• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.2
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• pp.83-95
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• 2016

Hepatitis C virus (HCV) infection is a major medical challenge affecting around 200 million people worldwide. The main site of HCV replication is the hepatocytes of the liver. HCV is a positive enveloped RNA virus from the flaviviridae family. Six major HCV genotypes are implicated in the human infection. In developed countries the children are infected mainly through vertical transmission during deliveries, while in developing countries it is still due to horizontal transmission from adults. Minimal nonspecific and brief symptoms are initially found in approximately 15% of children. Acute and chronic HCV infection is diagnosed through the recognition of HCV RNA. The main objective for treatment of chronic HCV is to convert detected HCV viremia to below the detection limit. Children with chronic HCV infection are usually asymptomatic and rarely develop severe liver damage. Therefore, the benefits from current therapies, pegylated-Interferon plus ribavirin, must be weighed against their adverse effects. This combined treatment offers a 50-90% chance of clearing HCV infection according to several studies and on different HCV genotype. Recent direct acting antiviral (DAA) drugs which are well established for adults have not yet been approved for children and young adults below 18 years. The most important field for the prevention of HCV infection in children would be the prevention of perinatal and parenteral transmission. There are areas of focus for new lines of research in pediatric HCV-related disease that can be addressed in the near future.

• Molecules and Cells
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• v.38 no.11
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• pp.998-1006
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• 2015

Retinols are metabolized into retinoic acids by alcohol dehydrogenase (ADH) and retinaldehyde dehydrogenase (Raldh). However, their roles have yet to be clarified in hepatitis despite enriched retinols in hepatic stellate cells (HSCs). Therefore, we investigated the effects of retinols on Concanavalin A (Con A)-mediated hepatitis. Con A was injected into wild type (WT), Raldh1 knockout ($Raldh1^{-/-}$), $CCL2^{-/-}$ and $CCR2^{-/-}$ mice. For migration study of regulatory T cells (Tregs), we used in vivo and ex vivo adoptive transfer systems. Blockade of retinol metabolism in mice given 4-methylpyrazole, an inhibitor of ADH, and ablated Raldh1 gene manifested increased migration of Tregs, eventually protected against Con A-mediated hepatitis by decreasing interferon-${\gamma}$ in T cells. Moreover, interferon-${\gamma}$ treatment increased the expression of ADH3 and Raldh1, but it suppressed that of CCL2 and IL-6 in HSCs. However, the expression of CCL2 and IL-6 was inversely increased upon the pharmacologic or genetic ablation of ADH3 and Raldh1 in HSCs. Indeed, IL-6 treatment increased CCR2 expression of Tregs. In migration assay, ablated CCR2 in Tregs showed reduced migration to HSCs. In adoptive transfer of Tregs in vivo and ex vivo, Raldh1-deficient mice showed more increased migration of Tregs than WT mice. Furthermore, inhibited retinol metabolism increased survival rate (75%) compared with that of the controls (25%) in Con A-induced hepatitis. These results suggest that blockade of retinol metabolism protects against acute liver injury by increased Treg migration, and it may represent a novel therapeutic strategy to control T cell-mediated acute hepatitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.59-66
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• 2011

Purpose: We previously reported that concurrent reactivation of latent Epstein-Barr virus (EBV) in children with hepatitis A virus (HAV) infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis. However, the incidence of concurrent reactivation was not accurate because the detection of EBV reactivation was based on serologic methods. Therefore, we studied the effects of polymerase chain reaction (PCR)-proven EBV reactivation, thus a more precise concurrence, on acute HAV infection in children. Methods: PCR were conducted in 34 patients, who had enrolled previous study and diagnosed with acute HAV infection between January 2008 and June 2010. Their medical records were reviewed. Results: Among 34 patients with acute HAV infection, 12 patients (35.3%) had EBV reactivation which was proven using serologic and molecular biologic techniques. There were significant differences in the peak levels of AST and ALT between the reactivated and non-reactivated groups (p=0.001 and p<0.001, respectively). The duration of full recovery from hepatitis was more prolonged in the reactivated group (p<0.001). Clinical parameters, such as serum protein (p<0.001) and albumin concentrations (p<0.001), atypical lymphocyte count (p=0.001), prothrombin time-international normalized ratio (PT-INR, p<0.001), and splenomegaly (p<0.001), showed significant differences. The clinical features in the reactivated sub-group >10 years of age revealed more liver dysfunction compared to the non-reactivated sub-group. A comparison with a previous study was performed. Conclusion: PCR-proven reactivation of latent EBV in children with HAV infection is common and EBV reactivation with HAV infection adversely affects the clinical features of hepatitis, especially in older children.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.2
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• pp.345-351
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• 2010

