• Journal of Preventive Medicine and Public Health
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• 제33권3호
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• pp.323-333
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• 2000

Objectives : Chronic HBsAg carriers are the principal source of infection for other susceptible people, and are themselves at high risk of developing serious liver diseases. In Korea, it has been estimated that 65-75% of the HBsAg positives remained as persistent carriers. Additionally, familial clustering of MBV infection has frequently been observed among carriers. Some would become progressive, chronic hepatitis patients, and others would not. The aim of this study was to evaluate the association between various factors, such as the duration of infection, type of virus, mutation of precore/core region in HBV, major histocompatibility class-I, and developing chronic liver diseases among familial HBV carriers. Methods : Chronic carrier status was identified by repeated serological tests for HBsAg at intervals of six months or more. A familial chronic carrier was defined when the disease was observed in a family member over two generations. Two families were recruited, among which a total of 20 chronic HBsAg carriers(11 carriers in No.1, and 9 in No.2 family) were identified. Data on the general characteristics and liver disease status were collected. Identification of the HBV-DNA was successful only for 13 subjects among the 20 carriers. Analysis of viral DNA in terms of subtype, pre-core and core region mutations was carried out. The type of major histocompatibility class-1 for the 13 subjects was also analysed. Results & Conclusions : Seven of 10 chronic HBV carriers of the 1st generation and one of 10 of the 2nd generation were clinical patients with chronic hepatitis, the others, three of the 1 st and nine of the 2nd generation, were asymptomatic carriers. This data indicates that the duration of HBV carriage is one of the major factors for disease severity. The subtype of HBsAg analysed using MBV-DNA identified in 13 carriers were adr, and the pattern of precore nonsense mutation in HBV-DNA was identical among family members, which meads that the same virus strains were transmitted between the family members. The association between the precore or core mutations in HBV-DNA and the disease severity was not observed. While it was suggested that a specific type of MHC class-I may be related to disease progression.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.253-259
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• 2004

Objectives : To investigate the prevalence of hepatitis B and C virus infections and determine the associated risk factors among young adults in Busan, Korea, which is known to have a high incidence of liver cancer. Methods : The study population consisted of volunteer participants in a health survey during 2002, which included 1,350 students (515 males and 835 females) aged between 16 and 24 years, from three different schools in Busan. The participating students were asked to fill in a self-administered questionnaire which included lifestyle habits and risk factors of hepatitis. Sera obtained from the participants were studied for HBsAg, anti-HBs, and Anti-HCV by enzyme immunoassay (EIA) method and for liver function tests. Results : Among the study subjects (N=1,350), the seropositivities of HBsAg 7.9%(95% CI=7.8-8.0), 7.6%(95% CI=7.6-7.7) in male and 8.1%(95% CI=8.0-8.2) in female. And the seropositivity of Anti-HBs was 69.7%(95% CI=69.0-70.4), 70.5%(95% CI=69.8-71.2) in male and 69.2%(95% CI=68.5-69.9) in female. The seropositivity of Anti-HCV was 0.4%, 0.2% in male and 0.5% in female. The seropositivity for HBsAg in the subjects not having a hepatitis B vaccination history was twice(95% CI=1.0-4.4) that of those that did. Also, the seropositivity for HBsAg in subjects having experienced sexual intercourse was 1.7 times (95% CI=0.9-3.0) that of the subjects who had not. Conclusions : The present study confirmed the high prevalence of HBsAg seropositivity and sexual transmission of HBV among adolescents and young adults may occur. Further studies to evaluate the relationship between HBV vaccination and sexual transmission are required for the young population in Korea.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6227-6231
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• 2013

In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.

