No abstract available.
Prevalence ; Humans ; Hepatitis B/*diagnosis/epidemiology/immunology

OBJECTIVETo better understand the proportions of reported hepatitis B cases in pilot surveillance cites through investigation and laboratory testing.

METHODSTo confirm the reported cases of hepatitis B by collecting blood specimen and laboratory testing on HBsAg, IgM of Anti-HBc, Anti-HAV in 18 pilot surveillance counties.

RESULTSAmong 2858 cases of hepatitis B reported in 2006, 23.97% of them were reported as suspected acute cases, 14.87% as acute cases, 20.33% as suspected chronic cases, 34.67% as chronic cases, 4.09% as cirrhosis and 2.06% as HCC. Among 1681 reported hepatitis B cases confirmed by laboratory testing, results showed that 24.16% of them were diagnosed as acute hepatitis B, but only 15.37% were confirmed as acute hepatitis B. Although the proportion confirmed as hepatitis B kept consistent as before, misclassification was found.

CONCLUSIONIn current surveillance system, reported hepatitis B cases were mainly chronic, only up to one third belonged to acute hepatitis B. The reported incidence of hepatitis B did not reflect the real incidence due to misclassification. To better define the burden on hepatitis B disease, it was necessary and urgent to revise the diagnostic criteria and to conduct surveillance on hepatitis B, under separate reporting categories which including acute and chronic cases of the disease.

China ; epidemiology ; Hepatitis B ; diagnosis ; epidemiology ; Hepatitis B Antibodies ; blood ; Humans ; Incidence ; Pilot Projects ; Population Surveillance

BACKGROUND AND AIMS: The etiology of acute viral hepatitis in Korea has been dynamically changing during the recent years. The aim of this study was to investigate the recent etiology and the clinical features of acute viral hepatitis in a single center of Korea. METHODS: We performed a retrospective analysis of a prospective cohort of 55 patients who were diagnosed with acute viral hepatitis A to E during the period from May 2005 to August 2006. In addition to the clinically acute manifestations, the confirmatory serological tests were performed for the diagnosis of acute hepatitis A, B, C and E. RESULTS: The proportion of patients with acute viral hepatitis A, B, C, E and others were 56.4% (n=31), 12.7% (n=7), 18.2% (n=10), 9.1% (n=5) and 3.6% (n=2), respectively. The mean age of the patients with acute hepatitis A, B, C and E were 29.1+/-4.38, 38.7+/-11.72, 45.3+/-17.62 and 32.4+/-6.58 years, respectively. There was no fatal case. All cases of acute hepatitis B and six out of ten cases of acute hepatitis C recovered spontaneously. Four out of the five patients with acute hepatitis E had no history of travel to endemic area. CONCLUSIONS: The most common etiology of acute viral hepatitis in Korea is hepatitis A virus, and hepatitis C and B virus were the next most common causes. The sporadic cases of acute hepatitis E were not rare, and coinfection of HAV and HEV was observed. A multicenter, prospective study is warranted in the future.
Acute Disease ; Adult ; Aged ; Cohort Studies ; Female ; Hepatitis A/diagnosis/epidemiology/virology ; Hepatitis B/diagnosis/epidemiology/virology ; Hepatitis C/diagnosis/epidemiology/virology ; Hepatitis D/diagnosis/epidemiology/etiology ; Hepatitis E/diagnosis/epidemiology/virology ; Hepatitis Viruses/isolation & purification ; Hepatitis, Viral, Human/*diagnosis/epidemiology/*virology ; Humans ; Korea ; Male ; Middle Aged ; Retrospective Studies

Hepatitis E is an infectious viral disease with clinical and morphologic features of acute hepatitis. Although HEV infection is endemic in the Indian subcontinent, Southeast and Central Asia, a large outbreak of hepatitis E was identified in China. Smaller outbreaks have been observed in the Middle East, northern and western parts of Africa, and Mexico. Sporadic hepatitis E also has been observed in several countries. In nonendemic regions, the sporadic cases of hepatitis E are almost always associated with travel to HEV-endemic regions. In Korea, there has been no report on hepatitis E. Recently, we experienced a case of acute icteric hepatitis in which serologic study showed seroconversion of IgM anti-HEV. The patient did not have any travel history to an HEV-endemic area. We report this as an initial case of acute hepatitis E in Korea.
Acute Disease ; Adult ; English Abstract ; *Hepatitis E/diagnosis/epidemiology ; Human ; Korea/epidemiology ; Male

Hepatitis E virus is an enterically transmitted virus that causes endemic cases of acute hepatitis in many countries in Africa, and Southeast and Central Asia. Sporadic cases of acute hepatitis E also have been reported in developed countries. In non-endemic areas, most of the sporadic cases of hepatitis E are introduced from the endemic areas. Until now, only three cases of acute hepatitis E have been reported in Korea. Recently, we experienced nine cases of acute hepatitis, in which serologic studies showed positive of IgM anti-HEV. We report these as cases of acute hepatitis E. These cases suggest that HEV infection occurs sporadically in Korea and should be considered as a cause of cryptogenic acute hepatitis.
Middle Aged ; Male ; Korea/epidemiology ; Humans ; Hepatitis E/diagnosis/*epidemiology ; Female ; Adult ; Acute Disease

Adolescent ; Adult ; China ; epidemiology ; Female ; Hepatitis E ; diagnosis ; epidemiology ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo analyze causes of growing hepatitis E (HE) cases reported in Guizhou province, and probe into existing problems faced by medical institutions in diagnosis of clinical and laboratory-confirmed cases, for the purpose of improving the quality of HE surveillance system.

METHODSSix hospitals reporting greater HE cases from 2007 to 2011 were pinpointed, whose reported cases rose suddenly in 2011. Such cases were investigated by means of impatient medical record review, results of laboratory test and clinician interview.

