J Korean Med Sci.  2012 Nov;27(11):1371-1377. 10.3346/jkms.2012.27.11.1371.

Behavioral and Healthcare-Associated Risk Factors for Chronic Hepatitis C Virus Infection in Korea

• Kim JY
• Cho J
• Hwang SH
• Kil H
• Bae SH
• Kim YS
• Lee HC
• Jeong SH

• KMID: 2157949
• DOI: http://doi.org/10.3346/jkms.2012.27.11.1371

Abstract

The risk factors related to hepatitis C virus (HCV) infection showed geographic and temporal differences. We investigated HCV-related risk factors in Korea where intravenous drug use (IVDU) is uncommon. The HCV-related risk factors were investigated in a prospective, multicenter chronic HCV cohort (n = 711) using a standardized questionnaire in four university hospitals. The results were compared with those of 206 patients with chronic liver diseases not related to either of HCV or hepatitis B virus infection (comparison group). The IVDU was found in 3.9% and remote blood transfusion (> or = 20 yr ago) in 18.3% in HCV cohort group, while that in comparison group was in none and 5.3%, respectively. In a multivariate logistic analysis, transfusion in the remote past (odds ratio [OR], 2.99), needle stick injury (OR, 4.72), surgery (OR, 1.89), dental procedures (OR, 2.96), tattooing (OR, 2.07), and multiple sexual partners (2-3 persons; OR, 2.14, > or = 4 persons; OR, 3.19), were independent risk factors for HCV infection. In conclusion, the major risk factors for HCV infection in Korea are mostly related to conventional or alterative healthcare procedures such as blood transfusion in the remote past, needle stick injury, surgery, dental procedure, and tattooing although multiple sex partners or IVDU plays a minor role.

Keyword

Epidemiology; Hepatitis C Virus; Risk Assessment; Transmission

MeSH Terms

Adult
Aged
*Attitude to Health
Blood Transfusion
Case-Control Studies
Cohort Studies
Female
*Health Behavior
Hepatitis C, Chronic/*etiology
Hospitals, University
Humans
Injections, Intravenous
Logistic Models
Male
Middle Aged
Needlestick Injuries/complications
Odds Ratio
Prospective Studies
Questionnaires
Republic of Korea
Risk Factors
Sexual Partners
Tattooing
Tooth Diseases/complications

Reference

1. Memon MI, Memon MA. Hepatitis C: an epidemiological review. J Viral Hepat. 2002. 9:84–100.

2. Alter MJ. Epidemiology of hepatitis C virus infection. World J Gastroenterol. 2007. 13:2436–2441.

3. Esteban JI, Sauleda S, Quer J. The changing epidemiology of hepatitis C virus infection in Europe. J Hepatol. 2008. 48:148–162.

4. Karmochkine M, Carrat F, Dos Santos O, Cacoub P, Raguin G. A case-control study of risk factors for hepatitis C infection in patients with unexplained routes of infection. J Viral Hepat. 2006. 13:775–782.

5. Delarocque-Astagneau E, Pillonel J, De Valk H, Perra A, Laperche S, Desenclos JC. An incident case-control study of modes of hepatitis C virus transmission in France. Ann Epidemiol. 2007. 17:755–762.

6. Ali SA, Donahue RM, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis. 2009. 13:9–19.

7. Sun CA, Chen HC, Lu CF, You SL, Mau YC, Ho MS, Lin SH, Chen CJ. Transmission of hepatitis C virus in Taiwan: prevalence and risk factors based on a nationwide survey. J Med Virol. 1999. 59:290–296.

8. Chung H, Ueda T, Kudo M. Changing trends in hepatitis C infection over the past 50 years in Japan. Intervirology. 2010. 53:39–43.

9. McCaughan GW, Omata M, Amarapurkar D, Bowden S, Chow WC, Chutaputti A, Dore G, Gane E, Guan R, Hamid SS, et al. Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis, management and treatment of hepatitis C virus infection. J Gastroenterol Hepatol. 2007. 22:615–633.

10. Suh DJ, Jeong SH. Current status of hepatitis C virus infection in Korea. Intervirology. 2006. 49:70–75.

11. Lee HS, Han CJ, Kim CY. Predominant etiologic association of hepatitis C virus with hepatocellular carcinoma compared with hepatitis B virus in elderly patients in a hepatitis B-endemic area. Cancer. 1993. 72:2564–2567.

12. Lee MS, Kim DH, Kim H, Lee HS, Kim CY, Park TS, Yoo KY, Park BJ, Ahn YO. Hepatitis B vaccination and reduced risk of primary liver cancer among male adults: a cohort study in Korea. Int J Epidemiol. 1998. 27:316–319.

13. Shin HR. Epidemiology of hepatitis C virus in Korea. Intervirology. 2006. 49:18–22.

14. Kim YS, Ahn YO, Lee HS. Risk factors for hepatitis C virus infection among Koreans according to the hepatitis C virus genotype. J Korean Med Sci. 2002. 17:187–192.