• 한국치위생학회지
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• 제3권2호
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• pp.89-99
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• 2003

This study aims to furnish basic data about prevention and infection control of Hepatitis B Virus(HBV) for those who, working in dental offices, are particularly exposed to a high risk of HBV infection. A survey was conducted to 310 students including freshmen, sophomores and juniors enrolled in the dental hygiene department in order to examine their knowledge about infection routes of HBV, clinical history of their family members and their own health. The outcomes of the survey showed following facts; 1. Students were found to lack knowledge about the present conditions of their HBsAg and HBsAb of HBV(PF0.05), conduct of preventive vaccination(PE0.05), completion of 3 required vaccinations(PF0.05) and formation of antibody(PF0.05). 2. Students named "blood"(88.6%) and "infected needles"(82.5%) as most likely infection routes of HBV(PE0.05 and PE0.01). These replies came mostly from sophomores(65.6% and 92.1%), followed by juniors(89.2%, 82.5%) and freshmen(81.1%, 73.0%). Least knowledge about infection routes of HBV was sensed with the reply "infection through breast-feeding of positive mother(27.9%)"(PE0.05). Generally, sophomores seemed to have much knowledge about infection routes, followed by juniors and freshmen in order. 3. As to clinical history of family members, 10 students(3.5%) replied that any of their family members is suffering from HBV now, 8(2.6%) revealed that some of their family members once suffered from it and 10(3.2%) reported cases of death of their family members from liver diseases. 4. Ninety-four point seven percent of respondents believed their health to be better than normal.

• IMMUNE NETWORK
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• 제10권4호
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• pp.126-134
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• 2010

Background: $CD8^+$ T cells contribute to the clearance of Hepatitis B virus (HBV) infection and an insufficient $CD8^+$ T cell response may be one of the major factors leading to chronic HBV infection. Since the HBx antigen of HBV can up-regulate cellular expression of several immunomodulatory molecules, we hypothesized that HBx expression in hepatocytes might affect $CD8^+$ T cell activity. Methods: We analyzed the activation and apoptosis of $CD8^+$ T cells co-cultured with primary hepatocytes rendered capable of expressing HBx by recombinant baculovirus infection. Results: Expression of HBx in hepatocytes induced low production of $interferon-{\gamma}$ and apoptosis of CD8+ T cells, with no effect on CD8 T cell proliferation. However, transcriptional levels of H-2K, ICAM-1 and PD-1 ligand did not correlate with HBx expression in hepatocytes. Conclusion: Our results suggest that HBx may inhibit $CD8^+$ T cell response by regulation of $interferon-{\gamma}$ production and apoptosis.

• 약학회지
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• 제57권1호
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• pp.43-54
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• 2013

Viral hepatitis is the inflammation of liver cells caused by viruses, and still one of the major health-care problems worldwide. A number of viruses to cause hepatitis are type A, B, C, D, E or G. Among these viruses leading to hepatitis, B and C are more troublesome being more prone to chronic illness which can cause the potentially fatal conditions of hepatocellular carcinoma (HCC) and/or liver failure. If immediate treatment is not initiated, liver transplant is the only option left. Over the past few decades there has been remarkable progress in diagnose and monitor all hepatitis virus infections for treatment and prevention. Nonetheless, important challenges remain to develop more effective and safe vaccines for prevention as well as antiviral agents to reduce viremia/viral load by inhibiting viral replication. The development and evaluation of antiviral agents through carefully designed clinical trials over the last 25 years has heralded a new dawn in the treatment of patients chronically infected with the hepatitis B and C viruses, but not so for the D virus. The introduction of Direct Acting Antivirals (DDAs) for the treatment of HBV carriers has permitted the long term use of these compounds for the continuous suppression of viral replication. This review aims to summarize the current status and development approaches of antiviral drugs for the treatment of viral hepatitis and future perspectives.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2019-2025
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• 2016

