Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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A Study on the Seropositivity of HBsAg among Biennial Health Examinees ; A Nation-wide Multicenter Survey

1998년 한국인 성인에서 혈청 HBsAg 양성률 추정을 위한 조사연구

  • Kim, Dae-Sung (Department of Preventive Medicine, Gachon Medical School) ;
  • Kim, Young-Sik (Department of Family Medicine, University of Ulsan College of Medicine) ;
  • Kim, Jae-Yong (Korean Institute for Health and Social Affairs) ;
  • Ahn, Yoon-Ok (Department of Preventive Medicine, Seoul National University College of Medicine)
  • 김대성 (가천의과대학 예방의학교실) ;
  • 김영식 (울산대학교 의과대학 가정의학교실) ;
  • 김재용 (보건사회연구원) ;
  • 안윤옥 (서울대학교 의과대학 예방의학교실)
  • Published : 2002.06.01
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Abstract

Objective : The primary objective of this study was to estimate the prevalence of HBsAg-positives in the late 1990's among Korean adults. In addition, we evaluated the association of age, a residential area, a vaccination rate, a family history of chronic liver diseases and a past history of acute liver disease with the seropositivity of HBsAg, and estimated the prevalence of chronic HBV infection by follow-up for 6 month or more. Methods : A total of 10 areas, six metropolitan and four small cities, were selected. In each cities, one health screening center was selected for recruitment of study subjects. The study subjects were enrolled from a general health examination program that is provided by medical insurance companies. Questionnaires on various risk factors were administered to the study subjects. Sera was drawn and tested for HBsAg by radioimmunoassay. HBeAg and ALT were also tested for those of HBsAg positive. The HBsAg positives was retest for HBsAg 6 months later Results : Among the study subjects (n= 1816), the seroprevalence of HBsAg was 5.5% (95% CI=4.5%-6.6%), 7.4% in men (95% CI=5.8-9.4) and 3.6% in women (95% CI=2.5-5.0). A past history of acute liver disease and a family history of chronic liver diseases was shown to be risk factors for HBsAg positivity. Among the 31 HBsAg-positives, negative seroconversion rate was estimated to be 3.2%, Thus, prevalence of chronic HBV infection was estimated to be 5.3% (95% CI=3.7-6.6). Conclusion : In this study, the HBsAg seroprevalence rate was lower than that of the other studies in 1980's, particularly in young adult and women. Considering the public health importance of liver cancer and chronic liver diseases, the further effort is needed to prevent and reduce the HBV infection.

목적 : 1998년 한국인 성인에서의 혈청 HBsAg의 양성률을 추정하는 것을 일차적 목적으로 하며, HBsAg 양성률의 연령별로 분포, 지역적 차이, 과거 간질환력, 만성간질환 가족력 및 예방접종과의 관련성을 파악하며 또한 양성자를 6개월간 추적후 재검사 하여 B형 간염의 만성보균율을 파악하고자 하는 것을 이차적 목적으로 하였다. 방법 : 1998년 전국 10개 지역에서 의료보험관리공단의 정기건강검진 수진자를 대상으로 하여 HBsAg의 혈청유병률을 조사하였다. HBsAg 양성인 사람들을 대상으로 6개월 이상 추적조사하여 B형간염 만성보균율을 파악하였다. 총 1,816명에 대한 혈청과 설문서가 수집되었다. HBsAg는 RIA로 측정하였다. 결과 : HBsAg의 혈청유병률은 5.5%(95% CI-4.5-6.6)였으며 남자에서 7.4%(95% CI=5.8-9.4), 여자에서 3.6%(95% CI=2.5-5.0)로 나타났다. 급성간질환 과거력과 만성간질환 가족력을 HBsAg 혈청검사결과와 비교한 결과 유의한 관련성이 있는 것으로 나타났다. HBsAg 양성자에서 6개월 후에 음성으로 전환한 사람은 3.2%(95% CI=0.1-16.7)였으며 따라서 B형간염의 만성보균율은 5.3%(95% CI=3.7-6.6)로 추정되었다. 결론 : 본 연구결과에서는 HBsAg의 양성률이 1980년대의 연구결과들에 비하여 비교적 낮게 추정되었으며 이는 특히 여성과 젊은 연령층에서 두드러지게 나타났다. 그러나 우리나라에서의 간암 및 만성간질환의 공중보건학적 중요성을 고려하면 지속적인 간염발생의 예방대책이 필요하다고 할 수 있다.

