The Concept and management of Hepatitis B Virus Infection: Difference between General Practitioners and Hepatologists.
- Author:
Jin Ju PAIK
1
;
Hyeon Jin LEE
;
Young Ho LEE
;
Ka Young LEE
;
Tae Jin PARK
Author Information
1. Department of Family Medicine, Pusan Paik Hospital Inje University, Pusan, Korea.
- Publication Type:Original Article
- Keywords:
hepatitis B;
concept;
management
- MeSH:
Busan;
Surveys and Questionnaires;
General Practitioners*;
Hepatitis B virus*;
Hepatitis B*;
Hepatitis*;
Hepatitis, Chronic;
Humans;
Immunization;
Immunization, Secondary;
Interferons;
Korea;
Physicians, Family;
Public Health;
Serologic Tests;
Vaccination;
Vaccines
- From:Journal of the Korean Academy of Family Medicine
1998;19(4):326-336
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Korea is one of the endemic areas of viral hepatitis B, and 6-8% of general population are hepatitis B virus carriers. Although there have been little reduction in morbidity and infectivity of viral hepatitis B owlng to newer vaccines and the effects of immunizations, there are some differences among physicians in managing hepatitis B virus infection, and guidelines have not been established. Therefore in this study, we investigated general practitioners' concept and the practical management of viral hepatitis B in comparison with the hepatologists'. METHODS: Information was obtained through questionnaires sent to 67 hepatologists and 400 general practitioners(general internists, general surgeons, family physicians, general physicians, and public health center managers) in Pusan during the 5 months from April to August, 1997. Overall respondents were 142(116 General practitioners, 26 Hepatologists), and the response rate was 32.9%. RESULTS: In general practitioners, the most commonly used serologic test for viral hepatitis was HBsAg/MBsAb(71.0%). 51.9% of subjects underwent anti-HBs test 3-5 months later after vaccination. The most common revaccination method for healthy non-responders of initial vaccination was 3 series of immunizations with the same vaccine of equal dosage (36.9% ). 65.7% of subjects were tested for LFT every 6 months for chronic carriers, and 41.5% of them were advised - interferon treatment for chronic active hepatitis patients only if the patients requested it. In comparison with general practitioners, hepatologists had a tendency to add anti-HCV test for the serologic evaluation of hepatitis(56.6% vs 26.2%), to limit age for vaccination(82.6% vs 54.1% ), and to delay prescribing hepatotonics until the AST and ALT levels increased up to 2 folds normal(53.8% vs 39.1%). 38.5% of hepatologists did not recommend giving booster injection of hepatitis. CONCLUSIONS: Practioal guidelines is necessary to manage viral hepatitis B patients.
