Objectives In alignment with the World Health Organization’s goal of eliminating hepatitis C, this study assessed the current treatment status and reasons for non-treatment among patients with hepatitis C in Jeonbuk State, Republic of Korea, to inform strategies for improving care engagement.
Methods Among 311 individuals diagnosed with hepatitis C and reported through the National Notifiable Infectious Disease Surveillance system between January 2023 and June 2024, 208 patients were surveyed after excluding those who had died or could not be contacted. Statistical analyses included the chi-square test, the Cochran-Armitage test for trend, and logistic regression.
Results Overall, 116 participants (55.8%) reported having received antiviral therapy. Among the 92 untreated individuals, the most common reason for non-treatment was the absence of symptoms (n=23; 25.0%), followed by the burden of drug costs (n=21; 22.8%).
Conclusion These findings highlight suboptimal treatment uptake and key barriers that may hinder progress toward hepatitis C elimination. Expanding screening and strengthening linkage-to-care strategies, while addressing financial barriers, will be essential to achieving national elimination targets.
Objectives Patients receiving hemodialysis (HD) are at increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) due to repeated blood exposure, vascular access procedures, and blood transfusions. The study aimed to determine the seroconversion rates of HBV and HCV among patients undergoing dialysis and to identify associated risk factors.
Methods A total of 220 adult patients receiving dialysis who were seronegative for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies at baseline were enrolled. Serologic testing was repeated at 6 months.
Results Sixteen patients (7.3%) seroconverted to HBsAg positivity, and 23 (10.5%) seroconverted to anti-HCV positivity. HBV seroconversion was significantly associated with multiple dialysis center visits. HCV seroconversion was significantly associated with dialyzer reuse, multiple dialysis center visits, and dialysis duration ≥2 years. Elevated liver enzyme levels were strongly correlated with seroconversion for both viruses.
Conclusion HBV and HCV seroconversion remain concerns in HD units. Standardized infection control practices, minimization of patient transfers, and strict adherence to national guidelines are essential to reducing risk.
Objectives The prevalence of hepatitis B in the Republic of Korea has declined, yet the disease burden persists. After various changes in targets and methods, the national hepatitis B surveillance system now exclusively monitors acute cases. We aimed to assess the alignment of this system with its intended purpose and to recommend improvements supporting the national strategic plan for viral hepatitis management.
Methods This study assessed acute hepatitis B cases reported to the Korean Disease Control and Prevention Agency’s mandatory surveillance system over a 10-year period (2013–2022). It evaluated 5 factors from the Centers for Disease Control and Prevention’s Updated Guidelines for Evaluating Public Health Surveillance Systems: simplicity, positive predictive value, data quality, timeliness, and usefulness.
Results The nonspecific nature of acute hepatitis B symptoms, along with the complexity of diagnostic criteria, indicated a high potential for misreporting. The surveillance system demonstrated a high positive predictive value (94.4%), with data quality and timeliness also rated high. However, data following the onset of the coronavirus disease 2019 pandemic indicate the need for improvement. Moreover, given the relative importance of specific characteristics of chronic infectious diseases, only limited interventions are implementable through the current surveillance system.
Conclusion The evaluation of the Republic of Korea’s acute hepatitis B surveillance system revealed high positive predictive value, data quality, and timeliness. However, improvements can be made in the misreporting of chronic cases and the system’s usefulness. More accurate reflection of the characteristics of acute hepatitis B cases is essential for better management of viral hepatitis.
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Objectives This study aimed to investigate differences in the anti-hepatitis A virus (HAV) antibody seropositivity rate by age and gender. Methods: We collected information on anti-HAV immunoglobulin G and immunoglobulin M status from samples submitted for HAV antibody testing in 2012–2022. A total of 1,333,615 cases were included in the analysis. Results: By age, the seropositivity rate was represented by a U-shaped curve, such that the rate was low for the group aged 20 to 39 years and higher in those who were younger or older. Over time, the curve shifted rightward, and the seropositivity rate declined gradually in the group aged 35 to 39 years and older. A gender-based difference in antibody seropositivity rate was especially noticeable in the group aged 20 to 29 years. This difference between genders widened in the participants’ early 20s—when men in the Republic of Korea enlist in the military—and the divergence continued subsequently for older individuals. Conclusion: These results indicate a higher risk of severe infection among older individuals and a gender-based difference in seroprevalence. Therefore, it is necessary to implement policies to promote vaccination in adults.
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Objectives We aimed to estimate the impact of the national hepatitis B immunization program on the incidence of acute hepatitis B infection among adolescents in South Korea.
