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혈청 anti - HCV 양성자의 역학 및 가족내 감염과 HBV 표지자에 관한 조사
이헌주(Heon Ju Lee),강호정(Ho Jung Kang),김기덕(Kee Duck Kim),박찬원(Chan Won Park),윤현대(Hyun Dae Yoon),전진종(Jin Chong Chun),최교원(Kyo Won Choi),최희진(Hee Jin Choi) 대한내과학회 1992 대한내과학회지 Vol.43 No.6
N/A Background: Transfusion is a well-known source of hepatitis C virus (HCV) infection but over half of the hepatitis C patients do not have any suspicious source of infection. Epidemiological survey and serological test for HBV marks were done among anti-HCV positive chronic liver disease patient and their family members. Method: 74 cases of anti-HCV postitive chronic liver disease patients were evaluated for the evident source of HCV infection and 188 of their family members were consulted for the infection of HCV. To compare the mode of HBV infection with HCV, serum HBsAg, anti-HBc and anti-HBs were checked in 43 of HBsAg positive chronic liver disease patients, 190 of their family members, 64 anti-HCV postive chronic liver disease patients and 239 of normal control persons. Results: 35cases (47.3%) of 74 anti-HCV positive chronic liver disease patients had no suspicious source of infection and only 16 cases (21.6%) had the history of past transfusion. No family members except 3 (one infant, one IV drug abuser and one wife) in 3 families among 74 families were anti-HCV positive. 29 of 43 (67. 4%) families of HBsAg positive chronic liver disease patients had at least one of HBsAg positive member. Characteristically, HBsAg was positive in almost all cases of offsprings born to mothers of HBsAg and HBeAg positive chronic liver disease. 2 of 64 (3.1%) serum anti-HCV positive patients had HBsAg in their sera. Anti-HBs positive cases were 11 of 64 (17.2%.) anti-HCV positive chronic liver disease patients and isolated anti-HBc positive cases were 40 of 64 (62.5%). On the other hand, in normal control, the positive rate of anti-HBs and isolated anti-HBc were 57,4% and 24.3%(> in each (p<0,005, in both). Conclusion: In Korea, vertical transmission was the main source of HBV infection but HCV disease might be horizontal and sporadic. No remarkable difference in HBV infection rate between anti-HCV positive chronic liver disease patients and control persons. Superinfection of HCV on person who already was exposed to HBV may occur but this assumption could be depend on accurate testings for HBV and HCV. Some derangement in immune system and reaction or interaction between HBV and HCV should be considered in anti- HCV positive patients but before, isolated serum anti- HBc positive sera of chronic liver disease patients should be examined by confirmatory tests. To reduce the number of HCV patients, defining the evident source of the sporadically infected HCV cases could be helpful.
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