• Radiation Oncology Journal
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• 제28권2호
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• pp.106-110
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• 2010

B형 간염바이러스의 재활성화는 세포독성치료 및 면역억제치료를 시행 받은 만성 B형 간염 환자 및 보균자들에서 잘 알려진 합병증이다. 방사선치료의 경우, B형 간염바이러스 재활성화에 대한 연구는 그 수가 적으며, 대개 이전에 항암화학요법 또는 경동맥화학색전술을 시행 받은 환자를 포함한다. 간의 방사선조사만을 시행 받은 환자에서의 B형 간염바이러스의 재활성화에 대한 연구는 보고된 바 없으며, 이에 본 증례를 보고한다. 본 연구를 통하여, 간의 국소방사선조사 단독으로 B형 간염바이러스의 재활성화 유발의 가능성을 확인하였으며, 따라서, 간을 포함한 방사선조사 시 B형 간염관련 간질환 환자의 경우 방사선 관련 간질환뿐 아니라 바이러스의 재활성화에 대한 고려도 요구된다.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.89-98
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• 1988

While there have been not a few reports on the seroepidemiological characteristics of hepatitis B virus (HBV) infection in Korea, most of them, however, have had several limitations; operational definition of HBV infection, validity of detection methods of HBV serologic markers, size of the study population, and confirmation of the vaccination history against HBV, etc. In order to avoid such limitations, authors randomly selected 1,495 healthy adults among the 217,511 insured (target population) of Korean Medical Insurance Corporation, living in seoul, and tested HBV serologic markers by RIA method and conducted direct interview to them. Although HBV serologic markers (HBsAg, anti-HBs and anti-HBc) of all the subjects were tested, 392(26.2%) of interview failure cases and 361 vaccinee were excluded from the actual population. Finally, the serologic markers tested of 742 nonvaccinee (study population) only were analysed for the seroepidemiologic observation of the natural infection of HBV. The seroepidemiological characteristics of HBV infection in Korea were as follows ; 1. Point prevalence of HBs antigenemia was 11.7(9.1{\sim}14.3)% in male, which was slightly higher than that of female, 9.5($3.7{\sim}15.3$)%. This level was one of the highest among those of Asian-Pacific countries. Decreasing tendency of HBsAg prevalence alter the age of 50 was observed, which seems to be due to selective attrition of HBV chronic carriers among the healthy adults and/or to the limited-lasting duration of the HBs antigenemia, in part. 2. Point prevalence of anti-HBc(78.8% in male,50.9% in female) was higher than that of anti-HBs(65.2% in male,46.6% in female), respectively. And both of them were higher in male than in female. Increasing tendency of the prevalence of both antibodies was observed by age, which seems to be largely due to recurrent infection in adults and to some cumulative effect, in part, of their relatively longer-lasting duration. 3. The level of HBV infection defined by positive for at least one of the 3 serologic markers of HBV by RIA method was 84.7($81.8{\sim}87.6$)% in male and 61.2($51.9{\sim}70.5$)% in female, which was also one of the highest among those of Asian-Pacific countries. The proportion of susceptible population to HBV infection among healthy adults was 15.3% in male and 38.8% in female. 4. The relative frequency of current or past infection and chronic carrier among HBV infected person was estimated. The currently or past infected was estimated 75.7% in male and 71.8% in female, and chronic carrier state, 13.8% in male and 14.1% in female. The analysis of the geometric mean of the antibody titer in anti-HBs positive sera indicated also to be compatible with the above findings, suggesting that active, even though inapparent, infection of HBV occur so frequently among healthy adults in Korea.

