High Prevalence of Hepatitis C Virus Infection in Aborigines in Taiwan

Wu, Jau-Shin; Lu, Chih-Feng; Chou, Wen-Hsiang; Chen, Haur-Yuong; Lee, Han-Fang; Wu, Ying-Chang; Lin, Shaobin

doi:10.7883/yoken1952.45.165

Cited by 22 publications

(15 citation statements)

References 19 publications

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“…As to the cause of high HCV infection in isolated communities, following several previous unfruitful searches Tawaraya et al, 1995;Wu et al, 1992], we ascertained, through investigation of life-long residential histories of villagers, that physical presence in the village in a specified period in the past was prerequisite for risk exposure to HCV infection within the village. It is not clear if the mere absence from the village was protective or if the experience of having resided outside of the village might have altered their life style towards a reduced risk for HCV infection.…”

Section: Discussionmentioning

confidence: 99%

“…This community was chosen because its inhabitants had been noted to have high rate (43%) of anti-HCV prevalence in a 1991 island-wide survey of aboriginal villages, undertaken because some aboriginal villages were noted to have higher prevalence of anti-HCV [Wu et al, 1992; and records of the National Institute of Preventive Medicine]. In order to avoid collecting data from household members with similar risk exposures, we solicited only one adult of a specified age range from each of 80 households that had been selected by stratified random sampling according to the address of each household.…”

Section: Adult Subjectsmentioning

confidence: 99%

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High rate of hepatitis C virus infection in an isolated community: Persistent hyperendemicity or period-related phenomena?

Hsu

Yuh

et al. 1997

J. Med. Virol.

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We investigated underlying risks for hyperendemic hepatitis C virus (HCV) infection among the 1853 inhabitants of a mountainous village in Eastern Taiwan with high prevalence of HCV and hepatitis B virus (HBV). Among the 80 selected adults, we found that having resided away from the village before 1985 was protective against HCV infection, while residing in the village after 1985 posed little risk for HCV infection to children and young adults < 30 years of age. Among the 559 school children 7 through 14 years of age, anti-HCV prevalence was 1.9%, and the HBV carrier rate was 29%. Following up 270 children 1 year later, we found that new HCV infection occurred in 0.74% and new or repeated HBV infection occurred in 6.5% of the children, indicating distinct transmission patterns between HBV and HCV. Children of anti-HCV-positive mothers were either anti-HCV-negative or were infected by distinct genotypes of HCV from those infecting their mothers; most married couples in whom both were infected, were infected by HCV of discordant genotypes, indicating negligible importance of sexual or vertical HCV transmission. A case-control study comparing 13 anti-HCV-positive and 53 anti-HCV-negative children showed that having received parenteral medication in local clinics was a significant risk for HCV infection. Our data indicate that, unlike the case of HBV, HCV transmission by vertical or sexual route, or through casual contact are extremely inefficient, and our data further suggest that HCV hyperendemicity is unlikely to persist as a result of the more stringent practice of parenteral precautions in nearly all aspects of daily life.

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Section: Discussionmentioning

confidence: 99%

Section: Adult Subjectsmentioning

confidence: 99%

High rate of hepatitis C virus infection in an isolated community: Persistent hyperendemicity or period-related phenomena?

Hsu

Yuh

et al. 1997

J. Med. Virol.

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“…A similar situation might be present in different areas of the same country. For example, although the prevalence of anti-HCV in Taiwan was 1-3% [12][13][14][15] , there were several HCV hyperendemic townships in southern Taiwan where anti-HCV prevailed in more than 15% of inhabitants [16][17][18][19] . To investigate the actual prevalence of HCV infection, we conducted a large-scale communitybased survey in southern parts of Taiwan including some HCV hyperendemic townships from 2000 to 2003.…”

Section: Seroepidemiology Of Hcv Infection In Southern Taiwanmentioning

confidence: 99%

“…This indicates that regional differences of genotype distribution might exist between northern and southern Taiwan. In addition, several areas hyperendemic for HCV have been discovered in southern Taiwan [16][17][18][19] ; the molecular epidemiology of HCV may differ in these areas. In 1,164 subjects positive for anti-HCV and HCV RNA in serum from three HCV hyperendemic areas (community-based; Masago, Tzukuan and Taoyuan) and a tertiary referral center (hospitalbased) in southern Taiwan, we determined genotype distribution to evaluate the age-specifi c prevalence of HCV genotypes and clarify the relationship between genotype and pathogenesis of HCV infection [29] ; HCV genotypes were examined by the method of Okamoto et al [30] .…”

