• Pediatric Infection and Vaccine
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• 제5권1호
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• pp.96-103
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• 1998

목 적 : B형 간염 바이러스(hepatitis B virus; HBV) 보유 산모로부터 출생한 신생아의 수직감염 양상을 관찰하고 HBV 백신의 면역반응 및 방어효과를 평가하기 위하여 본 연구를 시행하였다. 대상 및 방법 : 1995년 7월부터 1996년 12월까지 18개월간 가톨릭대학교 성빈센트병원을 방문한 HBV 보유 산모와 이들로부터 분만된 신생아중 12개월간 추적관찰이 가능하였던 78례를 연구대상으로 하였다. 이들 HBV 보유 산모의 신생아에게 출생 직후부터 HBV 면역 글로불린(HBIG)과 가열 불활성화 혈장 백신을 접종한 후 4, 8, 12개월시에 검체를 채취하여 일반표지자의 양상을 면역효소법 및 방사면역법으로 측정한 후 HBV 보유 산모와 그 신생아의 각 표지자간의 관계 및 변화를 분석하였다. 결 과 : 1) 연구 대상 산모 중 HBV 보유자는 5.0%(106/2,117), HBeAg 양성 및 음성의 비율은 38.5%(37/96)와 61.5%(59/96)이었다. 2) HBV 보유 산모로부터 출생한 영아에 있어서 백신에 대한 anti-HBs 양전율은 4, 8, 12개월 시 각각 85.9%(67/78), 75.6%(59/78), 73.1%(57/78)로 유의한 차이가 있었으나(P<0.05), 산모의 HBeAg 유무와는 관련이 없었다. 형성된 anti-HBs의 기하 항체가는 4개월에 비하여 8개월, 12개월에 유의하게 증가하였다(P<0.05). HBV 백신과 HBIG 투여의 HBV 보유자 이행에 대한 12개월시의 방어 효과는 HBeAg 양성 및 음성 산모로부터 분만된 영아에서 각각 89.8%와 100%이었다. 3) 12개월의 관찰 기간동안 산모로부터 감염이 있었던 경우는 78명 중 5명으로 모두 HBeAg 양성 산모에서 분만된 영아이었고 이 중 3명에서 HBV 보유자로 이행되었다. 출생 직후 HBeAg 양성 및 음성 산모의 신생아에서 HBsAg 양성이었던 경우는 각각 4명으로 HBeAg 양성 산모의 신생아 4명 중 3명에서 감염이 발생하였다. 결 론 : 국내에서 개발된 백신의 하나인 가열 불활성화 B형 간염 혈장 백신의 항체 양전률은 85.9%이었으며, HBIG과 동시 투여하였을 때 12개월간의 HBV 보유자 이행에 대한 방어효과는 HBeAg 양성 산모에서 출생한 경우 89.8%인 반면 HBeAg 음성 산모에서 출생한 경우는 100%이었다.

• 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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• 제20권2호
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• pp.280-286
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• 1987