• 대한간학회지
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• 제24권4호
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• pp.384-391
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• 2018

Backgrounds/Aims: The objective of our study was to determine the epidemiological, laboratory, and serological characteristics of patients with chronic hepatitis B virus (HBV) infection and normal transaminases. The study also aimed to evaluate liver damage by measuring the liver fibrosis (LF) grade and to identify possible factors associated with the presence of fibrosis. Methods: A retrospective observational study was conducted in patients with chronic HBV infection and classified as inactive carriers or immune-tolerant. Epidemiological variables of age, sex, immigrant, alcohol consumption, and body mass index (BMI), as well as virological variables (HBV DNA) and transaminase level were collected throughout the follow-up. The LF grade was evaluated by transient elastography. The cutoff value for significant fibrosis (SF) was liver stiffness ${\geq}7.9kPa$. Results: A total of 214 patients were included in the analysis, and 62% of them had a BMI ${\geq}25kg/m^2$. During follow-up, 4% of patients showed transaminase elevation (<1.5 times normal). Most patients had a viral DNA level <2,000 IU/mL (83%). Data on LF were available in 160 patients; of these, 14% had SF, 9% F3, and 6% F4. The variables associated with the presence of SF were transaminase alteration during follow-up, as 23% of patients with SF had elevated transaminases versus 3% of patients without SF (P<0.005), and BMI, as the vast majority of patients with SF (88%) had a BMI ${\geq}25kg/m^2$ versus 56% of patients without SF (P<0.05). Conclusions: In patients with chronic HBV infection and normal transaminases, liver damage does not seem to be related to DNA levels, alcohol consumption, or immigrant status. SF seems to be associated with transaminase alteration during follow-up and elevated BMI. It is therefore recommended to measure LF grade with validated non-invasive methods in such patients.

• Radiation Oncology Journal
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• 제29권1호
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• pp.53-62
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• 2011

방사선간염은 대개 황달을 동반하지 않은 알칼리인산 분해효소(alkaline phophatase)의 상승을 특징으로 보인다. 하지만, 방사선간염 환자의 일부에서는 아미노전달효소(transaminase)의 상승을 특징적인 소견으로 보이고, 이러한 소견은 특히 간암 환자의 70~90%가 B형 간염 바이러스 보균자인 아시아 지역에서 흔하게 관찰된다. 또한 B형 간염 바이러스 보균자인 간암 환자를 방사선으로 치료했을 때 방사선간염이 더 흔하게 발생한다. 이런 사실들은 B형 간염 바이러스 보균자에서 방사선간염의 발생 기전이 비보균자에서의 그것과 다를 수 있다는 것을 시사하고, B형 간염 바이러스 보균자에서 발생하는 방사선간염의 발생기전은 B형 간염 바이러스의 재활성화와 연관이 있을 것으로 추측된다. 하지만, 현재 간암의 방사선치료 후 B형 간염 바이러스의 재활성화에 대한 연구는 미미한 수준이다. 이에 저자들은 간암 환자의 토모테라피 후 발생한 B형 간염 바이러스 재활성화 3예를 보고하고자 한다.

• 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.

• 정신신체의학
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• 제8권1호
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• pp.3-10
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• 2000

연구목적 : 저자는 만성 B형 간질환 환자의 정신과학적 측면과 사회학적 측면을 관찰해 보고자 본 연구를 실시하였다. 방법 : 저자는 1966년부터 1999년까지의 Medline database에 등록된 B형 간질환에 관한 모든 문헌들을 고찰하였다. 결과 : 만성 B형 간질환 환자와 관계되는 정신과학적 측면은 섬망, 전반적인 의학적 상태에 기인하는 정신병(특히 조증), 불안, 우울, 적응장애, 알코올 남용과 의존, 및 약물남용과 의존 등이다. 만성 B형 간질환 환자와 관계되는 사회학적 측면은 간염보균자로서의 낙인문제, 감염과 연관된 죄책감, 증가된 가족들의 부담에 대한 죄책감, 대인관계의 소외와 철수, 성장애, 직업상실 및 의료진의 치료 거부등이다. 결론 : 만성 경과를 거치는 B형 간염환자의 여러 가지 정신과학적 사회학적 문제로 볼 때, 적절한 조기의 교육적 상담 개업이 필요하다고 하겠다. 적절한 교육적 상담 개입은 간염으로부터 간경화 간암으로의 진행과정에 B형 간염환자의 치료의 순응도를 높이고 나아가 악화의 과정을 예방할 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제24권4호
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• pp.465-472
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• 1991