Section: Distribution Of Hcv Genotypes In Southern Taiwanmentioning

confidence: 99%

Treatment of Chronic Hepatitis C in Southern Taiwan

Chuang

et al. 2005

Intervirology

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Chronic hepatitis C virus (HCV) infection may lead to cirrhosis and hepatocellular carcinoma. Interferon (IFN)-α is effective in the treatment of chronic hepatitis C. The rate of response to IFN is enhanced by increasing the IFN dose. Extending the treatment duration can reduce the relapse rate. Addition of ribavirin to IFN increases the sustained virological response (SVR). Thus, combination therapy with IFN and ribavirin was adopted for the treatment of chronic hepatitis C in Kaohsiung Medical University Hospital in 1998. Approximately 60% of patients receiving IFN/ribavirin therapy gained SVR. IFN 6 million units three times per week combined with daily ribavirin for 6 months achieved SVR more frequently than combination therapy with 3 million units. Factors for SVR in these combination regimens were HCV genotype, viral load and early virological response. Long-term follow-up of patients treated with IFN has shown that SVR might reduce the risk of progression to cirrhosis and hepatocellular carcinoma. Pegylated (peg)-IFN has a longer half-life and better efficacy. Combination therapy with peg-IFN and ribavirin accomplished higher SVR than conventional IFN and ribavirin. A multicenter clinical trial was conducted in Taiwan to compare the efficacy of combination therapy between peg-IFN/ribavirin and conventional IFN/ribavirin for 6 months. SVR was higher in patients receiving peg-IFN and ribavirin, especially in those infected with HCV genotype 1b. Based on the results obtained, the national health insurance started to sponsor the combination therapy in October 2003, with a suggested duration for 6 months. Some small-scale studies in Taiwan have postulated higher SVR for treatment duration of 12 than of 6 months in patients with genotype 1b. Further investigation should be conducted in the near future.

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“…5 In contrast, the prevalence of HCV infection varies by region in Taiwan, ranging from 1.6% to 37%. [6][7][8] Horizontal routes, especially iatrogenic contact with contaminated syringes or needles, are the major transmission route of HCV in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

Lifetime Risk and Sex Difference of Hepatocellular Carcinoma Among Patients With Chronic Hepatitis B and C

Huang

Jen

Yang

et al. 2011

JCO

192

127

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A B S T R A C T PurposeBoth hepatitis B (HBV) and C viruses (HCV) are causes of hepatocellular carcinoma (HCC), but lifetime risk and sex difference remain unclear. This study aimed to assess the lifetime risk and sex difference of HCC among patients with chronic HBV and/or HCV. MethodsA prospective cohort of 23,820 residents of Taiwan age 30 to 65 years were enrolled from 1991 to 1992, with 477 instances of HCC occurring subsequently. Serum samples collected at enrollment were tested for seromarkers and viral load of HBV and HCV. Newly developed HCC was ascertained through computerized data linkage with national cancer registry and death certification systems. ResultsThe cumulative lifetime (age 30 to 75 years) incidences of HCC for men and women positive for both HBV surface antigen (HBsAg) and antibodies against HCV (anti-HCV) were 38.35% and 27.40%; for those positive for HBsAg only, 27.38% and 7.99%; for those positive for anti-HCV only, 23.73% and 16.71%; and for those positive for neither, 1.55% and 1.03%, respectively. There was a significant male predominance in incidence of HCC for chronic HBV carriers but not for chronic carriers of HCV or both. Multivariate adjusted hazard ratio of developing HCC decreased with age in HBsAg-seropositive men but increased with age in anti-HCV-seropositive women. Among dual-infected participants, there was an inverse association between HBV and HCV viral load. Risk of HCC increased significantly with increasing viral load of HBV and HCV. ConclusionThere exists a suppressive effect of HCV on HBV viral load. Individual and combined effects of the two viruses on HCC vary with sex and age.

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High Prevalence of Hepatitis C Virus Infection in Aborigines in Taiwan

Cited by 22 publications

References 19 publications

High rate of hepatitis C virus infection in an isolated community: Persistent hyperendemicity or period-related phenomena?

High rate of hepatitis C virus infection in an isolated community: Persistent hyperendemicity or period-related phenomena?

Treatment of Chronic Hepatitis C in Southern Taiwan

Lifetime Risk and Sex Difference of Hepatocellular Carcinoma Among Patients With Chronic Hepatitis B and C

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