• Clinical and Experimental Pediatrics
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• v.51 no.7
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• pp.696-703
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• 2008

Korea is now classified as an area of intermediate endemicity for hepatitis B virus (HBV), due to the implementation of universal HBV vaccination and national preventive programs for HBV infection. A national program of HBV vaccination was launched in Korea in 1988 for school-going children and was listed on a vaccination guideline in 1991. In 1995, universal vaccination for newborn infants was started for the prevention of perinatal HBV transmission. The prevalence of HBsAg among Korean middle school students has shown marked decreased from 3.2% in the late 1990s to 0.44% in 2007. HBsAg positivity in preschool children was 0.9% in 1995, decreased to 0.2% in 2007 by national prevention program of hepatitis B vertical transmission, launched in 2002. Vaccine failure rate of HBV immunoprophylaxis is 4.2% by this program. The infected children should be monitored per 6-12 months interval. Lamivudine and interferon are approved therapies for children with chronic hepatitis B in immune-clearance phase in Korea.

• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.240-256
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• 1997

Purpose: To evaluate the hepatitis B vaccination program which has been conducted since 1980, Korea. Methods: This study was carry out self reported questionnaire and serologic test covering 2,072 elementary school students who were born between 1980 and 1987, selected by cluster sampling. The HBV serologic markers (HBsAg, Anti-HBs and Anti-HBc) were tested by radioimmunoassay (RIA). The contents of questionnaire include demographic data of students and parents, vaccination status, vaccination frequency, vaccination age, past history of mother's HBV test. Results: 1) The HBsAg positive rates by sex showed 3.7% for male and 2.7% for female, representing an average rate of 3.4%. The HBsAg positive rates by age group showed 5.6% for 13 years and l.5% for 6 years, representing a tendency of lowering rate as ages being younger. 2) The pre-natal HBV test rate was 10.2%, while post-natal HBV test rate was 42.5%. The test showed that the parents' educational level being higher than others, the pre- and post-natal HBV test showed higher rates. In case the fathers occupation being office worker, the post-natal HBV test showed a higher rate compared with other occupation. 3) Overall vaccination rate was 82.6%, complete vaccination rate 69.8%, booster injection rate 42.8%. The vaccination rate, complete vaccination rate and booster injection rate increased as the age being younger. If the educational level of parents were higher, the vaccination rate, complete vaccination rate and booster injection rate showed higher rates. Younger students showed younger vaccination age, and higher educational background of family showed younger vaccination ages. 4. With regard to positive rate of HBV markers by vaccination age, HBsAg and Anti-HBc positive rate showed higher degrees in the following order; preschool age (1-6 years), school age (6-13 years) and infancy (0-1 year). Anti-HBs positive rate was increased as the frequency of vaccination increased. Five years after initial complete vaccination, minimum protective rate was lowest, 69.6%.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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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.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.170-174
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• 2005

Objectives: The aim of this study was to evaluate the response to a hepatitis B vaccination, and investigate the HBV DNA in subjects with isolated anti-HBc. Methods: 34 subjects with persistent isolated anti-HBc were included in the study. 32 subjects negative for HBsAg, anti-HBs and anti-HBc were included as a control group. They were all vaccinated with Hepaccine at 0, 1 and 2 months, and anti-HBs titers were measured 1 month after the 1st and 3rd vaccinations (1 and 3 months). The HBV-DNA was tested by polymerase chain reaction in subjects with isolated anti-HBc. Results: After the 1st & 3rd vaccinations, the anti-HBs titers$\geq$10mIU/ml were 70.6 & 70.6% in isolated anti-HBc group, and 34.4 & 81.2% in the control group, respectively. There were statistically significant differences after the 1st vaccination, but none after the 3rd, between the two groups. In the isolated anti-HBc and control groups, the primary, amnestic and no responses were 0 vs. 46.9%, 55.9 vs. 6.3% and 29.4 vs. 18.8%, respectively. The HBV DNA was not detected in all subjects with isolated anti-HBc. Conclusion: None of the subjects with isolated anti-HBc had a false positive result (primary response); therefore, they should be excluded from vaccination programs in Korea. To differentiate between immunity and occult infections, a single dose of vaccine, with a follow-up anti-HBs test, is preferable for subjects with isolated anti-HBc. An amnestic response indicates late immunity, and no response a suspect occult infection.