For evaluating the boosting (anamnestic) effects of the most recent commercially produced plasma derived heat-inactivated hepatitis B vaccine (A. Co.), 117 adults with naturally acquired antibody to hepatitis B surface antigen (anti-HBs) were selected at random. In addition, out of case immunized at zero and 1 month, and boosted at 6 months (primary boosting) by conventional vaccine (B. Co), inactivated by pepsin digestion and formalin treatment, 11 cases who showed elevated titer after primary boosting were also submitted to the study. The results were as follows: 1) Out of the 117 subjects with naturally acquired anti-HBs, 6(5.1%) showed isolated anti-HBs and the titers were below 10 ratio units (RU). Negative seroconversion was seen in 4(3.4%) of the 117 cases at 12 months after the screening and, of these cases, 3 showed isolated anti-HBs and the titers were below 10 RU. 2) Eighty-three percent of the cases with naturally acquired isolated anti-HBs below 10 RU did not respond to a booster injection with 3 us dose of A. Co. vaccine at all, but 90% of the other subjects responded. 3) The anti-HBs titers of all the 11 cases who showed a rise of more than 10 RU (increased GMT, 28.04) at one month after primary booster injection by $20{\mu}g$ dose of B. Co. vaccine decreased at 19 months after the primary booster. And 3 subjects (27.3%) of the 11 reached negative seroconversion. All of the 11 cases, who had secondary booster injection with $3{\mu}g$ dose of A. Co. vaccine at 19 months after primary boosting, showed increased anti-HBs titer at least 20 RU or more (increased GMT, 57. 72) at one month after the boosting. According to the above results in the anti-HBs screening survey for the purpose of immunization with hepatitis B vaccine, subjects with isolated anti-HBs below 10 RU should be regarded as being in an unimmunized state. In cases who are in risk circumstances, immunized primarily with a $20{\mu}g$ dose of B. Co. vaccine, a secondary booster injection should be given within 2 years after initiation of primary immunization and a $3{\mu}g$ booster dose of A. Co. vaccine can be reliably used.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.211-220
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• 1985

저자들은 급성간염 39예, 만성간염 79예, 간경변증 30예, 원발성간암 16예, 보유자 14예 및 비교군 129예의 모두 307명을 대상으로 하여 SGOT, SGPT 및 HBV 표식자를 조사하여 다음의 결과를 얻었다. 1. HBsAg의 발현율은 급성간염의 66.7%, 만성간염의 63.3%, 간경변증의 36.7%, 원발성간암의 81.3% 및 비교군에서 27.1%인 것으로 나타났다. 2. AntiHBc의 발현율은 급성간염의 0%, 만성간염의 21.5%, 간경변증의 36.7%, 원발성간암의 31.3%, 보유자의 0% 및 비교군에서 44.2%로 나타났다. 3. HBeAg은 만성간질환중 만성간염에서 45.6%로 가장 높게 나타났고 AntiHBe는 원발성간암에서 56.3%로 가장 높았다. 4. AntiHBc는 각종 간질환, 보유자 및 비교군에서 높게 나타났으며 이는 AntiHBc자체는 간질환에 직접 관계가 없는 감염의 흔적으로 생각된다. 5. HBsAg 보유자 14명중 6명(42.3%)에서 혈청 GOT, SPT 치의 이상 상승이 있었다. 6. HBV에 감염된 혈청학적 증거가 있으면서 간기능에 이상이 있을 때, HBV 이외에 non-A, non-B 바이러스, Delta agent 또는 타 바이러스나 관련된 다른 요인과의 관계가 있을 수 있는 점을 고려하여야 할 것으로 생각된다. HBV의 5 가지 표식 자가 모두 음성으로 나타난 환자는 급성간염의 5.1%, 만성간염의 5.1%에 달했으며, 이것은 HBV 이외의 다른 원인이 병인이 될 수 있음을 시사하며 비교군 중 SGOT, SGPT치의 증가를 보인 군에서는 17.6%, 정상 SGOT, SGPT치를 나타낸 군에서는 12.8%에서 모든 HBV 표식자가 음성으로 나타났다.

• Clinical and Experimental Pediatrics
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• 제62권11호
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• pp.416-421
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• 2019