Alcoholic hepatitis is an acute and severe liver disease associated with high mortality rate. This study was conducted to develop the instrument of criterion for symptoms improvement after temperance. We made the symptoms improvement questionnaire for alcoholic hepatitis patients through reviewing traditional oriental medical literatures and got advices from the advisor committee with delphi technique. The advisor committee on this study was organized by 10 professors of internal medicine of oriental medical colleges nationwide. The questionnaire was composed of questions about 10 symptoms - fatigue, pain, anorexia, abdominal bloat, heaviness of the body, itch, nausea, sleep, dryness in the mouth and stools. We named it Alcoholic Hepatitis Symptoms Improvement Questionnaire(AHSIQ). We surveyed 65 male alcoholic hepatitis patients and checked liver function profile and AHSIQ before and after temperance four times for six weeks. As a result of factor analysis the scales of AHSIQ had content validity and construct validity. And internal consistency reliability was good(Cronbach's alpha=0.768-0.871). The total scale scores were statistically significant in gamma-GTP related validity. We suggest that AHSIQ would be effective for measuring symptoms improvement degree in alcoholic hepatitis patients through further investigations with larger clinical trials.

• The Journal of Korean Society of Virology
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• v.30 no.2
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• pp.151-159
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• 2000

Hepatitis C virus (HCV) is one of the important human pathogen that can cause acute and chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Recently, the third generation radiation immuno assay (RIA) method has been developed as a very sensitive test to detect anti-HCV antibody. However, false positive is the problem with RIA test. To solve this the RIA results were compared to those of 5-antigen recombinant immunoblot assay (5-RIBA) and reverse transcription-polymerase chain reaction (RT-PCR). Among 12,767 serum samples tested from clinic visitors, total 275 (2.2%) samples were antibody positive by RIA. RIBA was performed with 148 RIA positives cases but among them was shown eighty five was antibody positive and sixty three (42.6%) was negative result. However, nested RT-PCR test was shown also carried out with 43 positive, 6 intermediates and 25 negatives of RIBA. As a result of the nested RT-PCR results, HCV antigen were detected in RIBA positive, 33.3% (2/6) RIBA intermediate and 12% (3/25). Clinical syndrome of all 148 patients as a with chronic active hepatitis (46.0%), cirrhosis (18.9%), hepatocellular carcinoma (8.1%) and others (27.0%) and they were positive in reaction by RIA test. But RIBA positive patients with 34.9% of chronic active hepatitis, 18.6% of cirrhosis, 4.6% of hepatocellular carcinoma and 41.9% of others were detected to be positive case by nested RT-PCR.

• Journal of Korean society of Dental Hygiene
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• v.9 no.2
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• pp.125-136
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• 2009

The purpose of this study was to investigate the recognition of the infection routes, symptoms and treatments of HBV by students of health-related departments so as to help students learn correct knowledge about hepatitis B and provide the basic data for establishment of oral health policies to prevent hepatitis B and improve the quality of infection management. For the subjects of this study, 666 students of health-related departments and other departments of universities in Daegu City, Gyeongbuk Province were arbitrarily chosen and given a questionnaire. Then the questionnaires collected between October 1st and 31st, 2007 were analyzed. Major findings from this study are summarized below. 1. Regarding general characteristics of the subjects, 311 were students of health-related departments and 355 were students of other departments. 55.9% of the health-related department students and 49.0% of the other department students received immunization against hepatitis. 36.0% of the health-related department students and 31.6% of the other department students had antibodies. 2. Regarding the recognition of the infection routes of HBV, the right answer "Infected through placenta" was chosen by more juniors(94.4%), sophomores(93.8%) and freshmen(74.1%) of health-related departments than other students in this order (P<0.05). The answer "Infected through sexual intercourse" was chosen by the highest percentage(75.0%) of juniors followed by freshmen(69.2%) and sophomores(31.9%) (P<0.05). 3. The percentages of health-related department students who knew that "HBV can develop into hepatic cirrhosis or liver cirrhosis were the highest among juniors(88.9%), freshmen(87.7%) and sophomores(68.8%) in this order(P<0.05). Among the other department students, the percentages of right answers to the question "Acute HBV infection shows jaundice" were the highest among juniors(75.0%), sophomores(74.8%) and freshmen(58.7%)(P<0.05).