RESULTS136 of the 354 reported HE cases investigated were found compliant with the diagnostic criteria of HE with an accordance rate of 38.42%. Difference of the HE diagnostic accordance rate among individual years, hospitals and reporting departments was statistically significant. Such rate of hospital reports was found to be the lowest in 2011, ranging from 0 to 18.18% respectively; HE cases reported by non-infectious departments accounted for 61.30% of total cases reported, with its accordance rate considerably below the infectious departments (8.29%). HE positive cases and HE positive rate in 2011 were significantly higher than that of preceding years.

CONCLUSIONSuch increase of reported HE cases in 2011 in the province was mostly attributable to more HE laboratory tests made by the hospitals, yet the accordance rates were lower than satisfactory. In this regard, the medical institutions in question were advised to enhance their competency training for HE diagnosis and case report quality.

China ; epidemiology ; Hepatitis E ; diagnosis ; epidemiology ; Hospitals ; Humans ; Laboratories ; Research Design

BACKGROUND/AIMS: Orientia -tsutsugamushi infection is an acute febrile disease due to the accidental transmission through human skin of forest dwelling vector Leptotrombidium larva. The authors observed liver dysfunctions in patients diagnosed with tsutsugamushi disease (Scrub typhus) in the past 3 years and report the data in the hope of bringing attention to this disease in the differential diagnosis of autumn-season hepatitis, especially of non-A, non-B and non-C hepatitis. METHODS: Medical records of 22 patients diagnosed with tsutsugamushi disease by the hemagglutinin method between October 2000 and November 2002 were reviewed. RESULTS: Female gender was dominant in the ratio of 3.4:1. Mean age was 56.4 +/- 2.6. Admission was between 23rd September and 15th November with the peak between mid October and early November. Fever, being the most common symptom, was observed in 21 cases, myalgia in 13, arthralgia in 12, chills in 6, and skin rash in 6. An incubation period of 7-9 days was most common (10 cases), 13-15 days (4), 10-12 days (3), within 3 days (3), and 4-6 days (2). Average ALT, AST and GGTP were increased to 93.2 +/- 17.3 IU/L (18 +/- 345 IU/L), 92.5 +/- 11.7 IU/L (34-255 IU/L) and 132.2 +/- 14.5 IU/L (19-251 IU/L), respectively, but total bilirubin was normal. All the patients improved with doxycycline therapy. CONCLUSIONS: Since it usually shows liver dysfunction, it is important to take Orientia tsutsugamushi into consideration in differential diagnosis of autumn-season, febrile hepatic disease.
Adult ; Aged ; Diagnosis, Differential ; *Disease Outbreaks ; Hepatitis/*diagnosis/microbiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Scrub Typhus/complications/*diagnosis/epidemiology

BACKGROUND/AIMS: Most cases of hepatitis B virus (HBV) are transmitted vertically in endemic areas of HBV. The positivity of serum HBeAg/HBV DNA in pregnant women is associated with vaccine failure. Recently, a national program for HBV vaccines free of charge in neonates born to HBsAg-positive pregnant women is being performed. The aim of this study was to investigate the positivity of serological markers of HBV in pregnant women in Jeju, which is an island separated from the Korean peninsula and a promising cohort to evaluate the effect of a prevention program of HBV infection. In addition, we investigated the geographic differences in the prevalence of HBV infection because it has been reported that the prevalence of HBV has been high in this area previously. METHODS: Between January 2001 and December 2002, all women who gave delivery were studied retrospectively. Women between the ages of thirty and forty, who received health screening at the Asan Medical Center health promotion center in Seoul, were analyzed as controls. RESULTS: During the study period, 1,030 pregnant women (30.8 +/- 4.3 years) and 7,270 controls (33.1 +/- 5.0 years) were enrolled. The positivity of HBsAg was high in Jeju compared with that of Seoul (6.4% vs. 4.9%) (P=0.036). The positivity of HBeAg/HBV DNA was 31.8% (21/66) in HBsAg-positive pregnant women. The positivity of anti-HBs was low in Jeju compared with that of Seoul (54.5% vs. 68.8%) (P<0.001). CONCLUSIONS: The positivity of HBsAg was found to be high in pregnant women in Jeju. Intensive supervision for HBV infection in pregnant women should be given in this area.
Adult ; DNA, Viral/blood ; English Abstract ; Female ; Hepatitis B/diagnosis/*epidemiology ; Hepatitis B Surface Antigens/blood ; Hepatitis B e Antigens/blood ; Hepatitis B virus/genetics/isolation & purification ; Humans ; Korea/epidemiology ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis/*epidemiology ; Seroepidemiologic Studies ; Serologic Tests

Occult HBV infection is characterized by the absence of serum HBsAg with persistence of low level of intrahepatic HBV DNA. Several suggested mechanisms for the origin of occult HBV infection include strong suppression of viral replication and gene expression, mutation in the regulatory regions of HBV genome, formation of immunoglobulin-bound HBsAg, viral interference, and blockage of HBsAg secretion from infected hepatocytes. Standardized assays are not yet available, and sensitive HBV DNA amplification assay is necessary for the diagnosis of cryptic infection. Detection rate of HBV DNA is highest in IgG anti-HBc positive population. However, neither anti-HBc nor anti-HBs can be detected in a significant proportion of infected persons. Occult HBV infection occurs in a number of clinical settings and is highly prevalent in HCV-infected patients as well as in patients with cryptogenic chronic liver disease including hepatocellular carcinoma.
DNA, Viral/analysis ; Hepatitis B/*diagnosis/*epidemiology/metabolism ; Hepatitis B Antibodies/blood ; Hepatitis B Core Antigens/immunology ; Hepatitis B Surface Antigens/blood ; Humans