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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

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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.

Author information

Author notes

  1. Eun Sun Jang and Moran Ki contributed equally to this work as first authors.

Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea

    Eun Sun Jang & Sook-Hyang Jeong

  2. Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, South Korea

    Moran Ki & Hwa Young Choi

  3. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Gyeonggi, South Korea

    Kyung-Ah Kim

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  1. Eun Sun Jang
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Consortia

The Korean hepatitis epidemiology study group

  • Eun Sun Jang
  • , Moran Ki
  • , Geum-Youn Gwak
  • , Kyung-Ah Kim
  • , Gi-Ae Kim
  • , Do Young Kim
  • , Dong Joon Kim
  • , Man Woo Kim
  • , Sung Eun Kim
  • , Yun Soo Kim
  • , Young Seok Kim
  • , In Hee Kim
  • , Chang Wook Kim
  • , Ho Dong Kim
  • , Hyung Joon Kim
  • , Neung Hwa Park
  • , Soon Koo Baik
  • , Jeong Ill Suh
  • , Byung-Cheol Song
  • , Il Han Song
  • , Jong Eun Yeon
  • , Byung Seok Lee
  • , Youn Jae Lee
  • , Young Kul Jung
  • , Woo Jin Chung
  • , Sung Bum Cho
  • , Eun-Young Cho
  • , Hyun Chin Cho
  • , Gab Jin Cheon
  • , Hee Bok Chae
  • , Dae Hee Choi
  • , Sung-Kyu Choi
  • , Hwa Young Choi
  • , Won Young Tak
  • , Jeong Heo
  •  & Sook-Hyang Jeong

Corresponding author

Correspondence to Sook-Hyang Jeong.

Ethics declarations

Conflict of interest

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

Ethical approval

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

Informed consent

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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  • DOI: https://doi.org/10.1007/s12072-019-09975-y

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