• Childhood Kidney Diseases
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• v.10 no.2
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• pp.162-173
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• 2006

Purpose : To report the decreasing indicence of HBV(Hepatitis B virus)-associated membranous nephropathy in children after HBV vaccination and to elucidate the clinical course and treatment strategies of IMN(Idiopathic membranous nephropathy). Methods : We retrospectively reviewed the clinico-pathological findings of HBV-MN and IMN patients who underwent a renal biopsy from 1986 to 2005. We compared the HBV-MN and the IMN groups and the remission and the non-remission groups of patients with IMN. Results : Among 24 cases of MN patients, HBV-MN comprised 6 cases(25%) and IMN 18 cases(75%). Clinical masnifestations were nephrotic syndrome(3 cases, 50%), nephritic syndrome(1 case, 16.7%), asymptomatic(2 cases, 33.4%) in the HBV-MN group, asymptomatic(10 cases, 55.5%), nephrotic syndrome(5 cases, 27.8%), and gross hematuria(3 cases, 16.7%) in the IMN groups. From 1996 to 2000, there were 2 cases(28%) of HBV-MN and 5 cases(72%) of IMN. After 2001 all 10 cases were IMN. In the HBV-MN group, 4 cases(66.7%) received interferon and 1 cases received methylprednisolone pulse therapy. In the IMN group, 16 cases(88.9%) received methylprednisolone, 8 cases(44.4%) were in complete remission, 2 cases(11.1%) were in partial remission, 2 cases(11.1%) were in chronic renal failure, and 5 cases(27.8%) were lost to follow-up with sustained proteinuria, 1 case(5.6%) continued to have frequent relapse of nephrotic syndrome without renal insufficiency. In the comparison between remission and non-remission groups, nephrotic range proteinuria and hypertension were more significantly common in the non-remission group(P<0.05). Conclusion : With HBV vaccination, HBV-MN has decreased markedly. IMN is a rare glomerular disease in children. Because the prognosis for patients with nephrotic range proteinuria is poor this group needs more aggressive treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.5955-5958
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• 2012

Hepatocellular carcinoma (HCC), the sixth most prevalent cancer worldwide, continues to have high prevalence in many countries of Asia. The main challenge is the high prevalence of chronic hepatitis and aflatoxin, for example in China. HBV vaccination should be the major preventive tactic in Asian countries. The burden of HCC is low in Iran because most cases are due to HBV and this infection was less common. Although in Iran, a mass vaccination program started in 1993, its impact on decreasing the burden of HCC due to HBV can only be expected in future decades.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.223-229
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• 1984

An attempt to confirm the associations of some selected risk factors of HBV infection and measure their risks, a cross-sectional study with 1,209 urban office workers was carried out. For the study, a simple questionnaire which contained several questions on personal experience and behaviors on several known selected risk factors of HBV infection was applied to each subject, and the Hepatitis B virus surface antigen and its antibody were checked by RPHA and PHA method, respectively. Risk factors chosen for this study were experience of blood transfusion and personal contact variables, such as frequencies of eating-out, drinking after office hours, going to tea room, sharing cigarettes, etc. The results obtained were as follows: 1. The proportion of HBsAg positive was 10.6%, and total HVB infected including the Anti-HBs positive cases without vaccination was 44.2%. Both were higher in male than in female. 2. Frequent personal contact through glasses and dishes in eating-outs and drinkings turned out not to be a significant risk factor of Hepatitis B surface antigenecity. 3. Frequent visits to tea room was a significant risk factor of HBV infection which combined HBsAg positive cases and Anti-HBs cases who had not received HBV vaccination. The odds ratio was 1.56 4. Blood transfusion was not a significant risk factor of both HBsAg positive and total HBV infection. In summary, indirect oral contacts through eating-outs and drinkings was not significant risk factor in Korea at least between adults. Blood transfusion is no more major source of HBV infection in Korea probably because the adquate screening test of HBsAg for the blood donors is being made.

