Lim Young Suk
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Hepatol. 2009 Dec;15 Suppl 6:S25-8. doi: 10.3350/kjhep.2009.15.S6.S25.
Chronic hepatitis C (CHC) is the third most common cause of chronic liver disease and hepatocellular carcinoma (HCC) in Korea, following hepatitis B virus (HBV) infection and alcohol. HCV prevalence among Koreans older than 40 years of age has been estimated to be 1.29%. The prevalence of CHC increases with age, with the peak prevalence at the age of 60 or older. Blood transfusions have generated no risk of HCV infection since April 1991, when routine screening for anti-HCV in blood donors was adopted in Korea. Although injection drug use seems to be one of the most important risk factors of HCV infection among young adults in urban areas, the majority of CHC patients are not associated with injection drug use. Exposure to acupuncture was identified as a significant risk factor among older adults in rural areas. The mean age of patients with HCV-related cirrhosis and HCC was consistently about 10 years above that of patients associated with HBV. Genotypes 1b and 2a are the two most common types with almost equal proportions, and other genotypes are extremely rare. Korean patients with CHC have a high likelihood of responding to combination therapy with pegylated interferon and ribavirin, with a sustained virological response rate of 60-70% in patients with genotype 1 and 85-90% in those with genotype 2.
在韩国,慢性丙型肝炎(CHC)是继乙型肝炎病毒(HBV)感染和酒精之后,慢性肝病和肝细胞癌(HCC)的第三大常见病因。据估计,40岁以上韩国人的HCV患病率为1.29%。CHC的患病率随年龄增长而增加,60岁及以上人群的患病率达到峰值。自1991年4月韩国采用对献血者进行抗HCV常规筛查以来,输血不再产生HCV感染风险。虽然注射吸毒似乎是城市地区年轻成年人中HCV感染最重要的危险因素之一,但大多数CHC患者与注射吸毒无关。在农村地区,针灸被确定为老年人中的一个重要危险因素。HCV相关肝硬化和HCC患者的平均年龄始终比HBV相关患者高约10岁。1b型和2a型是两种最常见的基因型,比例几乎相等,其他基因型极为罕见。韩国CHC患者对聚乙二醇干扰素和利巴韦林联合治疗有很高的反应可能性,1型患者的持续病毒学应答率为60 - 70%,2型患者为85 - 90%。