15. Shin HR, Kim JY, Ohno T, Cao K, Mizokami M, Risch H, Kim SR. Prevalence and risk factors of hepatitis C virus infection among Koreans in rural area of Korea. Hepatol Res. 2000. 17:185–196.

16. Kim YS, Ahn YO, Kim DW. A case-control study on the risk factors of hepatitis C virus infection among Koreans. J Korean Med Sci. 1996. 11:38–43.

17. Shin HR, Kim JY, Kim JI, Lee DH, Yoo KY, Lee DS, Franceschi S. Hepatitis B and C virus prevalence in a rural area of South Korea: the role of acupuncture. Br J Cancer. 2002. 87:314–318.

18. Kwon JH, Bae SH. Current status and clinical course of hepatitis C virus in Korea. Korean J Gastroenterol. 2008. 51:360–367.

19. Becheur H, Harzic M, Colardelle P, Deny P, Coste T, Dubeaux B, Chochon M, Roussin-Bretagne S, Doll J, Andrieu J. Hepatitis C virus contamination of endoscopes and biopsy forceps. Gastroenterol Clin Biol. 2000. 24:906–910.

20. Habib M, Mohamed MK, Abdel-Aziz F, Magder LS, Abdel-Hamid M, Gamil F, Madkour S, Mikhail NN, Anwar W, Strickland GT, et al. Hepatitis C virus infection in a community in the Nile Delta: risk factors for seropositivity. Hepatology. 2001. 33:248–253.

21. Alter MJ. Hepatitis C virus infection in the United States. J Hepatol. 1999. 31:Suppl 1. 88–91.

22. Hellard ME, Hocking JS, Crofts N. The prevalence and the risk behaviours associated with the transmission of hepatitis C virus in Australian correctional facilities. Epidemiol Infect. 2004. 132:409–415.

23. Yazdanpanah Y, De Carli G, Migueres B, Lot F, Campins M, Colombo C, Thomas T, Deuffic-Burban S, Prevot MH, Domart M, et al. Risk factors for hepatitis C virus transmission to health care workers after occupational exposure: a European case-control study. Clin Infect Dis. 2005. 41:1423–1430.

24. Rustgi VK. The epidemiology of hepatitis C infection in the United States. J Gastroenterol. 2007. 42:513–521.

25. Massari M, Petrosillo N, Ippolito G, Solforosi L, Bonazzi L, Clementi M, Manzin A. Transmission of hepatitis C virus in a gynecological surgery setting. J Clin Microbiol. 2001. 39:2860–2863.

26. Esteban JI, Gomez J, Martell M, Cabot B, Quer J, Camps J, Gonzalez A, Otero T, Moya A, Esteban R, et al. Transmission of hepatitis C virus by a cardiac surgeon. N Engl J Med. 1996. 334:555–560.

27. Guadagnino V, Stroffolini T, Rapicetta M, Costantino A, Kondili LA, Menniti-Ippolito F, Caroleo B, Costa C, Griffo G, Loiacono L, et al. Prevalence, risk factors, and genotype distribution of hepatitis C virus infection in the general population: a community-based survey in southern Italy. Hepatology. 1997. 26:1006–1011.

28. Nelson DB. Infectious disease complications of GI endoscopy: part II, exogenous infections. Gastrointest Endosc. 2003. 57:695–711.

29. Wu H, Shen B. Health care-associated transmission of hepatitis B and C viruses in endoscopy units. Clin Liver Dis. 2010. 14:61–68. viii

30. Vandelli C, Renzo F, Romano L, Tisminetzky S, De Palma M, Stroffolini T, Ventura E, Zanetti A. Lack of evidence of sexual transmission of hepatitis C among monogamous couples: results of a 10-year prospective follow-up study. Am J Gastroenterol. 2004. 99:855–859.

31. Thomas DL, Zenilman JM, Alter HJ, Shih JW, Galai N, Carella AV, Quinn TC. Sexual transmission of hepatitis C virus among patients attending sexually transmitted diseases clinics in Baltimore--an analysis of 309 sex partnerships. J Infect Dis. 1995. 171:768–775.

32. Alter MJ, Kruszon-Moran D, Nainan OV, McQuillan GM, Gao F, Moyer LA, Kaslow RA, Margolis HS. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med. 1999. 341:556–562.

33. Guadagnino V, Stroffolini T, Foca A, Caroleo B, Loiacono L, Giancotti A, Menniti F, Piazza M. Hepatitis C virus infection in family setting. Eur J Epidemiol. 1998. 14:229–232.

34. Kao JH, Hwang YT, Chen PJ, Yang PM, Lai MY, Wang TH, Chen DS. Transmission of hepatitis C virus between spouses: the important role of exposure duration. Am J Gastroenterol. 1996. 91:2087–2090.

35. Caporaso N, Ascione A, Stroffolini T. Investigators of an Italian Multicenter Group. Spread of hepatitis C virus infection within families. J Viral Hepat. 1998. 5:67–72.