Seroprevalence Study of Hepatitis C in Leprosy Patients / 나학회지

ABSTRACT

Hepatitis C is transmitted via parenteral routes and has commonly chronic course with progression to liver cirrhosis and hepatocellular carcinoma. The seroprevalence of HCV in Korea is about 1%, but in leprosy patients it is not well-known. So, the study was performed on anti-HCV seroprevalence and its epidemiologic survey in leprosy patients. The leprosy patients were 619 subjects(M343, F276) who were hospitalized in Catholic Skin Clinic from 1997 to 2001. Serum anti-HCV was checked by MEIA(Microparticle Enzyme Immunoassay) method, as well as HBsAg, HBsAb and alanine aminotransferase(ALT) value. In addition, age, sex, residency, duration of leprosy, and the frequency of liver problems were reviewed by medical records. The results were as follows; 1. The mean age of subjects was 68.3+/-9.2 years with ranging from 28 to 94 years. 2. The anti-HCV seropositivity among 619 leprosy patients was 39.3% and it showed increasing trend with aging(p0.05). 3. The residency of anti-HCV positive subjects were Gyeongbuk(40.7%), Gyeongnam(35.4%), Daegu(19.4%), and other areas(28.9%) in order. 4. The seropositivities of HBsAg and HBsAb were 4.5% and 11.8% respectively. Only 6(2.5%) patients were positive on both HBsAg and anti-HCV. 5. In 563 leprosy patients excluding unknown type(56 subjects), the anti-HCV seropositivities in leprosy type were 41.2%(163/396) in lepromatous leprosy(LL), 35.0%(14/40) in borderline leprosy(BB), 31.5%(40/127) in tuberculoid leprosy(TT) respectively with insignificant correlation(p>0.05). The HBsAg seropositivities were 4.8% in LL, 5.0% in BB, 3.1% in TT respectively, with insignificant correlation(p>0.05). 6. There were significant relationships between the seroprevalence of anti-HCV and the duration of leprosy in the well-recorded 433 leprosy patients (p or =40U/L) group was significantly higher than in normal group(<40U/L)(58.3% vs 37.2%, p<0.05). Of the 6 anti-HCV and HBsAg positive patients, ALT value was elevated in one patient. Comparatively, the anti-HCV positives were likely to have a higher incidence of liver problems. In conclusion, the seropositivity of anti-HCV in leprosy patients(39.3%) was high. There were significant relationship of the seropositivity of anti-HCV with age, duration of leprosy, residency, ALT value, and the frequency of liver problems, but not associated with sex, HBV markers and types of leprosy. Therefore check-up of routine biochemical screen of anti-HCV and the evaluation for the possible transmission routes (such as transfusion, drug abuse, sexual/household contact, shared needles, folk remedies, acupunctures, tattoos, etc.) are needed to set-up the precautionary measures in leprosy patients.