• Proceedings of the KAN Conference
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• 2004.11a
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• pp.99-109
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• 2004

• Journal of Korean society of Dental Hygiene
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• v.1 no.2
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• pp.181-192
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• 2001

The purpose of this was to evaluate the level of knowledge about Hepatitis B and AIDS among dental hygiene students at six dental hygiene educational programs in nationwide, compare the findings to those of Song's study. 1703 dental hygiene students surveyed by mail and answered a questionnaire, using the questionnaire used developed by DiClemente el al., on Hepatitis B vaccination, antibody production, experience of unintentional needle stick injuries, experience of surgical operation and blood transfusion, personal risk factors for HBV and HIV, management of HBV and HIV postexposure management et al. The data indicated that dental hygiene students (79.0%) in this study had more HIV vaccination than dental hygiene(74.3%) in Song's study. As for recognition of antibody production after Hepatitis B vaccination, only 34.6% of respondents answered they knew having antibody production and 95% of respondents knew not having antibody production. Over one-half of the respondents (55%) answered they didn't even recognize having antibody production. 52.3 percent of dental hygiene students experienced unintentional needle stick injuries. The findings on the knowledge about Hepatitis B and AIDS were that dental hygienists (76.5 points) received higher mean score than those of dental hygiene students (71.0 points) and that the distribution of right answer rate also showed wider range in dental hygiene students (27.7~97.5%) than those of dental hygienist (41.2~99.5%). There were no statistical differences among dental hygiene education programs. Finding of this study support that the curriculum of dental hygiene program should include instruction on sources and methods of transmission of infectious diseases, risk of virus transmission in the workplace and principles of infection control. Furthermore, infection-control practices should be utilized routinely and their application to dental personnel, management of HBV and HIV postexposure management. Furthermore, for preventing the further spread of infectious diseases (HBV, HIV and AIDS${\cdots}$) caused by bloodborne viruses, imposing an obligation rather than recommendation on Hepatitis B vaccination to all dental personnel and routinely utilizing infection-control guidelines for all dental patients in dental practices (include dental educational programs) should be accomplished by coordination the government agency.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1234-1240
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• 2002

Purpose : This study was carried out to obtain the vaccination rate and age appropriateness of vaccination in children under five years of age in Jeonbuk province. Methods : Eight hundred and fifty infants and children were enrolled in this study. Vaccination rate(Number of vaccinees/Number of subjects), places of vaccination, age appropriateness of vacination were examined by either vaccine record review or interview with parents or guardians. Results : The salient features of the findings were as follows : All subjects were aged under five and mostly under two years of age(68.8%). Places of vaccination were health centers or subcenters( 50.4%), private clinics(44.3%), and general hospitals(5.3%). Routine vaccinations such as BCG, hepatitis B vaccine(HBV), diphtheria, tetanus, acellular pertussis(DTaP) and Trivalent Oral Polio Vaccine(TOPV), measles, mumps, rubella(MMR), and Japaneses B encephalitis(JBE) were vaccinated mostly in health centers or subcenters, while chickenpox(CHP) and haemophilus influenzae vaccines(Hib), which are not routine in Korea, were vaccinated in private clinics. The vaccination rates of BCG(99.2%), HBV(93.5%) and DTaP(96.1%) were very high. But those of MMR(83.7%), CHP(72.5%), JBE(50.2%), and Hib(15.8%) were lower than expected. Considering the age appropriateness of vaccination, some infants and children were not appropriately vaccinated(vaccination rate/age appropriateness of vaccine; HBV, 93.5%/88.4% : DTaP, 94.6%/73.1% : JBE, 50.2%/ 18.5%). Conclusion : The vaccination rate of BCG, HBV, DTaP and TOPV was very high, but MMR, CHP, JBE, and Hib vaccination rate was not high enough to be able to protect against epidemic. We should pay more attention to vaccinating children, and there is a need for a program that will enhance coverage for vaccines.