In February 2019, the order Bunyavirales, previously family Bunyaviridae, was amended by new order of 10 families including Hantaviridae family, and now accepted by the International Committee on Taxonomy of Viruses (ICTV). Hantaviridae is now a family of the order Bunyavirales, and the prototype virus species is Hantaan orthohantavirus. The family Hantaviridae is divided into four subfamilies including Mammantavirinae, Repantavirinae, Actantavirinae and Agantavirinae. The subfamily Mammantavirinae is divided into four genera including Orthohantavirus, Loanvirus, Mobatvirus and Thottimvirus. The four Hantavirus species have been found in Korea including three Orthohantaviruses (Hantaan orthohantavirus, Seoul orthohantavirus and Jeju orthohantavirus) and one Thottimvirus (Imjin thottimvirus).
Bunyaviridae ; Classification ; Hantaan virus ; Hantavirus ; Humans ; Korea ; Seoul ; Virology

PURPOSE: We aimed to identify the epidemiology and the clinical characteristics of human parainfluenza virus type 4 (HPIV-4) infection compared to HPIVs 1–3 infections in Korean children. METHODS: We reviewed medical records of children with HPIV infection who visited Seoul National University Children's Hospital from 2015 to 2017. Detection of respiratory viruses was performed using real time-polymerase chain reaction (rt-PCR), which could differentiate HPIVs 1–4. Diagnosis was classified as a febrile illness, upper respiratory tract infection (URI), croup, bronchiolitis, or pneumonia. The epidemiology, demographic features, and clinical characteristics among HPIV types were compared. The clinical data were analyzed only for the previously healthy children. RESULTS: Of the 472 children diagnosed with HPIV infection, 108 (22.9%) were previously healthy: 24 (22.2%), 19 (17.6%), 39 (36.1%), and 26 (24.1%) in HPIV types 1, 2, 3, and 4, respectively. The median age of children with HPIV-4 infection was 11 (0–195) months: the proportion of children aged < 2 years and 2 to < 5 years were 65.4% and 19.2%, respectively. Clinical diagnoses of HPIV-4 infection were bronchiolitis (38.5%), pneumonia (30.8%), and URI (30.8%). Croup was the most prevalent in HPIV-2 (21.1%) and none in HPIV-4 infection (P=0.026). Hospital admission rates among HPIV types were not significantly different (P> 0.05). CONCLUSIONS: We observed seasonal peak of HPIV-4 infection in 2015 and 2017. HPIV-4 was a common respiratory pathogen causing lower respiratory tract infection in hospitalized children.
Bronchiolitis ; Child ; Child, Hospitalized ; Croup ; Diagnosis ; Epidemiology ; Humans ; Medical Records ; Parainfluenza Virus 4, Human ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Tract Infections ; Seasons ; Seoul

BACKGROUND/AIMS: The renal effects of nucleos(t)ide analogs in patients with chronic hepatitis B are controversial. We aimed to compare the impact of entecavir (ETV) and tenofovir (TDF) on renal function in patients with hepatitis B virus (HBV)-related cirrhosis. METHODS: We performed a retrospective cohort study of 235 consecutive treatment-naïve patients with HBV-related cirrhosis who were treated with ETV or TDF between December 2012 and November 2013 at Severance Hospital, Seoul, Korea. RESULTS: Compensated cirrhosis was noted in 183 patients (ETV 130, TDF 53), and decompensated cirrhosis was noted in 52 patients (ETV 32, TDF 20). There were no significant changes in estimated glomerular filtration rates (eGFR) from baseline in either the ETV- or TDF-treated groups at week 96 (Chronic Kidney Disease Epidemiology Collaboration, ETV −1.68% and TDF −5.03%, p=0.358). Using a multivariate analysis, the significant factors associated with a decrease in eGFR >20% were baseline eGFR, diabetes mellitus (DM), and the use of diuretics. The use of antiviral agents and baseline decompensation were not determined to be significant factors. CONCLUSIONS: In patients with HBV-related cirrhosis, TDF has shown similar renal safety to that of ETV over a 2-year period. Renal function should be closely monitored, especially in patients who exhibit decreasing eGFR, DM, and the use of diuretics.
Antiviral Agents ; Cohort Studies ; Cooperative Behavior ; Diabetes Mellitus ; Diuretics ; Epidemiology ; Fibrosis* ; Glomerular Filtration Rate ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Kidney Diseases ; Korea ; Multivariate Analysis ; Retrospective Studies ; Seoul ; Tenofovir*

