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The change in the nationwide seroprevalence of hepatitis C virus and the status of linkage to care in South Korea from 2009 to 2015

Abstract

Background

Hepatitis C virus (HCV) requires epidemiological monitoring to estimate its disease burden and to develop countermeasures. This study aimed to investigate the difference between the 2015 and 2009 nationwide anti-HCV seroprevalence and to determine linkage to care estimates in South Korea.

Methods

A total 268,422 examinees ≥ 20 years old were included in 2015 from 33 medical institutions nationwide. Electronically extracted data were retrospectively analyzed to calculate the age-, sex-, and area-adjusted anti-HCV prevalence. Seroprevalence in 2015 was measured using the same method as that in 2009. For anti-HCV-positive subjects, medical records were reviewed to see whether HCV RNA testing or antiviral treatment was performed.

Results

Adjusted anti-HCV prevalence was 0.60% (95% confidence interval, 0.57–0.63) based on general Korean population in 2015. It showed an increasing trend according to age; 0.23% in thirties, 0.38% in forties, 0.63% in fifties, 1.08% in sixties, and 1.65% in those aged ≥ 70 years. From 2009 to 2015, the adjusted anti-HCV prevalence decreased by 30%, with odds ratio of 0.70 (95% CI 0.70–0.71). There was significant intranational regional variation and changing pattern of seroprevalence. Among 1359 anti-HCV-positive subjects, HCV RNA test was performed in 60% and 25.4% had positivity. Treatment-initiated and cured rates in 2015 were 18.5% and 10.9%, respectively.

Conclusions

Anti-HCV prevalence in South Korea was 0.6% in 2015, showing a 30% decrease from that in 2009. Although the HCV RNA testing rate was increased since 2009, this remains suboptimal. Moreover, the treatment uptake rate should be improved in South Korea.

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Abbreviations

HCV:

Hepatitis C virus

RNA:

Ribonucleic acid

DAA:

Direct acting antiviral drug

SVR:

Sustained virologic response

AST:

Aspartate aminotransferases

ALT:

Alanine aminotransferases

GGT:

Gamma-glutamyl transferase

CI:

Confidence interval

HLA:

Human leukocyte antigen

IL:

Interleukin

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Acknowledgements

This study was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare (Grant number: HC15C1193) and by a grant of the Chronic Infectious Disease Cohort Study (Korea HCV Cohort Study, 4800-4859-304) from the Korea Centers for Disease Control, Republic of Korea. The Korean hepatitis epidemiology study group included: Eun Sun Jang: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Moran Ki: Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, Geum-Youn Gwak: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Kyung-Ah Kim: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Gyeonggi, Gi-Ae Kim: Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul. Do Young Kim: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Dong Joon Kim: Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Gangwon, Man Woo Kim: Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Sung Eun Kim: Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi, Yun Soo Kim: Department of Internal Medicine, Gachon College of Medicine, Incheon, Young Seok Kim: Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Gyeonggi, In Hee Kim: Department of Internal Medicine, Chonbuk National University Hopital, Chonbuk National University College of Medicine, Chonju, Republic of Korea, Chang Wook Kim: Department of Internal Medicine, Uijeongbu St.Mary’s Hospital, Catholic University College of Medicine, Uijeongbu, Gyeonggi, Ho Dong Kim: Department of Internal Medicine, St.Carollo General Hospital, Suncheon, Jeonnam, Hyung Joon Kim: Department of Internal Medicine, Chung-Ang University Hospital, Chungang University College of Medicine, Seoul, Neung Hwa Park: Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan, Soon Koo Baik: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, Jeong Ill Suh: Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Gyeongbuk, Byung-Cheol Song: Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Il Han Song: Department of Internal Medicine, Dankook University Hospital, Cheonan, Chungnam, Jong Eun Yeon: Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Byung Seok Lee: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea, Youn Jae Lee: Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea, Young Kul Jung: Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Gyeonggi, Woo Jin Chung: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Sung Bum Cho: Department of Internal Medicine, Chonnam National University Hwasun Hospital, Jeonnam, Eun-Young Cho: Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Jeonbuk, Hyun Chin Cho: Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Gyeongnam, Gab Jin Cheon: Department of Internal Medicine, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Gangwon, Hee Bok Chae: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Dae Hee Choi: Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon, Sung-Kyu Choi: Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Hwa Young Choi: Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, Won Young Tak: Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Jeong Heo: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Sook-Hyang Jeong: Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi.

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Correspondence to Sook-Hyang Jeong.

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Conflict of interest

Eun Sun Jang, Moran Ki, Hwa Young Choi, Kyung-Ah Kim and Sook-Hyang Jeong have nothing to declare.

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The study protocol was reviewed and approved by the institutional review board of each hospital.

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Requirement for informed consent was waived due to the retrospective nature of this study.

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The members of the Korean hepatitis epidemiology study group are listed in the Acknowledgements section.

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Jang, E.S., Ki, M., Choi, H.Y. et al. The change in the nationwide seroprevalence of hepatitis C virus and the status of linkage to care in South Korea from 2009 to 2015. Hepatol Int 13, 599–608 (2019). https://doi.org/10.1007/s12072-019-09975-y

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Keywords

  • Hepatitis C virus
  • Epidemiology
  • Prevalence
  • Anti-HCV
  • HCV RNA
  • Antiviral treatment