• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.267-278
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• 1997

The purpose of this study was to investigate the incidence rate of hepatitis B in the military service and to examine the effect of the asymptomatic hepatitis B surface antigen(HBsAG) carries on the incidence of hepatitis B. The subject were 223,270 men who were conscripted to the Korean Army from 1991 to 1994. According to the conscripted year, four conscription cohort were constructed. At the screening examination for military service no test for hepatitis B were performed in 1991 and 1992. In 1993, a screening test for hepatitis B were performed and those who were confirmed as HBsAg positive o. showed high titers $(\geqq100IU)$ of nm glutamic-pyruvic transaminase(SGPT) were excluded from conscription. In 1994, the criteria for conscription was changed and those who were HBsAg positive were not excluded from conscription. Only those who showed $\geq$ SGPT 100IU were excluded. The main results were as follows ; 1. The positive rate of HBsAg is 5.5% in the conscripted men. 2. The incidence rates of the hepatitis B in 1991 and 1992 conscription cohort were 9.96 and 8.10 per ten thousand person-year, respectively. The incidence rate of the hepatitis B was 1.34 per ten thousand person-year in 1993 conscription cohort which was confirmed as HBsAg negative at the screning test, and 7.41 per ten thousand person-year in 1994 conscription cohort which included the HBsAg positive. 3. The incidence rate of hepatitis B was 99.98 per ten thousand person-year in HBsAg positive group and 2.25 per ten thousand person-year in HBsAg negative group. The incidence rate of the group with high SGPT and HBsAg positive was 255 times higher than that of normal population. 4. The incidence of hepatitis B in HBsAg negative group did not increase even though the probability of personal contact with HBsAg positive had been increased. from the above results, the men who have high SGPT with HBsAg positive should be excluded from military service, and it can not be said that asymptomatic HBsAg carriers influence on the hepatitis B incidence among the HBsAg negative through personal contact.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.155-167
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• 1997

The identification of serum HBV DNA is very important for the assessment of the disease activity in persistent infection, for the evaluation of the infectivity of an individuals blood. The dot blot, however, has limited sensitivity and sometimes inconsistent with other serological markers and clinical settings. Using the most important recent advance in molecular biology, the polymerase chain reaction(PCR), specific DNA sequences can be amplified more than a million-fold in a few hours and with this technique the detection of the extreme low level of DNA is possible. This study was to determine sensitivity of the PCR for the detection of serum HBV DNA in comparison with dot blot analysis and to investigate the serum HBV DNA status and clinical significance of PCR in patients with chronic HBsAg positive liver disease. The subjects of this study were 17 patients with asymptomatic HBsAg carriers(9 HBeAg positive patients, 8 anti-HBe positive patients), 91 chronic hepatitis B(50 HBeAg positive patients, 41 anti-HBe positive patients), 57 liver cirrhosis(21 HBeAg positive patients, 36 anti-HBe positive patients), 27 hepatocellular carcinoma(10 HBeAg positive patients, 17 anti-HBe positive patients). The results were summerized as following; The detection rates of HBV DNA by dot blot, PCR were 58.9%, 72.2% in HBeAg positive patients, 34.3%, 53.9% in anti-HBe positive patients. The detection rates of HBV DNA by PCR in HBeAg negative patients were 25.0% in asymptomatic HBsAg carriers, 61.0% in chronic hepatitis B, 52.8% in liver cirrhosis, 52.9% in hepatocellular carcinoma. The positive rate for HBV DNA is a significant difference between HBeAg positive and negative asymptomatic HBsAg carriers, but not significantly difference in other groups. In conclusions, this study confirmed that the PCR is much more sensitive than the dot blot analysis in detecting the HBV DNA in the sera of patients with chronic liver disease. The presence of HBV DNA in the serum was detected by PCR with higher sensitivity and it suggested that active viral replication is still going on in most patients with chronic HBsAg positive liver disease irrespective of HBeAg/anti-HBe status, and PCR may be used as a prognostic factor in asymptomatic HBsAg carriers.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.203-210
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• 1984

Primary screening test for serum HBsAg by RPHA from 4,805 persons who were clinically well through preemployment examination for the period of one calendar year of 1983 revealed 476 (9.9%) positive individual carriers. There were no significant differences in distribution of positives of serum HBsAg by age group, profession, or province area. Among positives of serum HBsAg, 356 (74.8%) showed normal findings and 120 (25.2%) showed abnormal findings in liver function test, respectively. Radioimmunoassay was done in 169 positives of HBsAg and RIA detected 10 negative persons who were positive by RPHA revealing 5.9% of false positive rate and 94.1% of sensitivity of RPHA. In RIA profile of HBV markers, pattern I (HBsAg+, Anti-HBe+) was 46.6%, pattern II (HBsAg+, HBeAg+) was 33.3%, pattern III (HBsAg+only) was 18.3%, pattern IV (HBsAg+, HBeAg+, Anti-HBs+) was 1.3%, pattern V (HBsAg+, HBeAg+, Anti-HBe+) was 0.6%, respectively. There were no positives of HBsAg among 10 persons who were negatives of HBsAg by RIA.