• Korean Journal of Veterinary Research
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• v.40 no.1
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• pp.101-109
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• 2000

Duck viral hepatitis is an acute, highly infectious viral disease of young dacklings aged from two days to three weeks. The significant lesion associated with the disease was enlarged liver including necrotic foci and numerous hemorrhagic spots. We have isolated five strains of duck hepatitis virus (DHV) from field cases showing about 20% mortality with a sign of opisthotonos. When a-day-old ducklings were intramuscularly inoculated with one of the isolates, 92% of the birds were died within 5 days. We attempted to develop an attenuated strain of duck hepatitis virus (DHV) using one of the isolates by serial chicken embryo passages. The propagation of DHV in chicken embryos was carried 140 passages. The virus titer increased gradually from the $21^{st}$ through the $50^{th}$ passage, but there was no significant increase of virus titer in subsequent passages after then. Through the serial passages, the virulence of the virus for chicken embryos was gradually increased but decreased for ducklings. The pathogenicity of the virus for ducklings was preserved up to the $21^{st}$ passage but disappeared at the $50^{th}$passage. An attenuated Korean isolate which was passaged 140 times in chicken embryos gave good protection in ducklings against both challenge infection to a Korean virulent strain and to a DHV-DRL strain, a type 1 reference strain of DHV, which indicated that the Korean isolates could be classified as DHV type 1. And the above results suggest that an attenuated Korean isolate can be used for developing a live DHV vaccine.

• Korean Journal of Veterinary Research
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• v.63 no.2
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• pp.15.1-15.5
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• 2023

The hepatitis A virus (HAV) induces severe acute liver injury and is adapted to human and monkey cell lines but not other cells. In this study, the HAV was inoculated into porcine kidney (PK-15) cells to determine its infectivity in porcine cells. The growth pattern of the HAV in PK-15 cells was compared with its growth pattern in fetal rhesus kidney (FRhK-4) cells. The growth of HAV was less efficient in PK-15 cells. In conclusion, HAV replication was verified in PK-15 cells for the first time. Further investigations will be needed to identify the HAV-restrictive mechanisms in PK-15 cells.

• Korean Journal of Veterinary Service
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• v.43 no.1
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• pp.23-29
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• 2020

Hepatitis E Virus (HEV) infection is a worldwide disease and the primary cause of acute viral hepatitis in the world. It can be isolated from many different species including pigs. HEV is a zoonotic pathogen and foodborne disease. The main animal reservoir is domestic pigs. It is usually asymptomatic in pig but it is a public health concern, causing acute hepatitis in humans of varying severity. This study focused on the presence of HEV in pig and pork product. One hundred feces and one hundred fifty serum samples were randomly collected from pigs in slaughterhouses in Gwangju from November in 2018 to February in 2020. In addtion, seventy-five pork products were collected from markets in Gwangju. Feces and pork product samples were examined for the presence of HEV RNA using an reverse-transcription realtime PCR (RT-qPCR) assay. Serum samples were tested for the presence of HEV-specific IgG antibodies using Enzyme-linked immunosorbent assay (ELISA). HEV antigen and antibody positive rates were 3.0% (3/100) and 19.3% (29/150), respectively, in Gwangju and nearby areas such as Jeonnam and Jeonbuk. However, HEV antigen was not detected from any of pork product in this study. In conclusion, the prevalence of HEV should be continuously monitored because HEV was sporadically detected in Gwangju and nearby areas.

• Journal of Preventive Veterinary Medicine
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• v.41 no.3
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• pp.121-123
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• 2017

The hepatitis E virus (HEV) is a leading causative agent of acute hepatitis in humans. Zoonotic HEV strains have been isolated from several animal species, including pigs. New HEV variants have been recently isolated from camels in the Middle East. In the present study, fecal samples from fallow deer, formosan deer, alpaca, and guanaco were analyzed for the detection of HEV. One HEV strain was detected from guanaco, a species of camelids. The nucleotide sequence of guanaco HEV was identical to those of deer HEV-3 strains, which implied the cross-species transmission of HEV-3 from deer to guanaco.