Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Analysis of the Change in Seropositive Rate of the Epstein-Barr Virus in Koreans: A Single-Center Study

한국인의 Epstein-Barr Virus 항체 양성률 변화양상에 대한 분석: 단일기관 연구

  • Kim, Su Kyung (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Joon-Sik (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Dongsub (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, Cheol-In (Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Doo Ryeon (Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Peck, Kyong Ran (Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, Eun-Suk (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Yae-Jean (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 김수경 (성균관대학교 의과대학, 삼성서울병원 소아청소년과) ;
  • 최준식 (성균관대학교 의과대학, 삼성서울병원 소아청소년과) ;
  • 김동섭 (성균관대학교 의과대학, 삼성서울병원 소아청소년과) ;
  • 강철인 (성균관대학교 의과대학, 삼성서울병원 감염내과) ;
  • 정두련 (성균관대학교 의과대학, 삼성서울병원 감염내과) ;
  • 백경란 (성균관대학교 의과대학, 삼성서울병원 감염내과) ;
  • 강은숙 (성균관대학교 의과대학, 삼성서울병원 진단검사의학과) ;
  • 김예진 (성균관대학교 의과대학, 삼성서울병원 소아청소년과)
  • Received : 2019.11.22
  • Accepted : 2020.07.23
  • Published : 2020.08.25
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Abstract

Purpose: Epstein-Barr virus (EBV) infection is related to infectious mononucleosis or nasopharyngeal cancer, and its epidemiology may change according to the socioeconomic development of communities. This study aimed to evaluate the recent epidemiology of EBV seropositive rate in Korea. Methods: We retrospectively reviewed EBV serology test results obtained from a part of clinical care at Samsung Medical Center, Seoul, South Korea, from January 2000 to December 2017. Results: The EBV seropositive rate in 26,527 subjects during the study period was 81.0% (21,485/26,527): 44.4% (2,716/6,122) in subjects aged 0-9 years, 75.8% (2,077/2,739) in those aged 10-19 years, and 94.5% (16,692/17,666) in those aged ≥20 years. The EBV seropositive rate decreased from 89.4% (8,592/9,616) in 2000-2008 to 76.2% (12,893/16,911) in 2009-2017 (P<0.001). Especially, the EBV seropositive rate in subjects aged 0-19 years significantly decreased from 2000-2008 to 2009-2017 (0-9 years, 62.8% [1,172/1,866] in 2000-2008 and 36.3% [1,544/4,256] in 2009-2017; 10-19 years, 83.8% [745/858] in 2000-2008 and 70.8% (1,332/1,881) in 2009-2017) (P<0.001). Conclusions: The EBV seropositive rate in children has decreased in the last 20 years. As the age of patients with primary EBV infection increased, there is a need for interest in clinical manifestation, such as infectious mononucleosis, in adolescents and young adults.

목적: Epstein-Barr virus (EBV)는 초감염 연령이 사회, 문화 및 경제적인 환경에 따라 다르게 나타나며, 이에 따른 임상 양상도 다르다. 우리나라도 점차 EBV 감염의 발생 시기가 늦어짐에 따라 초감염시 전형적인 양상의 전염성 단핵구증 임상증상을 보이는 환자들의 수가 증가하고 있다. 이 연구의 목적은 전 연령의 EBV 항체검사 결과를 분석함으로써 현재 우리나라 항체 보유율 현황을 파악하는 것이다. 방법: 2000년부터 2017년까지 삼성서울병원에서 EBV 항체검사를 시행한 전 연령의 환자들의 성별, 거주지, 검사 시행 당시 환자의 나이 및 검사 시행 년도에 따른 항체 양성률을 분석하였다. EBV-viral capsid antigen (VCA) IgG 혹은 EBV-VCA IgM이 양성인 경우를 항체 보유율이 양성인 환자로 분류하였다. 결과: 전체 환자 26,527명을 대상으로 한 EBV 항체 양성률은 81.0% (21,485/26,527)였으며 0-9세의 EBV 항체 양성률이 44.4% (2,716/6,122), 10-19세의 경우 75.8% (2,077/2,739), 만 20세 이후부터는 94.5% (16,692/17,666)이상으로 확인되었다. 검사 시행 시기에 따라 EBV 항체 양성률의 변화는 2000-2008년에 비해 2009-2017년 사이의 항체 양성률이 89.4%, 76.2%로 통계학적으로 유의미하게 감소하였다(P<0.001). 특히 0-19세 사이의 소아청소년의 경우 2000-2008년에 비해 2009-2017년 사이의 EBV 항체 양성률이 두드러지게 감소하였다(0-9세: 2000-2008년 62.8% [1,172/1,866], 2009-2017년 36.3%[1,544/4,256]; 10-19세: 2000-2008년 83.8% [745/858], 2009-2017년 70.8% [1,332/1,881]) (P<0.001). 결론: 2000년 이후 전체 인구의 EBV 항체 보유율은 81.0%로 높게 유지되고 있으나, 초감염이 발생하는 소아청소년기의 항체 보유율은 감소추세를 보이고 있어 EBV 초감염이 발생하는 연령이 늦어지고 있음을 시사하고 있다. 따라서 EBV 초감염 발생 연령의 증가에 따른 청소년 및 젊은 성인에서의 전염성 단핵구증과 같은 임상 양상 발현에 대한 관심이 필요하다.

Keywords

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