Hepatocellular carcinoma (HCC) is major health problem with high mortality rates, especially in patients with hepatitis B virus (HBV) infection. Telomerase function is one of common mechanisms affecting genome stability and cancer development. Recent studies demonstrated that genetic polymorphisms of telomerase associated genes such as telomerase associated protein 1 (TEP1) rs1713449 and PIN2/TERF1-interacting telomerase inhibitor 1 (PINX1) rs1469557 may be associated with risk of HCC and other cancers. In this study, 325 patients with HCC and 539 non-HCC groups [193 healthy controls, 80 patients with HBV-related liver cirrhosis (LC) and 266 patients with HBV-related chronic hepatitis (CH)] were enrolled to explore genetic polymorphisms of both SNPs using the allelic discrimination method based on MGB probe TaqMan real time PCR. We demonstrated that all genotypes of both genes were in Hardy-Wienberg equilibrium (P>0.05). Moreover, there was no significant association between rs1713449 genotypes and HCC risk, HCC progression and overall survival (P>0.05). Interestingly, we observed positive association of rs1469557 with risk of HCC when compared with the LC group under dominant (CC versus CT+TT, OR=1.89, 95% CI= 1.06-3.40, P=0.031) and allelic (C versus T alleles, OR=1.75, 95% CI=1.04-2.94, P=0.033) models, respectively. Moreover, overall survival of HCC patients with CC genotype of rs1469557 was significantly higher than non-CC genotype (Log-rank P=0.015). These findings suggest that PINX1 rs1469557 but not TEP1 rs1469557 might play a role in HCC progression in Thai patients with LC and be used as the prognosis marker to predict overall survival in HCC patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.3595-3604
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• 2015

Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

• 농촌의학ㆍ지역보건
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• 제17권2호
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• pp.129-136
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• 1992

To evaluate the possible route of intrafamilial transmission among carriers of hepatitis B surface antigen ($HB_sAg$), epidemiologic and serologic data were obtained on 107 household contacts of 35 carriers of HBsAg and on 71 household contacts of 25 controls who were negative for serologic markers of hepatitis B virus. The HBsAg prevalence was 26.5% among the contacts of carriers compared to 0.0% among the contacts of controls. And the combined prevalence for all hepatitis markers was 48.5% among the contacts of carriers compared to 26.0% among the contacts of controls(p<0.05). Especially the offspring of carriers showed significantly higher risk in the combined prevalence for all hepatitis markers (p<0.05). There were no significant relationship between HBV infection and past history like acupuncture, transfusion, operation and tattooed. Factors associated with the risk of intrafamilial transmission of HBV were not found in the sharing of household articles such as razor, towel, drinking glass, nail clippers, toothbrush and tableware.

• Journal of Yeungnam Medical Science
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• 제12권2호
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• pp.339-346
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• 1995

수혈 후 B형 간염 바이러스의 전파를 감소시키기 위한 방법으로 현재 적십자 혈액원에서 공급되는 적혈구 농축제재를 대상으로 HBV DNA, HBsAg, anti-HBs 및 anti-HBc를 측정 하여 수혈자에서 HBV DNA의 노출정도와 HBV DNA와 B형 바이러스 간염의 혈청학적 표지자와의 관련성을 조사하여 다음과 같은 결과를 얻었다. 대구 적십자 혈액원에서 공급되는 적혈구 농축제재에서는 HBsAg이 검출되지 않았으며, HBV DNA는 0.6%에서 검출되었는데, 모두 anti-HBc만 양성인 경우였다. Anti-HBc양성률은 37%였으며, 이들중 65.8%에서 anti-HBs도 양성으로 나타나 anti-HBc만 양성인 경우는 공혈혈액의 13.0% 정도로 추정되었다. 따라서, 우리나라와 같이 anti-HBc양성률이 높은 지역에서는 anti-HBs를 추가하는 경우 13%의 혈액제제만을 폐기함으로써 HBV DNA의 전파를 차단시킬수 있으리라 생각되며 현재 실시하고 있는 검사보다 예민도와 특이도가 높은 선별검사의 개발이 필요한 것으로 생각된다.