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Seo JY, Choi S, Choi B, Ki M. Age-period-cohort analysis of hepatitis A incidence rates in Korea from 2002 to 2012. Epidemiol Health 2016; 38:e2016040. [PMID: 27703127 PMCID: PMC5114437 DOI: 10.4178/epih.e2016040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/30/2016] [Accepted: 09/30/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the epidemiology of hepatitis A in Korea from 2002 to 2012 using age-period-cohort analyses. METHODS We used claims data from the Korean National Health Insurance Corporation for the entire population. Census data from 2010 were used as the standard population. The incidence of hepatitis A was assumed to have a Poisson distribution, and the models and effects were evaluated using the intrinsic estimator method, the likelihood ratio, and the Akaike information criterion. RESULTS The incidence of hepatitis A gradually increased until 2007 (from 17.55 to 35.72 per 100,000 population) and peaked in 2009 (177.47 per 100,000 population). The highest incidence was observed among 27-29-year-old individuals when we omitted data from 2005 to 2007. From 2005 to 2007, the peak incidence was observed among 24-26-year-old individuals, followed by 27-29-year-olds. The best model fits were observed when the age-period-cohort variables were all considered at the same time for males, females, and the whole population. CONCLUSIONS The incidence of hepatitis A exhibited significant age-period-cohort effects; its incidence peaked in 2009 and was especially high among Koreans 20-39 years of age. These epidemiological patterns may help predict when high incidence rates of hepatitis A may occur in developing countries during their socioeconomic development.
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Affiliation(s)
- Joo Yeon Seo
- Department of Preventive Medicine & Institute for Health and Society, Hanyang University College of Medicine, Seoul, Korea
| | - Sungyong Choi
- Gyeonggi Infectious Disease Control Center, Seongnam, Korea
| | - BoYoul Choi
- Department of Preventive Medicine & Institute for Health and Society, Hanyang University College of Medicine, Seoul, Korea
| | - Moran Ki
- Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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Shin HS, Kim SP, Han SH, Kim DY, Ahn SH, Han KH, Chon CY, Park JY. Prognostic indicators for acute liver failure development and mortality in patients with hepatitis A: consecutive case analysis. Yonsei Med J 2014; 55:953-9. [PMID: 24954323 PMCID: PMC4075399 DOI: 10.3349/ymj.2014.55.4.953] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Due to the seroepidemiological shift in hepatitis A (HA), its severity, mortality, and complications have increased in recent years. Thus, the aim of this study was to identify predictive factors associated with poor prognosis among patients with HA. MATERIALS AND METHODS A total of 304 patients with HA admitted to our institution between July 2009 and June 2011 were enrolled consecutively. Patients with complications defined as acute liver failure (ALF) were evaluated, and mortality was defined as death or liver transplantation. RESULTS The mean age of patients (204 males, 100 females) was 32 years. Eighteen (5.9%) patients had progressed to ALF. Of the patients with ALF, 10 patients (3.3%) showed spontaneous survival while 8 (2.6%) died or underwent liver transplantation. Multivariate regression analysis showed that Model for End-Stage Liver Disease (MELD) and systemic inflammatory response syndrome (SIRS) scores were significant predictive factors of ALF. Based on receiver operating characteristics (ROC) analysis, a MELD≥23.5 was significantly more predictive than a SIRS score≥3 (area under the ROC: 0.940 vs. 0.742, respectively). In addition, of patients with a MELD score≥23.5, King's College Hospital criteria (KCC) and SIRS scores were predictive factors associated with death/transplantation in multivariate analysis. CONCLUSION MELD and SIRS scores≥23.5 and ≥3, respectively, appeared to be related to ALF development. In addition, KCC and SIRS scores≥3 were valuable in predicting mortality of patients with a MELD≥23.5.