Background: The seropositivity rate of hepatitis B surface antigen (anti-HBs) antibodies is known to be ≥95% after hepatitis B virus vaccination during infancy. However, a low level or absence of anti-HBs in healthy children is discovered in many cases. Recent studies in adults reported that a reduced anti-HBs production rate is related to obesity. Purpose: To investigate whether body mass index (BMI) affects anti-HBs levels in healthy children following 3 serial dose vaccinations in infancy. Methods: We recruited 1,200 healthy volunteers aged 3, 5, 7, or 10 years from 4-day care centers and 4 elementary schools. All subjects completed a questionnaire including body weight, height, and vaccine type received. Levels of serum hepatitis B surface antigen (HBsAg) and anti-HBs in all subjects were analyzed using electrochemiluminescence immunoassay. The standardized scores (z score) for each sex and age were obtained using the lambda-mu-sigma method in the 2017 Korean National Growth Charts for children and adolescents. Results: Our subjects (n=1,200) comprised 750 males (62.5%) and 450 females (37.5%). The overall anti-HBs seropositivity rate was 57.9% (695 of 1,200). We identified significant differences in mean BMI values between seronegative and seropositive groups (17.45 vs. 16.62, respectively; P<0.001). The anti-HBs titer was significantly decreased as the BMI z score increased adjusting for age and sex (B=-15.725; standard error=5.494; P=0.004). The probability of anti-HBs seropositivity based on BMI z score was decreased to an OR of 0.820 after the control for confounding variables (95% confidence interval, 0.728-0.923; P=0.001). Conclusion: There was a significant association between anti-HBs titer and BMI z score after adjustment for age and sex. Our results indicate that BMI is a potential factor affecting anti-HBs titer in healthy children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권2호
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• pp.197-207
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• 2004

목적: 소아 만성 B형 간염 환아들에게 라미부딘으로 치료 시작 후 그 치료 효과를 평가하고 소아에서 라미부딘 장기 치료의 지속성과 안정성에 대해 검증하고자 하였다. 대상 및 방법: 1999년 3월부터 경북대학교병원 소아과에서 만성 B형 간염으로 라미부딘 치료를 시작한 후 2004년 9월 현재까지 최소 6개월 이상 치료한 48명(남 31, 여 17명, 1~18세, 평균 8세)을 대상으로 29개월(8~66개월) 추적 관찰하면서 연구를 시행하였다. 치료에 대한 효과는 치료 시작 후 혈청 ALT 치의 정상화와 HBV DNA의 음전 및 HBeAg/anti-HBe로의 혈청전환을 모두 만족할 때 치료반응이 있다고 정의하였다. Kaplan-Meier법을 이용한 누적 HBeAg 혈청전환율을 치료 시작 0.5, 1, 1.5, 2, 2.5, 3년에서 구하였다. 결과: 라미부딘으로 치료 시작 후 0.5년이 경과한 48명 중 치료 반응은 29명(60%)에서 보였고 9명(19%)에서는 HBsAg의 소실도 일어났다. 치료 시작 1년째 ALT치가 정상화된 환아는 94%, HBV DNA치가 음전된 환아는 94%, HBeAg 혈청전환까지 되어 치료 반응이 있던 환아는 34%였다. Kaplan-Meier법에 의한 누적 HBeAg 혈청전환율은 0.5, 1, 1.5, 2, 2.5, 3년째에 각각 13, 34, 50, 68, 79, 90%로 계산되었다. 특히 7세 미만의 소아 22명 중에서는 HBsAg의 소실이 8명(36%)에서 일어나 7세 이상에서 치료를 시작하는 것에 비하여 탁월한 성적을 보여주었다(p=0.002). 결론: 한국의 소아 만성 B형 간염 환아에서 라미부딘의 장기 치료는 HBeAg 혈청전환을 가속화 시키며 3년 동안 추적 관찰 결과 장기적으로 치료 반응이 지속되었다. 소아 만성 간염의 경과 관찰 중 면역제거기에 들어서면 라미부딘으로 장기간 적극적인 치료를 시도하는 것이 좋을 것으로 생각한다.