Methods We estimated the counterfactual incidence rate of reported acute hepatitis B among adolescents from 2016 to 2020 compared to the assumption that the national hepatitis B immunization program for children had not been implemented since 1995. The impact of the national hepatitis B immunization program for adolescents was measured by estimating the absolute risk reduction and averted acute hepatitis B infections among adolescents from 2016 to 2020 attributed to the national immunization program.
Results The relative risk reduction of acute hepatitis B among adolescents was estimated to be 83.5% after implementing the national hepatitis B immunization program. The incidence rate of reported acute hepatitis B infections among adolescents decreased from 0.39 to 0.06 per 100,000 person-years, and 43 acute hepatitis B infections, including 17 symptomatic cases, were averted annually from 2016 to 2020 by the national hepatitis B immunization program.
Conclusion The national hepatitis B immunization program for children was effective in preventing acute hepatitis B infection among adolescents in South Korea.
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Objectives On February 16, 2022, 12 cases of hepatitis E virus (HEV) infection were reported in a food manufacturing factory in Korea. The aim of this study was to identify additional cases and to determine the source of this HEV outbreak. Methods: This study was an in-depth investigation of 12 HEV immunoglobulin M (IgM)-positive cases and their demographic, clinical, and epidemiological characteristics. On-site specimens were collected from the environment and from humans, and a follow-up investigation was conducted 2 to 3 months after the outbreak. Results: Among 80 production workers in the factory, 12 (15.0%) had acute HEV infection, all of whom were asymptomatic. The follow-up investigation showed that 3 cases were HEV IgMpositive, while 6 were HEV IgG-positive. HEV genes were not detected in the HEV IgM-positive specimens. HEV genes were not detected in the food products or environmental specimens collected on-site. HEV was presumed to be the causative pathogen. However, it could not be confirmed that the source of infection was common consumption inside the factory. Conclusion: This was the first domestic case of an HEV infection outbreak in a food manufacturing factory in Korea. Our results provide information for the future control of outbreaks and for the preparation of measures to prevent domestic outbreaks of HEV infection.
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Objectives We aimed to reconfirm the source of hepatitis A virus (HAV) infection through epidemiological and genotype investigations of individual cases in a 2019 outbreak in South Korea. Methods: We investigated food intake histories, associations with hepatitis A, and genotypes of HAV in 31 patients with hepatitis aged 20 to 49 years registered in the integrated disease and health management system during December 1–7, 2019 (case group) and in 35 sex- and agematched people without a history of HAV vaccination or infection among patients’ families and colleagues (control group). Results: The consumption of salted clams was a significant factor (odds ratio, 4.33; 95% confidence interval, 1.32–14.18) in the risk factor analysis of food intake history. HAV genotypes were analyzed in 24 of 31 patients. Type IA and type IIIA were found in 23 and 1 cases, respectively. Conclusion: Salted clams are considered to have been the source of HAV infection at 49 weeks of the HAV outbreak in 2019; this result was consistent with that of a previous epidemiological investigation conducted by the Korea Disease Control and Prevention Agency in September 2019. Therefore, monitoring of the production and distribution of salted clams needs to be continued.
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<sec>
<title>Objectives</title>
<p>An epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011–2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future.</p></sec>
<sec>
<title>Methods</title>
<p>A retrospective study of the outpatients and health care workers (<italic>n</italic> = 7,285) in the target outpatient clinic during 2011–2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1<sup>st</sup>, 2006 and March 25<sup>th</sup>, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016.</p></sec>
<sec>
<title>Results</title>
<p>The rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve (<italic>p</italic> < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster (<italic>n</italic> = 56) or 2 clusters (<italic>n</italic> = 25). This result indicated exposure to a high-association infection source.</p></sec>
<sec>
<title>Conclusion</title>
<p>Anti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011–2012) at an outpatients clinic in Seoul.</p></sec>
<sec>
<title>Objectives</title>
<p>The purpose of this study was to examine the relationship between self-care agency and health self-efficacy measures, in patients with viral hepatitis.</p></sec>
<sec>
<title>Methods</title>
<p>Data were collected from 116 outpatients over the age of 19 years who were diagnosed with viral hepatitis between February 20, 2019 and April 30, 2019. This study used the Appraisal of Self-care Agency Scale-Revised and the Health Self-Efficacy measures. Descriptive statistics, Pearson’s correlation coefficients, and canonical correlations were used during data analysis [SPSS version 25.0 for Windows (SPSS, Chicago, IL, USA)].</p></sec>