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Affiliation(s)
- Hye Sun Shin
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sae Pyul Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea. ; Brain Korea 21 Project of Medical Science, Seoul, Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea. ; Brain Korea 21 Project of Medical Science, Seoul, Korea
| | - Chae Yoon Chon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. ; Liver Cirrhosis Clinical Research Center, Seoul, Korea
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Ozawa S, Privor-Dumm LA, Nanni A, Durden E, Maiese BA, Nwankwo CU, Brodovicz KG, Acosta CJ, Foley KA. Evidence-to-policy gap on hepatitis A vaccine adoption in 6 countries: Literature vs. policymakers’ beliefs. Vaccine 2014; 32:4089-96. [DOI: 10.1016/j.vaccine.2014.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 04/23/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022]
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Kwon SY, Park SH, Yeon JE, Jeong SH, Kwon OS, Lee JW, Kim HS, Seo YS, Kim YS, Sohn JH, Yim HJ, Choi JY, Lee MS, Kweon YO, Cheong JY, Kim HC, Lee HJ, Baik SK, An H, Byun KS. Clinical characteristics and outcomes of acute hepatitis a in Korea: a nationwide multicenter study. J Korean Med Sci 2014; 29:248-53. [PMID: 24550653 PMCID: PMC3924005 DOI: 10.3346/jkms.2014.29.2.248] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 11/29/2013] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to investigate the clinical characteristics of acute hepatitis A during a recent outbreak in Korea. Data of patients diagnosed with acute hepatitis A from 2007 to 2009 were collected from 21 tertiary hospitals retrospectively. Their demographic, clinical, and serological characteristics and their clinical outcomes were analyzed. A total of 4,218 patients (mean age 33.3 yr) were included. The median duration of admission was 9 days. The mean of the highest ALT level was 2,963 IU/L, total bilirubin was 7.3 mg/dL, prothrombin time INR was 1.3. HBsAg was positive in 3.7%, and anti-HCV positive in 0.7%. Renal insufficiency occurred in 2.7%, hepatic failure in 0.9%, relapsing hepatitis in 0.7%, and cholestatic hepatitis in 1.9% of the patients. Nineteen patients (0.45%) died or were transplanted. Complications of renal failure or prolonged cholestasis were more frequent in patients older than 30 yr. In conclusion, most patients with acute hepatitis A recover uneventfully, however, complication rates are higher in patients older than 30 yr than younger patients. Preventive strategies including universal vaccination in infants and active immunization of hepatitis A to adult population should be considered for prevention of community-wide outbreaks of hepatitis A in Korea.
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Affiliation(s)
- So Young Kwon
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Sang Hoon Park
- Department of Internal Medicine, Hallym Univesity College of Medicine, Hallym Univesity Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jong Eun Yeon
- Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Sook Hyang Jeong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Oh Sang Kwon
- Department of Internal Medicine, Gachon University Graduate School of Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jin Woo Lee
- Department of Internal Medicine, Inha University School of Medicine, Inha University Hospital, Incheon, Korea
| | - Hong Soo Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University College of Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Jong Young Choi
- Department of Internal Medicine, The Catholic University of Korea School of Medicine, The Catholic University of Korea St. Mary's Hosptial, Seoul, Korea
| | - Myung Seok Lee
- Department of Internal Medicine, Hallym Univesity College of Medicine, Hallym Univesity Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Young Oh Kweon
- Department of Internal Medicine, Kyungpook National University College of Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Jae Youn Cheong
- Department of Internal Medicine, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
| | - Haak Cheoul Kim
- Department of Internal Medicine, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan, Korea
| | - Heon Ju Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Korea
| | - Soon Koo Baik
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Yonsei University Wonju Christian Hospital, Wonju, Korea
| | - Hyonggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Kwan Soo Byun
- Department of Internal Medicine, Korea University College of Medicine, Korea University Guro Hospital, Seoul, Korea
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Hong JY, Ki MR, Hwang HJ, Sinny D, Park YJ, Bae GR, Lee MS. Factors related to completed status and seropositivity of hepatitis a immunization among children aged 1-3 years and 6-8 years in South Korea. Osong Public Health Res Perspect 2013; 4:93-8. [PMID: 24159538 PMCID: PMC3767099 DOI: 10.1016/j.phrp.2013.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 02/21/2013] [Accepted: 02/21/2013] [Indexed: 11/28/2022] Open
Abstract
This study was designed to identify factors associated with hepatitis A immunization status and seropositivity in Korean children. In-person interviews, reviewing their vaccination cards and testing hepatitis A antibody were conducted with 389 children aged 1–3 years and 544 children aged 6–8 years. In all age groups, earlier birth order was the only significant factor in children receiving either single or both doses of the vaccination. And completion of the second dose of vaccination was a prerequisite for increased seropositivity. Additionally, household income had a positive impact on seropositivity only in children aged 6–8 years. Our findings suggest that presence of an economic barrier is the underlying cause of the decreased hepatitis A vaccination services in Korea. Therefore, hepatitis A vaccine should be included in the essential National Immunization Program.
