1. Mun Hyuk Seong,1 Ho Kil,1 Young Seok Kim,2 Si Hyun Bae,3 Youn Jae Lee,4 Han Chu Lee,5 Byung Hak Kang,6 and Sook-Hyang Jeong1* Clinical and Epidemiological Features of Hepatitis C Virus Infection in South Korea: A Prospective, Multicenter Cohort Study Pf. 심 재준 / R1. 오 신주 Journal of Medical Virology 85:1724–1733 (2013)

2. Introduction Hepatitis C virus (HCV) one of the major causes of chronic liver disease worldwide, affecting approximately 170 million individuals. Patients infected with HCV are at high risk of chronic hepatitis, cirrhosis, and hepatocellular carcinoma(HCC). Studies on the risk factors of HCV infection are limited in Asian countries. HBV infection prevails, and HCV-related liver disease may be under- recognized or of less concern in these regions.

3. Introduction The importance of HCV infection as a cause of liver disease in the new era of HCV therapeutics with direct-acting antiviral agents. However, clinical studies on the current status of HCV infection have been limited in Korea, especially during the last 10 years In the present stduy, Epidemiological and clinical characteristics of HCV infection in Korea were investigated Identified risk factors related to HCV infection HCV cohort VS Comparison group with chronic liver disease unrelated to HCV or HBV infection who visited the same hospitals (non-B non-C liver disease group).

4. Methods Prospective, multicenter cohort 1,173 patients Aged >18 years Positive for anti-HCV antibody by third-generation enzyme immunoassay (EIA) enrolled at five university hospitals January 2007 ~ December 2011. Study Design and Patients

5. Methods Diagnostic categories of HCV-related liver disease Acute hepatitis C – 5% Chronic hepatitis C – 66% Past infection – 3% Cirrhosis – 15% HCC – 10% Study Design and Patients

6. Methods Non-B, non-C liver disease group Comparison group to the HCV cohort 534 patients with various liver diseases not caused by HCV or HBV Nonalcoholic fatty liver (28.6%) Alcoholic liver disease (16.1%), Cryptogenic liver disease (12.5%), Acute hepatitis A virus infection (8.8%) Toxic hepatitis (6.5%) Autoimmune liver disease (5.4%) Pancreaticobiliary disease (5.4%), Liver abscess (2.6%) Liver cysts and hemangioma (1.8%) Other conditions (12.3%) Wilson’s disease, hepatic tuberculosis, FitzHughCurtis syndrome, Gilbert’s syndrome, and abnormal results of liver function test. Study Design and Patients

7. Results Demographic and Socioeconomic Status

8. Comorbidity

9. Liver biopsy & Antiviral treatment received

10. Distribution of HCV Genotypes

11. Independent Risk Factors of HCV Infection in Korea

12. Frequency of Behavioral Risk Factors

14. Conclusion HCV-related liver disease was mostly prevalent in middle-aged and older patients with a slight predominance of women in Korea. Approximately 20% of the patients had cirrhosis or HCC. Genotypes 1b and 2a/c were the major genotypes. Antiviral therapy was attempted in a high percentage (43%) of patients.

15.  The pattern of behavioral risk factors differed according to age, gender, and geographic area.  These epidemiological and clinical features can change dynamically, Continuous monitoring of the epidemiology and clinical characteristics of HCV is warranted in this era of direct-acting antiviral agents for the successful treatment of HCV-related liver disease. Conclusion

16. Thank you !