Regional Distribution of Hepatitis C Virus Infection in the Republic of Korea, 2007-2011

Abstract

Background/AimsIn Korea, hepatitis C is included as an infectious disease in a sentinel surveillance system. Recently, a large variation in hepatitis C incidence between different regions in Korea has been noticed. The current study verified the nationwide distribution of hepatitis C infection for effective prevention and management.MethodsWe counted the number of hepatitis C patients who visited a hospital per county using the National Health Insurance database from 2007 to 2011. The age-adjusted prevalence ratio was used, and the age adjustment method was used as an indirect standardization method. Disease mapping and spatial analysis were conducted using a geographic information system.ResultsThe annual prevalence of diagnosed hepatitis C was approximately 0.12% to 0.13% in Korea. The age-adjusted prevalence ratios in Busan, Jeonnam, and Gyeongnam were high (1.75, 1.4, and 1.3, respectively). The three regions in the southern coastal area of the Korean Peninsula were identified as a high-prevalence cluster (Moran’s index, 0.3636).ConclusionsThe present study showed that hepatitis C infection has very large regional variation, and there are several high-risk areas. Preventive measures focusing on these areas should be applied to block the transmission of hepatitis C and reduce the disease burden.

Regional Diversity of Hepatitis C Virus Prevalence: Seeking for Culture Specific Mode of Transmission

“…Instead, epidemiologic studies seeking mode of infections related to the geographical, cultural, and medical factors should be initiated to prevent the further infection. It should be emphasized that although study by Kwon et al 2. only concentrated on evaluating the prevalence, their results on regional variations which is in accordance with the previous study provide a ground for the further investigation on epidemiological study over route of transmission.…”

“…Prevalence approximated by anti-HCV positivity tends to be exaggerated since persons with past infection after recovery and with false anti-HCV positive must be included in the figure. However, the most recently performed investigation6 using serologic data of health check-up participants demonstrated the similar regional variations as the study by Kwon et al 2. Although the figures from anti-HCV positivity study were generally larger than that from the National Health Insurance data, both studies reported Jeonnam and Busan having highest age-adjusted HCV prevalence in South Korea.…”

“…made use of the National Health Insurance data which naturally included only those who sought the medical assistances and reported the prevalence that is much lower than that of the previous reports. The figure presented by Kwon et al 2. is closer to HCV RNA prevalence among Korean blood donors between February 2005 and December 2009 which reported the prevalence of 0.16% 4.…”

“…However, Kwon et al 2. reported that there are noticeable differences in HCV distribution among the regions and counties, highest being age-adjusted prevalence greater than 3.5% in a county of Busan, southwest coast of South Korea.…”

“…However, if Korean cultural health behaviors were to be taken account, risk factors might have been more diverse and valuable. As Kwon et al 2. discussed in their work, residents of a specific part of Korea often undergo a type of phlebotomy called “Buhwang” as alternative medicine.…”