Keywords

References

  1. Ahn YO, Kim YS, Lee MS, Shin MH. Hepatitis B virus infection rate among Koreans. Seoul J Med 1992; 33: 105-14
  2. Ahn YO. Strategy for vaccination against hepatitis B in areas with high endemicity: focus on Korea. Gut 1996; 38(suppl 2): S63-6
  3. Ahn YO, Kim CY, Hiyama T, Tsukuma H, Shigematsu T, Kono S. Liver cancer among Koreans in Japan and Korea. In; Epidemiology & Prevention of Cancer. The proceedings of Munbusho 1989 International Symposium on Comparative Study of Etiology & Prevention of Cancer. Nagoya: The University of Nagoya Press, 1990; 177-84
  4. Lee HS, Byun JH, Kim CY. Etiology and outcome of acute viral hepatitis in Korean adults. J Korean Med Sci 1990; 5: 149-54 https://doi.org/10.3346/jkms.1990.5.3.149
  5. Yoo KY, Kim H, Lee MS, Park BJ, Ahn YO, Lee HS, Kim CY, Park TS. A reconstructed cohort study on the hepatitis B virus infection as a risk factor of liver cancer in Korea. J Korean Med Sci 1991; 6: 319-24 https://doi.org/10.3346/jkms.1991.6.4.319
  6. Lee MS, Kim DH, Kim H, Lee HS, Kim CY, Park TS, Yoo KY, Park BJ, Ahn YO. Hepatitis B vaccination and reduced risk of primary liver cancer among male adults: a cohort study in Korea. Int J Epidemiol 1998; 27: 316-9 https://doi.org/10.1093/ije/27.2.316
  7. Jung BC, Lee SH, Kim DS, Kim SI. Prevalence of HBsAg and anti-HCV among Korean blood donors. Korean Blood Transf 1994; 5(2): 143-150 (Korean)
  8. Sim JG, Seo JK, Suh SJ. Prevalence and the changes of hepatitis B viral markers from 1988 to 1993 in Korean children. J Korean Pediatric Society 1995; 38: 1535-9 (Korean)
  9. Ahn YO. Public health aspects of hepatitis B in Korea. In; Zuckerman A ed. Hepatitis B in the Asian-Pacific Region, volume 2, Chronic hepatitis B prevention strategies. London: Royal College of Physicians of London. 1998; 133-8
  10. Hardier SC, Margollis HS. Epidemiology of hepatitis B virus infection. In: Ellis RW, ed. Hepatitis B vaccine in clinical practice. New York: Marcell Dekker, 1993; 148-9
  11. Park BJ. Longitudinal study on the negative conversion rate of HBsAg among male adults in Korea. Seoul J Med 1989; 30: 243-8
  12. Mile A, Allowood GK, Moyes CD, Pearce ME, Newell K. A seroepidemio logical study of the prevalence of hepatitis B infection in a hyperendemic New Zealand community. Int J Epide miol 1987; 16: 84-90 https://doi.org/10.1093/ije/16.1.84
  13. West SK, Lingao AL, Domingo EO, Raymundo D, Caragay B, Liver Study Group. Incidence and prevalence of hepatitis B. A community-based survey in the Philippines. Am J Epidemiol 1986; 123: 681-9 https://doi.org/10.1093/oxfordjournals.aje.a114288
  14. Beasley RP, Hwang LY, Lin CC, Lew ML, Stevens CE, Szmuness W, Chen KP. Incidence of hepatitis B virus infections in preschool children in Taiwan. J Infect Dis 1982; 146: 198-204 https://doi.org/10.1093/infdis/146.2.198
  15. Ahn YO. Report on 'Korean Cancer Research Survey - Cohort Construction'. Seoul: Korea Science and Engineering Foundation, 1994; 53 (Korean)
  16. Chun BY, Lee MK, Rho YK. The prevalence of Hepatitis B Surface antigen among Korean by literature review. korean J Epidemiol 1992; 14(1): 54-62 (Korean)
  17. Kim YK, OH YC, Kim KH. A Study on some Biochemical tests in HBsAg(+) and/or Anti-HCV(+) Blood Donors. Korean Blood Transf 1993; 4(2): 207-15 (Korean)
  18. Clements ML, Miskovsky E, Davidson M, Cupps T, Kumwenda N, Sandman LA, West D, Hesley T, Ioli V, Miller W. Effect of age on the immunogenicity of yeast recombinant hepatitis B vaccines containing surface antigen (S) or PreS2 +S antigens. J Infect Dis 1994; 170: 510-6 https://doi.org/10.1093/infdis/170.3.510
  19. Wood RC, MacDonald KL, White KE, Hedberg CW, Hanson M, Osterholm MT. Risk factors for lack of detectable antibody following hepatitis B vaccination of Minnesota health care workers. JAMA 1993; 270: 2935-9 https://doi.org/10.1001/jama.270.24.2935
  20. Shaw FE Jr, Guess HA, Roets JM, Mohr FE, Coleman PJ, Mandel EJ, Roehm RR Jr, Talley WS, Hadler SC. Effect of anatomic injection site, age and smoking on the immune response to hepatitis B vaccination. Vaccine 1989; 7: 425-30 https://doi.org/10.1016/0264-410X(89)90157-6
  21. Park NH, Lee JB, Kim YS. The vaccination rate of hepatitis B vaccine among Korean adults. J Korean Acad Fam Med 1994; 15(4): 191-8 (Korean)
  22. Sohn SJ. A study on the positivity of HBsAg in urban, rural and coastal area. Korean J Prev Med 1986; 19(1): 45-55 (Korean)
  23. Ahn YO, Kim CY, Lee JB, Park BJ, Kwon EH, Lee JH, Kim NK. An epidemiologic observation on HBs antigenemia in Korean voluntary blood donors for the $6{\frac{1}{3}}$ years period, 1975-1981. J Korean Med Assoc 1983; 26(5): 425-37
  24. Kim YS, Kim JS, Huh BY. A study on hepatitis B virus markers and formation of anti-HBs after hepatitis B-vaccination in healthy Korean population. Korean J Epidemiol 1985; 7(1): 8-15 (Korean)
  25. Kim IS, Oh HC, Lee Y. Prevalence and changes of HBsAg and Anti-HBs for one year period in natural status and after hepatitis B vaccination. Korean J Epidemiol 1987; 9(1): 40-48 (Korean)
  26. National Statistical Office, Korea. Annual Reports on the Cause of Death Statistics, 1999, Seoul, Korea (Korean)