• Journal of Preventive Medicine and Public Health
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• v.33 no.3
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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.

• The Korean Journal of Nuclear Medicine
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• v.19 no.2
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• pp.81-86
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• 1985

To evaluate the significance of serum $beta_2-microglobulin$ in patients with various liver diseases, serum $\beta_2m$ levels were measured in 44 cases of normal controls, 32 cases of asymptomatic HBsAg carriers and 134 patients with various liver diseases, by radioimmunoassay using Phadebas $Beta_2-micro$ test kits. The following results were obtained: 1) The mean level of serum $\beta_2m$ was $1.39{\pm}0.25mg/l(Mean{\pm}S.D.)$ in normal controls ($1.39{\pm}0.23mg/l$ in 24 males, $1.38{\pm}0.27mg/l$ in 20 females). 2) The serum levels of $\beta_2m$ in patients with various liver diseases and asymptomatic HBsAg carriers were as follows; $1.40{\pm}0.27mg/l$ in asymptomatic HBsAg carriers, $2.42{\pm}0.37mg/l$ in 45 patients with acute viral hepatitis, $2.10{\pm}0.26mg/l$ in 46 patients with chronic persistent hepatitis, $2.60{\pm}0.34mg/l$ in 23 patients with chronic active hepatitis, and $2.60{\pm}0.49mg/l$ in 20 patients with liver cirrhosis. Serum $\beta_2m$ levels of each disease group were significantly higher than that of normal controls(p<0.001). 3) There was significant correlation between the levels of serum $\beta_2m$ and the degrees of lymphocytic infiltration in patients with chronic active hepatitis(p<0.001). 4) Significant correlations were observed between the levels of serum $beta_2-microglobulin$ and serum alanine aminotransferase(r=0.68, p<0.05) and bilirubin(r=0.63, p<0.05) in 15 patients with acute viral hepatitis. In conclusion, the serum $beta_2-microglobulin$ levels were increased in patients with various liver diseases, and it may serve as a new index of liver disease activity.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.141-142
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• 1996

• Pediatric Infection and Vaccine
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• v.11 no.1
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• pp.73-80
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• 2004

Purpose : The serial clinical findings, biochemical results, and serological hepatitis B virus(HBV) markers in Korean children with chronic HBV infection were analyzed to determine the relationships among these factors. Methods : Ninety children have been chosen from those who have visited to the Department of Pediatrics at St. Vincent's Hospital in The Catholic University of Korea from July 1st, 1995 to June 30th, 2000. The sample patients were followed up for over six months. HBV markers and liver function tests were all performed. Results : All children were asymptomatic at presentation. Eighty-three percent of the children had a history of chronic HBV infection in their families. Eighty-one percent were HBeAg positive, 16% were anti-HBe positive, while 3% were all HBeAg and anti-HBe negative. The prevalence of HBeAg among three age groups : 0~5; 6~10; and 11~15 year-old was 90%, 96% and 61% respectively. The prevalence of HBeAg in less than 10 year-old group was significantly higher than 11~15 year-old group(P=0.001). Serum ALT levels were within 40 IU/L in 64% children, 41~80 IU/L in 17%, 81~200 IU/L in 10%, and beyond 201 IU/L in 9%. The percentage of abnormality of ALT levels in HBeAg positive patients was significantly higher than that of HBeAg negative(P=0.036). Eleven of the 73 HBeAg positive children lost their HBeAg and seroconverted to anti-HBe. In these cases, all had transient elevations in ALT levels before HBeAg seroconversions. The annual rates of spontaneous seroconversion of HBeAg and HBsAg were 9.7% and 0.6%, respectively. Conclusion : Recognition of the dynamics of these changes in viral markers and biochemical findings is needed in the selection and evaluation of therapeutic regimens, establishment of treatment, and calling for controlled trials with adequate follow-up. The hepatitis B carrier state may be asymptomatic in children however, continued surveillance of carriers is important to determine the individual adverse prognostic factors of chronic HBV infections.