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

Choi

J of Gastro and Hepatol

et al. 2021

Background and Aim Several barriers prevent the proper screening, diagnosis, and treatment of hepatitis C virus (HCV) infection. We aimed to evaluate the status of HCV screening, confirmation, and treatment rates in a tertiary academic medical center in Korea. Methods Patients who visited Severance Hospital between 2015 and 2019 were eligible in this retrospective study. The testing and positivity rates for anti‐HCV antibodies and HCV RNA were sequentially analyzed. Results Between 2015 and 2019, 252 057 patients (117 131 men, 46.5%) who underwent anti‐HCV antibody testing were retrospectively reviewed. The median age of the study population was 51.0 years. Patients with positive anti‐HCV antibody test results (n = 2623, 1.0%) showed a higher proportion of liver cirrhosis (17.6% vs 2.0%) and unfavorable laboratory test results (all P < 0.05). The positivity rates were 1.3% and 0.8% in the medical and surgical departments, respectively. HCV RNA was tested in 1628 (62.1%) patients, with a 57.4% (n = 928) positivity rate. The medical department had a higher HCV RNA testing rate than the surgical department (75.4% vs 40.8%). Among the 928 patients who showed positivity for HCV RNA, 847 (90.7%) underwent genotype testing (mostly 1 and 2 [95.4%]). The treatment rate was 66.9% (n = 567); it was higher in the gastroenterology department (70.8%) than in the non‐gastroenterology departments (62.3%). Conclusions A considerable proportion of patients testing positive for anti‐HCV antibodies were not referred for proper management. Systematic and automated screening and referral systems, which may help identify patients requiring treatment for HCV infection, are necessary even in tertiary academic medical centers.

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Screening, confirmation, and treatment rates of hepatitis C virus infection in a tertiary academic medical center in South Korea

Choi

J of Gastro and Hepatol

et al. 2021

“…In a cancer screening cohort study, only 34.9% of HCV carriers were aware of their infection status [ 26 ]. In a nationwide multicenter study, wherein linkage to care was analyzed, 72.8% patients received antiviral treatment when HCV viremia was identified [ 27 ]. In a nationwide telephonic interview, the treatment rate was 80% among people who reported positive results for HCV [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study

et al. 2021

Background The current antiviral treatments available for hepatitis C virus (HCV) infection decrease the risk of hepatocellular carcinoma (HCC). Hence, patients with HCV infection who have not received antiviral treatment and have developed HCC may be those who missed timely antiviral treatment for HCV. However, the proportion of patients who missed timely antiviral treatment and its implications are largely unexplored. Methods A nationwide retrospective cohort of 4,592 newly diagnosed HCV-related HCC patients (2013–2017) was identified from the Korean National Health Insurance Service database. Prior antiviral treatment for HCV was defined as a history of at least one HCV-specific antiviral treatment before HCC diagnosis. The outcome was all-cause mortality. Results Prior antiviral treatment for HCV was identified in 802 (17.4%) patients, and 16%, 16%, 17%, 19%, and 19% of patients received antiviral treatment in the years 2013, 2014, 2015, 2016, and 2017, respectively (P = 0.21). During 8,085 person-years of follow-up (median, 1.4; maximum, 5.3 years of follow-up), 1,970 patients died. Mortality rates were lower in patients with prior antiviral treatment (15 deaths/100 person-years) than in those without prior antiviral treatment (27 deaths/100 person-years). The adjusted hazard ratio (95% confidence interval) for all-cause mortality on comparing patients who did and did not receive prior antiviral treatment was 0.68 (0.59, 0.79). Conclusion Timely antiviral treatment for HCV was suboptimal at the population level. Prior antiviral treatment for HCV reduced mortality rate in HCV-related HCC patients. Intensive HCV control strategies are needed to reduce the number of patients with HCV infection who miss timely HCV treatment.

“…In South Korea, the anti-HCV prevalence adjusted for age, sex, and area among 291,314 health examinees (≥20 years of age) was 0.78% in 2009 and 0.6% in 2015. 15,16 The anti-HCV prevalence increased with age, and it was higher in females (0.83%) than in males (0.75%), showing intranational geographic difference: a higher prevalence (1.53% to 2.07%) in the southern coastal area. More than 90% of Korean patients with chronic HCV infection were over 40 years of age, and more than half of the patients were asymptomatic or showing alanine aminotransferase levels within normal limits at their diagnosis of chronic hepatitis C. The major HCV genotypes are 1b (48%) and 2 (46%).…”

Section: Discussionmentioning

confidence: 99%

“…18,25,26 In this study, the anti-HCV positive rate among the respondents was unexpectedly high (11.0%, 10/91) considering that current anti-HCV prevalence among the Korean adult population of 0.6% to 0.8%. 15,16 It may be related to the inherent limitation of telephone survey and its low response rate. In our study, the response rate of the telephone survey was 17%, however, it was a relatively higher rate compared to those in the other surveys on many political or economic issues: general response rate in telephone survey is within the rage of 10% to 20% according to Gallop Korea.…”

Section: Discussionmentioning

confidence: 99%

A Survey of the Knowledge of and Testing Rate for Hepatitis C in the General Population in South Korea

et al. 2020

Self Cite

Background/Aims: To eliminate hepatitis C virus (HCV) infection, improving public knowledge of and access to HCV screening and treatment is essential. The aim of this study was to evaluate the knowledge of and testing rate for HCV and the opinions about the inclusion of the HCV test in the National Health Examination (NHE) among the general population in South Korea. Methods: A telephone interview survey was conducted by an independent research company using a 16 item-questionnaire (demographics, knowledge of HCV, testing and results, need for screening) in May 2019. The sample population consisted of 1,003 adult Korean residents adjusted by age, sex, and area according to the standard Korean population in 2019. Results: Among the 1,003 participants (505 women, mean age of 47.9 years), 56.4% recognized HCV; 44.4% understood that HCV is transmittable, and 56.8% thought that HCV is curable by medication. The recognition rate tended to increase with an increasing level of education. Testing for anti-HCV antibodies was reported by 91 people (9.1%); among them, 10 people (11.0%) reported a positive result, and eight people received treatment. The common reasons for HCV testing were a health check-up (58.5%), a physician's recommendation (11.0%) and elevated liver enzyme levels (10.7%). The majority of the population (75.1%) agreed with the integration of HCV into the NHE. Conclusions: The level of knowledge of HCV is suboptimal, and the self-reported testing rate for HCV is less than 10%; however, once HCV infection is diagnosed, the treatment rate seems to be high in South Korea. More active campaigns and effective screening are needed. (Gut Liver,