Few studies have compared outcomes in patients undergoing liver transplantation (LT) for hepatitis B virus (HBV) and alcoholic liver disease (ALD) in Asian countries in which living donor LT (LDLT) is dominant, where HBV is endemic and where there are no strict regulations on pre-transplant abstinence for ALD. This study compared post-LT outcomes of deceased donor LT (DDLT) in patients with ALD and HBV. Data from 220 patients who underwent primary DDLT at Seoul National University Hospital from January 2010 to December 2014, including 107 with HBV and 38 with ALD, were retrospectively analyzed. Seventy-four patients (69.2%) in the HBV group and 30 (78.9%) in the ALD group had United Network for Organ Sharing (UNOS) status 2A (P = 0.250). There were no significant differences in their 1-year (90.7% vs. 92.1%) and 3-year (82.1% vs. 82.3%) overall survival rates (P = 1.000). Multivariate analysis showed that high serum gamma glutamyltransferase concentration (≥ 70 IU/L) was independently prognostic of 1-year post-LT overall survival. Survival outcomes following DDLT were similar in Korean patients with ALD and HBV, even in the absence of strict pre-transplant abstinence from alcohol as a selection criterion.
Alcoholics* ; Asian Continental Ancestry Group ; gamma-Glutamyltransferase ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Liver Cirrhosis ; Liver Diseases, Alcoholic* ; Liver Transplantation* ; Liver* ; Living Donors ; Multivariate Analysis ; Retrospective Studies ; Seoul ; Social Control, Formal ; Survival Rate ; Tissue Donors*

PURPOSE: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. METHODS: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. RESULTS: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4.8% for LT and 2.9% for KT). PTLD usually presented with fever or gastrointestinal symptoms in a median period of 7 months after SOT. Eight cases had malignant lesions, and all the patients except one had evidence of Epstein-Barr virus (EBV) involvement, assessed by using in situ hybridization of tumor tissue or EBV viral load quantitation of blood. Remission was achieved in all patients with reduction of immunosuppression and/or rituximab therapy or chemotherapy, although 1 patient had allograft kidney loss and another died from complications of chemotherapy. The first case of PTLD was encountered after the introduction of tacrolimus for pediatric SOT in 2003. The recent increase in PTLD incidence in KT coincided with modification of clinical practice since 2012 to increase the tacrolimus trough level. CONCLUSION: While the outcome was favorable in that all patients achieved complete remission, some patients still had allograft loss or mortality. To prevent PTLD and improve its outcome, monitoring for EBV infection is essential, which would lead to appropriate modification of immunosuppression and enhanced surveillance for PTLD.
Allografts ; Child ; Drug Therapy ; Epstein-Barr Virus Infections ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; Immunosuppression ; In Situ Hybridization ; Incidence ; Kidney ; Kidney Transplantation ; Liver ; Lymphoproliferative Disorders* ; Male ; Medical Records ; Mortality ; Organ Transplantation* ; Retrospective Studies ; Rituximab ; Seoul ; Tacrolimus ; Transplants* ; Viral Load

BACKGROUND/AIMS: Quantification of hepatitis B surface antigen (HBsAg) is an emerging serologic test and may be useful for identifying treatment strategies for chronic hepatitis B (CHB). This study aimed to evaluate HBsAg titers during the natural course of CHB and identify correlations between HBsAg titers and hepatitis B virus (HBV) DNA concentrations across different CHB phases measured using an immunoradiometric assay (IRMA). METHODS: CHB phases were defined on the basis of HBV DNA concentrations, the presence of hepatitis B e antigen/antibody (HBeAg/Ab) and serum alanine aminotransferase levels. Serum HBsAg titers and paired HBV DNA concentrations in the different phases of CHB were compared using 627 serum samples. RESULTS: Mean HBsAg titers were significantly higher in the immunotolerant (IT) phase and immunoreactive (IR) HBeAg-positive phase than in the low-replicative (LR) and HBeAg-negative CHB (ENH) states. The correlation between HBsAg titers and HBV DNA concentrations was modest in the IT (n=36, r=0.804, p<0.001) and IR (n=48, r=0.773, p<0.001) phases, and it was poor in the LR state (n=116, r=0.289, p=0.002); however, no significant correlation was observed in the ENH state (n=67, r=0.146, p=0.237) or in the oral nucleos(t)ide analogue-treated group (n=267). CONCLUSIONS: HBsAg quantification using IRMA might be useful for discriminating different CHB phases and different stages of chronic liver disease.
Adult ; Alanine Transaminase/blood ; Biomarkers/blood ; DNA, Viral/*blood ; Disease Progression ; Female ; Hepatitis B Surface Antigens/*blood ; Hepatitis B e Antigens/blood ; Hepatitis B virus/*genetics/immunology ; Hepatitis B, Chronic/*immunology ; Humans ; *Immunoradiometric Assay ; Male ; Middle Aged ; Seoul ; Viral Load ; Virus Replication

