The Korean Journal of Medicine

  • 제80권1호
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  • Pages.63-67
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  • 2011
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

집단생활하는 경찰부대에서 A형 간염바이러스의 감염력 및 발병력 연구

Infectivity and Pathogenicity of Hepatitis A Virus during an Outbreak in a Communal Living Setting

  • Hyun, Hee-Jae (Department of Internal Medicine, National Police Hospital) ;
  • Park, So-Yeon (Department of Internal Medicine, National Police Hospital) ;
  • Choi, Soon-Uk (Department of Internal Medicine, National Police Hospital) ;
  • Ahn, Ju-Young (Department of Internal Medicine, National Police Hospital) ;
  • Jung, Jun-Oh (Department of Internal Medicine, National Police Hospital) ;
  • Lim, Su-Jin (Department of Internal Medicine, National Police Hospital) ;
  • Yoo, Ji-Won (Department of Internal Medicine, National Police Hospital) ;
  • Park, Sang-Jun (Department of Internal Medicine, National Police Hospital) ;
  • Kim, Youn-Kwon (Department of Internal Medicine, National Police Hospital) ;
  • Kim, Young-Jung (Department of Internal Medicine, National Police Hospital) ;
  • Cho, Jae-Hyun (Department of Internal Medicine, National Police Hospital)
  • 발행 : 2011.01.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 성인에서 현증 A형 간염 발생이 증가하면서 공중보건 문제가 되고 있다. A형 간염의 발생률과 항체 양성률에 관한 연구는 많이 보고되고 있으나, A형 간염바이러스의 감염력이나 발병력에 대한 연구는 거의 없는 실정이다. 본 연구는 집단생활하는 경찰부대의 A형 간염 유행의 2차 감염률과 발병률을 통해서 A형 간염바이러스의 감염률과 발병률을 연구하였다. 방법: 대원 3명이 A형 간염으로 입원치료하였던 전투경찰부대의 부대원 중 초발환자를 제외하고 이후에 발생한 A형 간염 환자 2명을 포함한 70명(이하 환자 접촉군)을 대상으로, A형 간염 임상 증상 동반 유무와 과거 A형 간염 백신접종 여부를 포함한 병력청취, 간기능검사를 포함한 혈액검사, 혈청검사를 3번째 현증 A형 간염 환자의 퇴원일에 검사하였으며, 잠복기를 감안하여 3번째 현증 A형 간염 환자의 황달 발현시점 2개월 후에 병력청취를 포함한 동일한 검사를 반복 시행하였다. A형 간염이 발생치 않은 다른 부대의 전투경찰대원 75명(이하 환자 비접촉군)을 비교 연구하기 위하여 병력청취 및 동일한 검사를 시행하였다. 전체 감수성 있는 긴밀접촉자 중 HAV 감염자의 비율을 바이러스의 2차 감염률로, HAV 감염자 중에서 현증 A형 간염으로 진단된자의 비율을 발병률로 정의하였다. 결과: 환자 비접촉군에서는 IgM anti-HAV, IgG anti-HAV가 모두 음성이었고, 환자 접촉군에서는 IgM anti-HAV, IgG anti-HAV 둘다 양성은 3명, IgG anti-HAV만 양성은 2명이었다. 연구 대상자 중 현증 A형 간염은 입원치료하였던 2명 이외는 없었다. 결론: 20대 젊은 남성들이 집단생활하는 경찰부대에서 A형 간염 초발환자와 접촉한 환자 접촉군의 A형 간염바이러스의 2차 감염률은 4.3~7.1였고, 발병률은 40.0~66.7%였다.

Background/Aims: Acute viral hepatitis A infection in adults is an emerging public health problem in Korea. The infectivity and pathogenicity of hepatitis A virus (HAV) among people living in close contact have not been studied previously. This study investigated the secondary attack rate and pathogenicity rate of HAV during an outbreak among auxiliary police in a communal living setting in Korea. Methods: A total of 70 people in close contact with a hepatitis A patient (index case) were enrolled in the study, which included a thorough oral history, physical examination, and laboratory testing. The subjects were part of an auxiliary police unit living in a communal setting (HAV contact group). Serum antibody titers were measured in the contact group at two points during the study. Subjects in another auxiliary police unit without exposure to hepatitis A were examined as a control group (HAV non-contact group). The secondary attack rate and pathogenicity rate were calculated from the data. Results: In the HAV non-contact group, none of the subjects had anti-HAV antibodies. In the HAV contact group, three subjects had both IgM and IgG anti-HAV antibodies, and two had only IgG anti-HAV antibodies. Two of three HAV-infected subjects were treated for hepatitis A. Conclusions: The secondary attack rate of HAV was 4.3~7.1% and the pathogenicity rate was 40~66.7% in the group of young adults.

키워드

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