• 한국약용작물학회:학술대회논문집
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• 한국약용작물학회 2009년도 심포지엄 및 춘계학술발표회
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• pp.239-240
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• 2009

• Journal of Yeungnam Medical Science
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• 제7권1호
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• pp.121-126
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• 1990

전신마취를 필요로 하는 무증상 HBsAg양성 간효소치가 증가된 환자 11명을 대상으로 enflurane으로 마취한후 술전, 술후 3일, 7일 및 10일에 간기능검사를 실시하여 그 변화를 비교 검사한 결과 다음과 같은 결론을 얻었다. 1) SGOT, SGPT SGOT, SGPT는 술후 3일에는 술전수치보다 약간 증가하였으나 7일, 10일에는 현저한 증가를 보였다. 8예에 있어서는 술후 3일에 술전치 보다 약간 증가한 양상을 보였고 7일, 10일에 술전치와 비슷하게 되었으나 3예에서는 3일에 SGOT, SGPT가 약간 증가하더니 7일, 10일에는 SGOT, SGPT가 300-500IU로 상당히 증가하여 간염치료를 하여 술후 2개월후에 술전치와 비슷하게 하강하였다. 2) Alkaline phosphatase, total protein, albumin, total bilirubin, and direct bilirubin은 술후 3일에 정상범위를 벗어난 변화를 보였으며 7일부터 정상범위내로 회복되었다. 이상의 결과를 보아 enflurane마취가 간기능에 큰 영향을 미치지 않는다고는 하나 HBaAg양성 간효소치가 증가한 환자에게는 마취시 간염으로 이행될 가능성이 높으므로 상당히 조심을 하여 마취를 시행하여야 할 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5463-5467
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• 2012

Hepatitis B virus (HBV) infection is contagious with transmissiobn vertically or horizontally by blood products and body secretions. Over 50% of Iranian carriers contracted the infection prenatally, making this the most likely route of transmission of HBV in Iran. To evaluate the resistance to adefovir (ADV) therapy in patients with chronic hepatitis B infection, a study was conducted on 70 patients (63 males and 7 females), who had received in first line lamivudine and second line adefovir. All were tested for the presence of hepatitis B surface antigen (HBsAg), hepatitis B envelope antigen (HBeAg), serum alanine amino transferase (ALT) level and HBV DNA load before and after treatment with ADV. In all samples, resistance to lamivudine and ADV was tested with real time PCR. Among seventy patients with chronic hepatitis B infection, 18 (25.7%) were resistant to LAM and 8 (11.4%) were resistant to ADV. Only one patient was negative for the presence of HBS-Ag (5.6%) and two were negative for HBe-Ag (11.1%). In this study we used a new method (ALLGIO probe assay) that has high sensitivity in detection of adefovir resistance mutants, which we recommend to other researchers. Mutant strains of the YMDD motif of HBV polymerase can be found in some patients under treatment with lamivudine and ADV. ADV has been demonstrated to be efficient in patients with lamivudine resistant HBV.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3657-3661
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• 2012

HBV infection is contagious and may be transmitted vertically or horizontally by blood products and body secretions. Over 50% of Iranian carriers have contracted the infection prenatally, making this the most likely route of transmission of HBV in Iran. This study assesses the resistance to Lamivudine in patients with chronic hepatitis B infection using a new ZNA probe Real Time PCR method. To evaluate the effectiveness of Lamivudine therapy for chronic hepatitis B infection, a study was conducted on 70 patients (63 men and 7women), who had received the drug first line. All patients were tested for the presence of HBsAg and HBeAg, the serum ALT level and the HBV DNA load before and after treatment. In all samples resistance to Lamivudine was tested with the ZNA Probe. Our results showed that ZNA Probe Real Time PCR method could detect wild type,YMDD, and its mutants, tyrosine-isoleucine-aspartate-aspartate and tyrosine-valine-aspartate-Aspartate. Among an estimated seventy patients with chronic hepatitis B infection, 18 (25.7%) were resistant to lamivudine. Only one patient was negative for presence of HBS-Ag (5.6%) and two patients were negative for HBe-Ag (11.1%). Real-time PCR with Zip nucleic acid probes is a sensitive, specific and rapid detection method for mutations in the YMDD motif, which will be essential for monitoring patients undergoing Lamivudine antiviral therapy.