Korea declared in 2006 that measles had been eliminated; however, a measles outbreak occurred in the southeastern area of Korea in 2011. Active surveillance of measles patients was conducted in Seoul 3 cases were detected in 2013 and 103 cases in 2014. Of 106 confirmed measles patients, 32 cases were within one university in Seongbukgu, and 23 were within three schools in Yongsangu. Students 14~29 years old comprised 78.3% (83/106) of the cases, and 75.5% (80/106) of the measles viruses were of genotype B3. One foreign traveler played an important role in the measles outbreak in Seoul. This measles outbreak in Seoul may provide useful data for future epidemiological studies of measles.
Epidemiologic Studies ; Genotype ; Humans ; Korea ; Measles virus ; Measles* ; Seoul*

Hepatitis A virus (HAV) positive stool samples were collected from acute hepatitis A patients during the two study periods of 2002 and 2011 in Seoul, South Korea, and their genetic variability was determined. From a total of 79 specimens, the nucleotide sequences of the VP1 and 2A junction were successfully amplified in 27 (34.2%) samples and subjected to sequence analysis. Genetically, there was a dramatic change in HAV subgenotypes from IA to IIIA during the past ten years. Sequence analysis identified that most strains belonged to genotype I, which is the main genotype globally. The subgenotype IA (93.3%, n=13/14) was the major subgenotype in 2002, whereas the subgenotype IIIA (69.2%, n=9/13) was predominant in 2011. Interestingly, a IIIA strain was identified from a patient who had a history of travel to India in 2002. The finding presented provides new insight into the genetic shift of circulating HAVs in South Korea.
Base Sequence ; Genetic Variation ; Genotype* ; Hepatitis A ; Hepatitis A virus* ; Humans ; India ; Korea ; Seoul ; Sequence Analysis

BACKGROUND: The Elecsys hepatitis B surface antigen (HBsAg) II quantitative assay is a newly introduced electrochemiluminescence immunoassay incorporating an initial 1:400 onboard dilution and a simple algorithm to determine HBsAg levels in serum. We evaluated the performance of the Elecsys HBsAg II assay and determined the impact of its initial onboard dilution on laboratory efficiency. METHODS: HBsAg levels were determined using both Roche Elecsys and Abbott Architect HBsAg assays. Linearity and precision of the Elecsys HBsAg II assay and its correlation with the Architect HBsAg assay were evaluated. In particular, precision was verified at Samsung Medical Center, Severance Hospital, Seoul St. Mary's Hospital in Seoul, using the same pooled serum controls. The efficiency of the dilution algorithm for both methods was verified using data from 1,848 clinical samples. RESULTS: The Elecsys HBsAg II assay showed a good linearity from 0.1 to 48,000.0 IU/mL and a good correlation (r=0.9998) between expected and measured values. Precision analyses performed at Samsung Medical Center, Severance Hospital, Seoul St. Mary's Hospital showed excellent performance with coefficients of variation between 1.28% and 6.82%. The values of the Elecsys HBsAg II and Architect HBsAg assays were well correlated (n=506, r=0.987, P<0.001) and also reliably determined in hepatitis C virus- and hepatitis B virus-co-infected patient sera (n=27). In terms of efficiency, 64.0% of samples provided a final HBsAg result on the first run without the need for further dilution, when using the 1:400 onboard pre-dilution protocol of the Elecsys HBsAg II assay. CONCLUSIONS: Given the excellent precision and correlation with the Architect assay, the Elecsys HBsAg II assay showed a potential advantage for laboratory efficiency by significantly reducing the need for retesting samples with high HBsAg levels.
Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis C ; Humans ; Immunoassay ; Seoul

Background: Hantavirus causes two distinct human diseases: Hemorrhagic Fever with Renal Syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS). Hantaviruses are maintained in the rodent reservoir and are transmitted to humans via contaminated excreta or bites. Objectives: This study aims to identificate of Seoul virus in R.novergicus in Hai phong port. Material and method: In this study, we trapped 25 of R. novergicus. Results:The results show four R. novergicus are positive for Seoul virus. Partial M segment sequence was recovered from the lung tissue of R. novergicus trapped in Hai Phong port in 2006. M segment of the Seoul virus of Hai Phong sequenced shown is similar to M segment of the Seoul virus of Hanoi. Conclusion:We discovered the Seoul virus in R.novergicus in Hai Phong port in 2006. The sequence belongs to the Seoul virus genotype and is most closely related to the strain B-1 from Japan and the strain AJ620583 from Indonesia.\r\n', u'\r\n', u'
Seoul virus ; R.novergicus ; Hai phong port