약물남용자들의 C형간염 감염 상태를 파악하고자 methamphetamine 남용에 의한 중독 증상으로 입원하고 있는 141명을 대상으로 하여 약물남용의 빈도와 기간, 약물 투여경로 등에 관한 조사와 함께 혈청내 C형간염 항체, B형간염 표식자 및 간기능 검사를 실시하고 이들 사이의 관련성을 검토하여 다음과 같은 결과를 얻었다. 1. C형간염 항체 양성률은 60.3%(85/141)이었으며 성별로는 차이가 없었으나 연령군별로는 40세 이상군에서 증가되는 경향이 있었다. 2. C형간염 항체의 양성률은 약물남용의 빈도가 높았던 군과 약물남용의 기간이 길었던 군에서 유의하게 높았으나 B형간염 표면항원의 양성률은 약물남용의 빈도 및 기간과 유의한 차이가 없었다. 이상의 결과로 보아 methamphetamine 남용자에서 C형간염 유병률은 매우 높을 것이며 감염 전파경로에 있어서 C형간염은 반복적인 경주적 폭로가 중요 전파 요인일 것으로 추측된다.

• 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.

• 대한화학회지
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• 제51권1호
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• pp.36-42
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• 2007

B형 간염 바이러스(Hepatitis B Virus, HBV)는 만성감염, 간암의 원인이 되는 등 가장 큰 공중보건문제 중의 하나이다. 그리하여 감염 초기에 바이러스의 DNA 농도를 측정하여 관찰 하는 것이 중요하다. 본 연구에서는 기존의 Real Time-PCR과 새로운 방법인 Micro-PCR를 이용하여 HBV를 검출하였다. 단국대학교 병원에서 HBV 감염 환자의 혈청 샘플 120개를 얻은 후 분석하였고 각각 장비에서의 검출한계와 재현성, 민감성, 특이성, 분석시간을 비교해 보았다. 그 결과 Micro-PCR과 Real-Time PCR은 높은 검출한계와 재현성, 민감성, 특이성을 가지고 있었다. 그러나 Micro-PCR은 Real-Time PCR보다 빠른 시간 안에 증폭이 가능하며 조작하는데 있어 간편하였고 적은 양의 시약이 소모됨을 알 수 있었다. 그러므로 Micro-PCR은 신뢰성 있고 빠른 임상적 진단이나 각종 검사가 요구되는 곳에서 이용 가치가 높은 장비라 할 수 있겠다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7725-7730
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• 2014

Hepatocellular carcinoma (HCC) is the third most common cause for cancer death in the world, now being especially linked to chronic hepatitis C virus (HCV) infection. This case-control study consisting of 65 HCC patients and 82 patients with other malignant tumours as controls was conducted to determine the association of HCV markers with HCC. Serum of each participant was obtained for detection of HCV Ab and RNA by DNA enzyme immunoassay (DEIA). Twenty six per cent (26.0%) of HCC patients had positive anti-HCV which was significantly greater than the control group (p=0.001). HCC patients significantly have a risk of exposure to HCV infection almost 3 times than the control group (OR=2.87, 95% C.I=1.1-7). Anti-HCV seropositive rate was significantly (p=0.03) higher among old age HCC patients and increases with age. Males with HCC significantly showed to have more than 9 times risk of exposure to HCV infection (OR=9.375, 95 % CI=1.299-67.647) than females. HCV-RNA seropositive rate was (70.8%) significantly higher among HCC patients compared to (22.2%) the control group (p=0.019). The most prevalent genotype (as a single or mixed pattern of infection) was HCV-1b. This study detected a significantly higher HCV seropositive rate of antibodies and RNA in HCC patients.