<sec>
<title>Results</title>
<p>The first canonical correlation coefficient was 0.65 (Wilks’ λ = 0.44, F = 5.63, <italic>p</italic> < 0.001) and the second was 0.42 (Wilks’ λ = 0.76, F = 3.08, <italic>p</italic> = .001). The first variate indicated a higher perception of having power for self-care (0.85) and developing power for self-care (0.92), and this was related to exercise (0.66), illness (0.76), emotion (0.75), nutrition (0.81), stress (0.60), and health practice (0.85). The second variate indicated a higher perception of having power for self-care (0.42), whilst lacking power for self-care (−0.82), was related to illness (0.35) and stress (0.72).</p></sec>
<sec>
<title>Conclusion</title>
<p>Nursing interventions and education aimed at enhancing the self-care of viral hepatitis patients are needed to assist patients to improve their health care behaviors.</p></sec>
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<sec>
<title>Objectives</title>
<p>To evaluate the impact of 3 treatment regimens upon health-related quality of life and work productivity using patient-reported outcomes (PROs) in chronic hepatitis C infected patients: sofosbuvir (SOF) + daclatasvir (DCV); SOF + DCV + ribavirin (RBV); SOF + simeprevir (SMV).</p></sec>
<sec>
<title>Methods</title>
<p>4 questionnaires were used to evaluate PROs before, during and after treatment: Short Form-36 (SF-36), Chronic Liver Disease Questionnaire (CLDQ) - hepatitis C virus (HCV), Work Productivity and Activity Index, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F).</p></sec>
<sec>
<title>Results</title>
<p>Of the global sample of 55 patients included in this study; SOF + DCV (<italic>n</italic> = 10); SOF + DCV + RBV (<italic>n</italic> = 29); SOF + SMV (<italic>n</italic> = 16) all had a statistically significant improvement in SF-36, CLDQ and FACIT-F scores during and post-treatment. No statistically significant differences in the PRO questionnaire values were observed between the distinct treatment regimens. The SOF and SMV patient groups presented higher mean PRO variations during and post-treatment, compared to the other groups: SF-36 functional capacity (16.1); SF-36 mental health (21.4); CLDQ activity (1.8); CLDQ emotional function (1.2); FACIT-F physical well-being (8.0); Total FACIT-F (21.6).</p></sec>
<sec>
<title>Conclusion</title>
<p>Treatment with SOF + DCV, with or without RBV, results in an improved PRO similar to treatment with SOF + SMV in chronic hepatitis C patients.</p></sec>
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<sec><title>Objectives</title><p>This study aimed to investigate the factors affecting the health-related quality of life (HRQOL) of patients with chronic hepatitis C (CHC).</p></sec><sec><title>Methods</title><p>This study is based on a descriptive survey and involved 125 gastroenterology outpatients visiting a university hospital in South Korea as the participants. HRQOL was assessed using the Liver Disease Quality of Life 1.0, which consisted of Short Form-36 (SF-36) and the Liver Disease Targeted Scale. Data were collected from December 2015 to April 2016, which were then analyzed through multiple regression analysis.</p></sec><sec><title>Results</title><p>HRQOL had a statistically significant correlation with age, sex, educational level, living type, employment status, monthly income level, and comorbidity status. This study showed that age > 51 years, female sex, high educational level, living alone, unemployment status, low monthly income, and presence of comorbidity had negative effects on the HRQOL of patients with CHC (R<sup>2</sup> = 8.7%–34.6%).</p></sec><sec><title>Conclusion</title><p>Based on the result of this study, intervention for patients with CHC needs to be developed to enhance their HRQOL. The findings can serve as a useful reference for nursing personnel in the development of therapeutic plans to upgrade the care of CHC patients.</p></sec>
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Objectives
To understand the illness experience of patients with chronic hepatitis C participating in clinical trials in the sociocultural context of Korea in an in-depth and comprehensive manner. Methods
A focused ethnography approach was used to discover the pattern of illness experience of patients with chronic hepatitis C in the cultural background of Korea. Interviews were conducted with 11 patients with chronic hepatitis C participating in clinical trials and the collected data were analyzed with the domain analysis, taxonomical analysis, componential analysis, and theme analysis proposed by Spradley. Results
With the cultural theme of “less-known illness, less-familiar illness,” four categories were derived: “my illness discovered by accident,” “shaken life,” “scary but inevitable treatment method,” and “precious life that can't be wasted,” along with 12 properties. Conclusion
Public campaigns or education programs are needed to meet the needs for information on the disease for patients with chronic hepatitis C participating in clinical trials and help the general public acquire knowledge or change view on this disease.
