Chae Hee Bok, Kim Jong-Hyun, Kim Ja Kyung, Yim Hyung Joon
Department of Internal Medicine, Chungbuk National Unviersity College of Medicine, Cheongju, Korea.
Korean J Hepatol. 2009 Dec;15 Suppl 6:S13-24. doi: 10.3350/kjhep.2009.15.S6.S13.
Hepatitis B virus (HBV) infection is the one of the most common causes of the liver diseases in Korea. Since the discovery of Australia antigen (hepatitis associated antigen, or HBsAg later), hepatitis associated antigen was tested widely. HBsAg was detected in 6.6-8.6% in 1980's. Later, it decreased to 5.7% in 1990's. Remarkably, seropositivity of the children deceased to 0.2% after the nationwide vaccination program. Although hepatitis B vaccines are highly effective, the failure rate of perinatal prophylaxis in babies born to HBsAg positive mother was reported to be 4.25%. Treatment of chronic hepatitis B was initiated after the introduction of interferon alpha. Lamivudine opened a new era of oral antiviral agent, and it has been widely used in Korea since 1999. Adefovir was proven to have a good efficacy for lamivudine-resistant chronic hepatitis B. Newer potent antiviral agents such as entecavir, clevudine, and telbivudine are available currently. Further studies are warranted for understanding factors influencing natural history, improving treatment outcomes, and overcoming vaccine non-response.
乙型肝炎病毒(HBV)感染是韩国肝脏疾病最常见的病因之一。自澳大利亚抗原(后来称为肝炎相关抗原或HBsAg)被发现以来,肝炎相关抗原得到了广泛检测。20世纪80年代,HBsAg的检出率为6.6%-8.6%。后来,在20世纪90年代降至5.7%。值得注意的是,在全国范围内实施疫苗接种计划后,儿童的血清阳性率降至0.2%。尽管乙型肝炎疫苗非常有效,但据报道,HBsAg阳性母亲所生婴儿的围产期预防失败率为4.25%。在α干扰素问世后,慢性乙型肝炎的治疗开始了。拉米夫定开创了口服抗病毒药物的新时代,自1999年以来一直在韩国广泛使用。阿德福韦被证明对拉米夫定耐药的慢性乙型肝炎有良好疗效。目前有恩替卡韦、替比夫定等更新的强效抗病毒药物。有必要进行进一步研究,以了解影响自然史的因素、改善治疗效果并克服疫苗无应答情况。