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Affiliation(s)
- Jee-Young Hong
- Department of Preventive Medicine, College of Medicine, Konyang University, Daejeon, Korea
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Seo JY, Choi BY, Ki M, Jang HL, Park HS, Son HJ, Bae SH, Kang JH, Jun DW, Lee JW, Hong YJ, Kim YS, Kim CH, Chang UI, Kim JH, Yang HW, Kim HS, Park KB, Hwang JS, Heo J, Kim IH, Kim JS, Cheon GJ. Risk factors for acute hepatitis A infection in Korea in 2007 and 2009: a case-control study. J Korean Med Sci 2013; 28:908-14. [PMID: 23772157 PMCID: PMC3678009 DOI: 10.3346/jkms.2013.28.6.908] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/09/2013] [Indexed: 11/29/2022] Open
Abstract
This study aimed to identify the risk factors associated with acute hepatitis A virus (HAV) infection in the Korean population. Participants were recruited from five referral hospitals across the country in 2007 and from 11 hospitals in 2009. Patients with positive anti-HAV IgM antibody tests became the case group, while patients treated for non-contagious diseases at the same hospitals were recruited as controls. A total of 222 and 548 case-control pairs were studied in the 2007 and 2009 surveys, respectively. Data from the surveys were analyzed jointly. In a multivariate analysis, sharing the household with HAV-infected family members (OR, 6.32; 95% CI, 1.4-29.6), contact with other HAV-infected individuals (OR, 4.73; 95% CI, 2.4-9.4), overseas travel in 2007 (OR, 19.93; 95% CI, 2.3-174.4), consumption of raw shellfish (OR, 2.51; 95% CI, 1.8-3.5), drinking bottled water (OR, 1.64; 95% CI, 1.3-8.4), and occupation that involve handling food (OR, 3.30; 95% CI, 1.3-8.4) increased the risk of HAV infection. Avoiding contact with HAV-infected individuals and avoiding raw foods eating could help minimize the risk of hepatitis A infection. Immunization must be beneficial to individuals who handle food ingredients occupationally or travel overseas to HAV-endemic areas.
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Affiliation(s)
- Joo Youn Seo
- Department of Preventive Medicine/Institute of Community Health, Hanyang University, College of Medicine, Seoul, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine/Institute of Community Health, Hanyang University, College of Medicine, Seoul, Korea
| | - Moran Ki
- Department of Preventive Medicine, Eulji University, School of Medicine, Daejeon, Korea
| | - Hye Lim Jang
- Department of Preventive Medicine/Institute of Community Health, Hanyang University, College of Medicine, Seoul, Korea
| | - Hee Suk Park
- Department of Preventive Medicine/Institute of Community Health, Hanyang University, College of Medicine, Seoul, Korea
| | - Hyun Jin Son
- Division of Public Health Crisis Response, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Si Hyun Bae
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Han Kang
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jin-Woo Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Young Jin Hong
- Department of Pediatrics, Inha University School of Medicine, Incheon, Korea
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Chang-Hwi Kim
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - U Im Chang
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jong-Hyun Kim
- Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | | | - Hong Soo Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Kyeong Bae Park
- Department of Pediatrics, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jae Seok Hwang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong Heo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - In Hee Kim
- Department of Internal Medicine, Chonbuk National Unversity Medical School and Hospital, Jeonju, Korea
| | - Jung Soo Kim
- Department of Pediatrics, Chonbuk National Unversity Medical School and Hospital, Jeonju, Korea
| | - Gab Jin Cheon
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
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Is Evaluation of Hepatitis A Immunity Required or Not? HEPATITIS MONTHLY 2011. [DOI: 10.5812/kowsar.1735143x.4149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Ghorbani GA. Is evaluation of hepatitis a immunity required or not? HEPATITIS MONTHLY 2011; 11:955-7. [PMID: 22368677 PMCID: PMC3282026 DOI: 10.5812/kowsar.1735143x.764] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 12/22/2011] [Accepted: 12/27/2011] [Indexed: 12/11/2022]
Abstract
Hepatitis A virus (HAV) infection is one of the most common causes of acute hepatitis and it is a serious health problem worldwide. HAV infection is a vaccine preventable disease that can produce the lifelong immunity seen in many developed countries with the vaccination schedule administered to children; however this vaccine is not used in developing countries at the present time. Improvements in food and water hygiene have caused a displacement of hepatitis A infection from children to adults which has increased mortality rates. Therefore evaluation of HAV immunity levels can help health authorities develop polices for prophylaxis especially in developing countries.
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Affiliation(s)
- Gholam Ali Ghorbani
- Department of Infectious Diseases, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Tehran, IR Iran
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Gholam Ali Ghorbani, Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqyiatallah University of Medical Sciences, Mollasadra Ave, Tehran, IR Iran. Tel.: +98-2182482487, Fax: +98-2182482472, E-mail:
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