Current status of hepatitis C virus infection and countermeasures in South Korea

Abstract

Hepatitis C virus (HCV) infection is a major cause of liver cirrhosis, hepatocellular carcinoma, and liver-related mortality. The new antiviral drugs against HCV, direct acting antivirals, result in >90% cure rate. This review aimed to summarize the current prevalence, clinical characteristics, outcomes, and treatment response associated with HCV infection, and countermeasures for optimal HCV control in South Korea. Based on a literature review, the current anti-HCV prevalence in the Korean population is 0.6 to 0.8%, with increasing prevalence according to age. The major HCV genotypes in Korean patients were genotype 1b and genotype 2. Successful antiviral treatment leads to significantly reduced liver related complications and mortality. However, only about one third of the individuals with HCV infection seem to be managed under the current national health insurance system, suggesting a remarkable rate of underdiagnoses and subsequent loss of opportunity to cure. A recent study in South Korea showed that targeted population screening for HCV infection is cost-effective. To prevent recently developed clusters of HCV infection in some clinics, mandatory surveillance rather than sentinel surveillance for HCV infection is required and governmental countermeasures to prevent reuse of syringes or other medical devises, and public education should be maintained. Moreover, one-time screening for a targeted population should be considered and a cost-effectiveness study supporting an optimal screening strategy is warranted.

Keywords: Control; Epidemiology; Hepatitis C; Screening; Treatment.

Figure 1.

Natural history of hepatitis C virus infection.

Figure 2.

The prospective clinical outcomes of chronic hepatitis C patients in Korea (A and B) [5]. The difference of clinical outcomes of chronic hepatitis C patients among treatment-naive patients (Naive), those who did not achieve a sustained virologic response (Non-SVR), and those with a sustained virologic response (SVR). (C) The composite disease progression rate including development of liver cirrhosis, decompensation, liver cancer, and mortality was lowest in the “SVR” group compared to the “Non-SVR” or “Naive” group. (D) The cumulative probability of liver cancer development was lowest in the “SVR” group compared to the “Non-SVR” or the “Naive” group [5]. HCC, hepatocellular carcinoma.

Figure 3.

The cost-effectiveness analysis of anti-HCV screening for Korean population in their 5th, 6th, and 7th decade, respectively, with various prevalence (A) and treatment rates (B) [10]. QALY, quality adjusted life years.