• Clinical and Experimental Pediatrics
• /
• 제51권7호
• /
• pp.696-703
• /
• 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
• /
• 제4권2호
• /
• pp.240-256
• /
• 1997

목 적 : 초등학생의 성별, 연령별, 예방 접종률, 접종 완성률, 접종 시기를 비교하고, 간염 표지자 양성률을 검토하여 경기도 지역에서 과거 15년 동안 영아, 유아 및 초등학생을 대상으로 병의원, 보건소 및 학교 등에서 실시한 B형 간염 예방 접종 실태를 파악하고자 하였다. 방 법 : 1993년에 경기도 지역 초등학교 학생들을 집락 추출(cluster sampling)하여 실시하였다. 학교마다 각 학년별로 한 학급을 선정하여 총 2,072 명을 대상으로 혈청학적 검사와 설문 조사를 실시하였다. 결 과 : 1) 성별 HBsAg 양성률은 남자 3.7%, 여자 2.7%였고, 평균 3.4%였다. 연령별 HBsAg 양성률은 7세 3.5%, 12세 5.2%로 연령이 증가함에 따라 높아지는 경향을 보였다. 2) 어머니들의 B형 간염 출산 전 수검율은 10.2%, 출산 후 수검율은 42.5% 였다. 부모의 학력이 높을수록, 아버지의 직업이 사무직인 경우에 출산 전, 출산 후 수검율이 높았다. 3) 전체 예방 접종률은 82.6%, 접종 완성률은 69.8%, 추가 접종률은 42.8%였다. 연령이 증가함에 따라 예방 접종률, 접종 완성률, 추가 접종률이 모두 감소하였다. 부모의 학력이 높을 수록 예방 접종률, 접종 완성률, 추가 접종률이 증가하였다. 연령이 어릴수록 1 세 미만에 접종한 비율이 증가하였고, 7세 이상에 접종한 비율은 감소하였다. 부모의 학력이 높을수록, 아버지의 직업이 사무직인 경우에 1세 미만에 접종한 비율이 높았다. 4) 예방 접종 시기에 따른 간염 표지자 양성률에서 HBsAg과 Anti-HBc 양성률은 1~6세, 7세 이후, 1 세 미만의 순서로 높았다. 접종회수가 증가함에 따라 Anti-HBs 양성률은 유의하게 증가하였다. 기본 3회 접종 후 5년째 된 군에서 Anti-HBs 양성률은 85.7%, 유효 역가율은 69.6% 로 가장 낮았다. 결 론 : 이상의 결과를 통하여 전체 접종률은 82.6%, 접종 완성률은 69.8% 로 아직 낮은 수준으로 나타났다. 특히 부모의 학력이 낮고 아버지 직업의 사회적 지위가 낮은 계층은 출산 전 출산 후 산모의 HBV 수검율, 자녀의 백신 접종률, 접종 완성률이 모두 낮은 것으로 보아 의료 기관의 접근도가 떨어지고 예방 접종의 중요성에 대한 인식도 낮은 것으로 생각된다. 앞으로 B 형 간염 예방 접종 사업은 지속적인 보건 교육과 함께 이러한 사회적 지위가 낮은 계층 자녀의 접종률을 높이는 특별 관리 대책이 필요하리라 생각된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권11호
• /
• pp.6227-6231
• /
• 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
• /
• 제38권2호
• /
• pp.170-174
• /
• 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
• /
• 제10권2호
• /
• pp.162-173
• /
• 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
• /
• 제13권12호
• /
• pp.5955-5958
• /
• 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
• /
• 제17권1호
• /
• pp.223-229
• /
• 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.

• 대한간호학회:학술대회논문집
• /
• 한국간호과학회 2004년도 학술대회지
• /
• pp.99-109
• /
• 2004

• 한국치위생학회지
• /
• 제1권2호
• /
• pp.181-192
• /
• 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
• /
• 제45권10호
• /
• pp.1234-1240
• /
• 2002

목 적: 전라북도지역의 어린이 예방접종의 실태를 파악함으로써 문제점을 알아보고 예방접종률과 접종 시기의 적절성을 향상시키고자 하였다. 방 법: 2000년 3월부터 6월까지 전북지역의 5세 이하의 소아 850명을 대상으로 하였으며 조사방법은 보호자의 면담과 예방접종수첩 등 의무기록을 근거로 이루어 졌다. 예방접종 종류에 따른 접종여부, 접종시기와 횟수, 접종장소에 대해 조사하였다. 결 과 : 1) 조사방법은 전체 850명 중 362명(43%)은 예방접종수첩을 통해 이루어졌으며, 488명(57%)은 보호자의 기억을 통한 면담으로 이루어졌다. 2) 전체 예방접종의 50.4%는 보건소에서, 44.3%는 개인의원에서, 5.3%는 대학병원과 종합병원에서 이루어졌다. 기본접종인 BCG(49%), B형 간염(47%), DTaP(61%), MMR(55%), 일본뇌염(73%)은 보건소에서 주로 접종되었고, 수두(62%)와 Hib백신(88%)등 선별접종은 개인의원에서 더 많이 이루어졌다. 3) 예방접종률은 BCG는 99.2%, B형 간염은 93.5%, DTaP & TOPV는 96.1%로 비교적 접종률이 높았으나, 선별접종인 MMR은 83.7%, 수두는 72.5%, 일본뇌염은 50.2%, Hib는 15.8%로 낮은 접종률을 보였다. 4) 예방접종 시기의 적절성은 B형간염은 88.4%, DTaP는 72.8%, 일본뇌염은 18.5%로 각각의 접종률인 93.5%, 94.6%, 50.2%와 큰 차이를 보였다. 결 론 : 1세 미만에 실시하는 예방접종들의 접종률은 비교적 높았으나 1세 이후에 실시하거나, 여러 차례 추가접종이 필요한 경우는 접종률과 적절성이 모두 낮았다. 특히, MMR, 수두, 일본뇌염, Hib 백신의 경우 지역사회에서의 유행을 예방하기에는 아직 낮은 수준으로 평가된다. 이러한 예방접종률을 높이기 위해서는 무엇보다도 부모들의 백신 접종에 대한 인식을 높이는 것이 중요하고, 예방접종기록을 표준화하고 전산화하며, 예방접종 기록을 초등학교 입학시에 제출하는 것을 의무화하는 것이 바람직할 것이다. 그리고, 예방접종 사업에 대한 평가와 이를 환류 할 수 있는 감시체계가 필요할 것으로 생각된다.