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Objectives
This study aimed to evaluate the specificity, sensitivity, cost, and turn-around time of three methods of gene polymorphism analysis and to study the relationship between IL28B rs12979860 and SVR rate to pegIFN-α/RVB therapy among patients with chronic hepatitis C. Methods
A total of 100 samples from chronic hepatitis C patients were analyzed in parallel using the three methods: direct sequencing, real-time polymerase chain reaction (PCR), amplification refractory mutation system (ARMS)-PCR. Results
The different profiles for IL28B rs12979860 alleles (CC, CT, and TT) obtained with PCR-RFLP, ARMS-PCR, and direct sequencing were consistent among the three methods. Prevalence of rs12979860 genotypes CC, CT and TT in HCV genotype 1a was 10(19.6%), 35(68.6%), and six (11.8%), respectively, and in HCV genotype 31, it was 13(26.5%), 31(63.3%), and five (10.2%), respectively. No significant difference was seen between rs12979860 genotype and HCV genotype (<i>p</i> = 0.710). Conclusion
Screening by ARMS – PCR SNOP detection represents the most efficient and reliable method to determine HCV polymorphisms in routine clinical practice.
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Objectives
Hepatitis B virus (HBV) is a member of the hepadnavirus family. The HBV genome contains four genes designated as S, C, P, and X. The HBV X (HBx) gene encodes for a 16.5-kDa regulatory protein that enhances HBV replication and exerts multifunctional activities. The aim of this study is to describe the rapid and easy purification of HBx using ELP (elastin-like polypeptide) fusion protein. Methods
The ELP–HBx fusion protein was overexpressed in <i>Escherichia coli</i>. Environmental sensitivity was demonstrated via turbidity and dynamic light scattering as a function of temperature. HBx was purified as an ELP fusion protein. ELPs are biopolymers of the pentapeptide repeat Val-Pro-Gly-Xaa-Gly that undergo an inverse temperature phase transition. ELP follows in temperature and salt consistency, precipitation, and solution repetition (inverse transition cycling) with polypeptide, where it purifies the protein in a simple manner. Results
Fusion proteins underwent supramolecular aggregation at 40 ℃ in 1 M NaCl and slowly resolubilized at subphysiologic temperatures. ELP domain proteolysis liberated a peptide of comparable size and immunoreactivity to the commercial HBx. Conclusion
This study suggests that HBx can be purified rapidly and easily using inverse transition cycling, and that this method can be applied in determination of HBx 3D structures and HBx stability study.
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Objectives
The epidemiological patterns of endemic hepatitis A virus (HAV) are unclear in northeastern Asia depending on the ethnicity of the country in question. The purpose of this study was to investigate the seroprevalence of HAV in northeastern China, South Korea, and Japan. Methods
A total of 1,500 serum samples were collected from five groups of inhabitants (300 each) who were over 40 years of age (Korean Chinese, indigenous Chinese, South Korean, Korean living in Japan, and indigenous Japanese). The samples were screened for antibodies to HAV using an enzyme-linked immunosorbent assay. Results
Positivity for HAV antibodies was 93.7% (95% confidence interval [CI]: 90.9–96.4) in Koreans living in northeastern China, 99.7% (95% CI: 99.0–100.3) in indigenous Chinese, 98.0% (95% CI: 96.4–99.6) in indigenous Koreans, 33.3% (95% CI: 28.0–38.7) in Koreans living in Japan, and 20.4% (95% CI: 15.8–25.0) in indigenous Japanese persons. The overall anti-HAV prevalence was not significantly different between northeastern China and South Korea, but it was different in Japan. Conclusions
These results indicate that differences in seroprevalence can be attributed to geological, environmental, and socioeconomic conditions rather than ethnicity.
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Objectives
The purpose of this study was to investigate the seroprevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) in Korea during 2005. Methods
Study subjects were selected from across Korea using a stratified multistage probability sampling design, and HAV and HEV seroprevalence was compared on the basis of sex, age, and residency. A total of 497 rural and urban people aged 10–99 years of age (mean ± SD age = 28.87 ± 17.63 years) were selected by two-stage cluster sampling and tested serologically for anti-HAV and anti-HEV IgG using an enzyme-linked immunosorbent assay. Results
Among this population, the overall seroprevalence of HAV was 63.80% (55.21% aged in their 20s and 95.92% in their 30s, <i>p</i> < 0.01) and that of HEV was 9.40% (5.21% aged in their 20s and 7.14% in their 30s, <i>p</i> < 0.01). Seroprevalence also varied according to area of residence. HEV prevalence in rural areas was higher than that of urban regions based on the anti-HEV antibody, odds ratio 3.22 (95% confidence interval: 1.46–7.10, <i>p</i> < 0.01). There were no significant differences between male and female against anti-HAV/HEV antibodies. Conclusion
Our study suggested that the seropositive rates of HAV and HEV might be related to age and environmental conditions.
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