2 at a Tertiary Care Hospital
    Mi Seon Park, Young-Mo Yang, Ki Hyun Park, Hyonok Yoon, Ju Sin Kim, Eun Joo Choi
    Korean Journal of Clinical Pharmacy.2022; 32(3): 191.     CrossRef
  • Analysis of Hepatitis C Virus Genotypes and RNA Quantitative Values in Cheonan, Republic of Korea from 2007 to 2016
    Bishguurmaa Renchindorj, Bo Kyeung Jung, Joowon Park
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    Youngmee Jee
    Global Health & Medicine.2021; 3(5): 288.     CrossRef
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    Dae Hyun Lim, Jae Yoon Jeong, Seongwoo Nam, Jongkyoung Choi, Hyeok Choon Kwon, Yong Bum Yoon, Yeonjae Kim, BumSik Chin
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
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    Jeong Heo, Yoon Jun Kim, Jin-Woo Lee, Ji Hoon Kim, Young-Suk Lim, Kwang-Hyub Han, Sook-Hyang Jeong, Mong Cho, Ki Tae Yoon, Si Hyun Bae, Eric D. Crown, Linda M. Fredrick, Negar Niki Alami, Armen Asatryan, Do Hyun Kim, Seung Woon Paik, Youn-Jae Lee
    Gut and Liver.2021; 15(6): 895.     CrossRef
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Original Articles
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
  • 20,387 View
  • 262 Download
  • 17 Web of Science
  • 19 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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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
  • 133 Download
  • 7 Web of Science
  • 6 Crossref
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

Citations

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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
  • 24,376 View
  • 263 Download
  • 17 Web of Science
  • 16 Crossref
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 Article
Prevalence of Hepatitis C Virus Genotype in Pusan, Korea.
Hai Rim Shin, Jue Bok Song, Byung Seong Suh, In Sik Kim, Yun Young Huh, Kap Yeol Jung, Joon Youn Kim, In Hoo Kim, Jung Man Kim, Wo Won Shin, Hak Do Yang, Myung Kee Lee
Korean J Epidemiol. 1997;19(2):111-121.
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AbstractAbstract PDF
Abstract
The authors investigated the distribution of Hepatitis C virus (HCV) genotype in blood donors with positive for anti-HCV (n=34), health check-up examiness with positive for anti-HCV (n=29), and in patients with various chronic liver disases positive for anti-HCV (n=63) in Pusan, Korea. HCV genotype was determined by using the molecular typing method through the reverse transcription - polymerase chain reaction (RT - PCR) with four type specific primers. Among 116 anti-HCV positive study subjects, 66.4% were positive HCV RNA by RT-PCR. The major HCV genotype was type II (31.9%) and it was followed by type III (27.6%). Two cases were type IV (1.7%). Double infection with two different HCV genotypes (mixed type) was found in three cases (2.6%). Three cases (2.6%) were not determined by the four type specific primers, it may have different subtype. Type II was more prevalent than type III in the blood donors and health check-up examinees, but the reverse was true in the chronic liver disease patients including hepatocellular carcinoma patients. Type II was more prevalent than type III among the anti-HCV positive subjects with risk factors such as acupuncture history, surgical operation history, and trans-fusion history. In contrast type III was more prevalent than type II among the subjects without the above risk factors. It is supposed that the pathogenicity of different kind of HCV genotype might be different. The results of this study suggest that the type II and type III may be the major CV genotype in Korea. The differences of HCV genotype distribution between the study groups support that the clinical significance according to the HCV genotype may be different.
Summary

Epidemiol Health : Epidemiology and Health