Kim Eun Soo, Cho Kwang Bum, Park Kyung Sik, Jang Byung Ik, Kim Kyeong Ok, Jeon Seong Woo, Kim Eun Young, Yang Chang Heon, Kim Wan Jung
*Department of Internal Medicine, Division of Gastroenterology, School of Medicine, Keimyung University †Department of Internal Medicine, Division of Gastroenterology and Hepatology, College of Medicine, Yeungnam University ‡Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Kyungpook National University §Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Catholic University of Daegu, Daegu ∥Department of Internal Medicine, Division of Gastroenterology and Hepatology, School of Medicine, Dongguk University, Gyeongju ¶Department of Internal Medicine, Division of Gastroenterology, School of Medicine, Soonchunhyang University, Gumi, Gyeongsang-buk-do, Korea.
J Clin Gastroenterol. 2014 Jul;48(6):553-8. doi: 10.1097/01.mcg.0000436435.75392.23.
There are few data regarding the prevalence of hepatitis-B virus (HBV) markers in inflammatory bowel disease (IBD) patients in Korea, which is a hepatitis-B-endemic area. The aim of this study was to assess the prevalence of HBV markers in IBD patients in comparison with controls.
We enrolled 513 IBD patients [241 Crohn's disease (CD) and 272 ulcerative colitis (UC)] whose hepatitis-B surface antigen and anti-HBs levels were evaluated. Anti-HBc was assayed in 357 patients. These markers were compared with those of 1020 sex-matched and age-matched controls.
Prevalence of hepatitis-B surface antigen in IBD patients was 3.7% and there was no significant difference between groups (CD 4.1%, UC 3.3%, control 4.4%, P=0.713). The frequency of effective vaccination against HBV (positive anti-HBs, without anti-HBc) was lower in IBD patients less than 30 years old compared with the same-aged controls (CD 43.3%, UC 48.5%, control 61.9%, P=0.002), whereas there was no difference between groups in subjects more than 30 years old. One third of IBD patients were at risk of susceptibility to HBV infection (nonimmune), particularly those less than 30 years old, compared with controls of the same age (CD 43.3%, UC 36.4%, control 21%, P<0.001). In IBD patients, multivariate analysis identified that age less than 30 years was an independent risk factor for nonimmune status.
IBD was not a risk factor for HBV infection even in endemic areas. However, many young IBD patients were susceptible to HBV infection. It is crucial to screen for HBV immunity and to implement a meticulous vaccination strategy for young Korean IBD patients.
在韩国这个乙型肝炎流行地区，关于炎症性肠病（IBD）患者中乙型肝炎病毒（HBV）标志物流行情况的数据较少。本研究的目的是评估IBD患者与对照组相比HBV标志物的流行情况。
我们纳入了513例IBD患者[241例克罗恩病（CD）和272例溃疡性结肠炎（UC）]，评估了他们的乙型肝炎表面抗原和抗-HBs水平。对357例患者检测了抗-HBc。将这些标志物与1020例性别和年龄匹配的对照组进行比较。
IBD患者中乙型肝炎表面抗原的流行率为3.7%，各组之间无显著差异（CD为4.1%，UC为3.3%，对照组为4.4%，P = 0.713）。年龄小于30岁的IBD患者中，针对HBV的有效疫苗接种率（抗-HBs阳性，无抗-HBc）低于同年龄对照组（CD为43.3%，UC为48.5%，对照组为61.9%，P = 0.002），而年龄大于30岁的受试者中各组之间无差异。与同年龄对照组相比，三分之一的IBD患者有HBV感染易感性风险（无免疫力），尤其是年龄小于30岁的患者（CD为43.3%，UC为36.4%，对照组为21%，P < 0.001）。在IBD患者中，多因素分析确定年龄小于30岁是无免疫力状态的独立危险因素。
即使在流行地区，IBD也不是HBV感染的危险因素。然而，许多年轻的IBD患者易感染HBV。对韩国年轻IBD患者进行HBV免疫筛查并实施细致的疫苗接种策略至关重要。
