J Korean Med Sci.  2023 Aug;38(34):e270. 10.3346/jkms.2023.38.e270.

Seroprevalence of Hepatitis C Virus Infection in North Korean Defectors Residing in Korea

• Hong YM
• Yoon KT
• Park YJ
• Woo HY
• Heo J

• KMID: 2545546
• DOI: http://doi.org/10.3346/jkms.2023.38.e270

Abstract

Background
This study aimed to investigate the prevalence rate of hepatitis C virus (HCV) infection and identify the demographic, and sociological characteristics and changes in awareness of HCV infection by participating the study for North Korean defectors residing in South Korea.
Methods
This study prospectively enrolled participants. Demographic, sociological and clinical data, and questionnaire surveys focused on awareness of HCV infection were collected.
Results
In total, 211 North Korean defectors participated in this study from September 2020 until June 2021. There were 174 women (82.5%), and the overall mean age was 48.9 years (range, 20 to 80 years). Of these participants, 112 (53.1%) had immigrated to South Korea since 2011. The overall prevalence of anti-HCV antibody among North Korean defectors was 1.9%. Thirty participants (14.2%) had hepatitis B surface antigens. A huge lack of awareness regarding HCV infection has been observed among North Korean defectors.
Conclusion
This is the first prospective study to investigate the prevalence rate of HCV infection among North Korean defectors residing in South Korea. As North Korean defectors are a vulnerable group concerning HCV infection, they may benefit from HCV screening policies and educational interventions for HCV infection.

Keyword

Hepatitis C Virus; Prevalence; Awareness; North Korean Defectors

Reference

1. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006; 45(4):529–538. PMID: 16879891.

2. El Khoury AC, Wallace C, Klimack WK, Razavi H. Economic burden of hepatitis C-associated diseases: Europe, Asia Pacific, and the Americas. J Med Econ. 2012; 15(5):887–896. PMID: 22458755.

3. Hajarizadeh B, Grebely J, Dore GJ. Epidemiology and natural history of HCV infection. Nat Rev Gastroenterol Hepatol. 2013; 10(9):553–562. PMID: 23817321.

4. Ministry of Unification (KR). Ministry of Unification’s homepage. Updated 2020. Accessed September 30, 2020. https://www.unikorea.go.kr/unikorea/ .

5. Lee YH, Lee WJ, Kim YJ, Cho MJ, Kim JH, Lee YJ, et al. North Korean refugee health in South Korea (NORNS) study: study design and methods. BMC Public Health. 2012; 12(1):172. PMID: 22401814.

6. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014; 61(1):Suppl. S45–S57. PMID: 25086286.

7. Lavanchy D. Evolving epidemiology of hepatitis C virus. Clin Microbiol Infect. 2011; 17(2):107–115. PMID: 21091831.

8. Heidrich B, Cetindere A, Beyaz M, Stahmeyer JT, Basaran MM, Braynis B, et al. High prevalence of hepatitis markers in immigrant populations: a prospective screening approach in a real-world setting. Eur J Gastroenterol Hepatol. 2014; 26(10):1090–1097. PMID: 25076065.

9. Maasoumy B, Wedemeyer H. Natural history of acute and chronic hepatitis C. Best Pract Res Clin Gastroenterol. 2012; 26(4):401–412. PMID: 23199500.

10. Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology. 2013; 57(4):1333–1342. PMID: 23172780.

11. Urban K, Payton C, Mamo B, Volkman H, Giorgio K, Kennedy L, et al. Hepatitis C screening and antibody prevalence among newly arrived refugees to the United States, 2010-2017. J Immigr Minor Health. 2023; 1–8.

12. European Centre for Disease Prevention and Control. Prevention of hepatitis B and C in the EU/EEA. Updated 2022. Accessed May 20, 2023. https://www.ecdc.europa.eu/en/publications-data/prevention-hepatitis-b-and-c-eueea .

13. Coppola N, Alessio L, Onorato L, Sagnelli C, Macera M, Sagnelli E, et al. Epidemiology and management of hepatitis C virus infections in immigrant populations. Infect Dis Poverty. 2019; 8(1):17. PMID: 30871599.

14. Greenaway C, Thu Ma A, Kloda LA, Klein M, Cnossen S, Schwarzer G, et al. The seroprevalence of hepatitis C antibodies in immigrants and refugees from intermediate and high endemic countries: a systematic review and meta-analysis. PLoS One. 2015; 10(11):e0141715. PMID: 26558905.

15. Kim DY, Han KH, Jun B, Kim TH, Park S, Ward T, et al. Estimating the cost-effectiveness of one-time screening and treatment for hepatitis C in Korea. PLoS One. 2017; 12(1):e0167770. PMID: 28060834.

16. Nishiura H, Lee H, Yuan B, Endo A, Akhmetzhanov AR, Chowell G. Infectious disease risks among refugees from North Korea. Int J Infect Dis. 2018; 66:22–25. PMID: 29126812.

17. Ahn SY, Ryou SH, Kim SB. Clinical characteristics of defectors from North Korea visiting a single tertiary hospital in South Korea. Korean J Med. 2015; 89(1):54–63.

18. Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017; 2(3):161–176. PMID: 28404132.

19. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. 2012; 30(12):2212–2219. PMID: 22273662.

20. Rossi C, Shrier I, Marshall L, Cnossen S, Schwartzman K, Klein MB, et al. Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refugees: a systematic review and meta-analysis. PLoS One. 2012; 7(9):e44611. PMID: 22957088.

21. Cho EJ, Kim SE, Suk KT, An J, Jeong SW, Chung WJ, et al. Current status and strategies for hepatitis B control in Korea. Clin Mol Hepatol. 2017; 23(3):205–211. PMID: 28942624.

22. Ayele A, Abera D, Hailu M, Birhanu M, Desta K. Prevalence and associated risk factors for hepatitis B and C viruses among refugees in Gambella, Ethiopia. BMC Public Health. 2020; 20(1):721. PMID: 32429964.

23. Kim KA, Jung YS, Kim CB, Kim KB, Yoon SJ. Trend of disease burden of North Korean defectors in South Korea using disability-adjusted life years from 2010 to 2018. J Korean Med Sci. 2021; 36(32):e211. PMID: 34402227.