서울과 경기지역 두 병원의 최근 A형간염 항체 양성률에 대한 비교 조사
Comparison of Recent IgG Anti-HAV Prevalence between Two Hospitals in Seoul and Gyeonggi area
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목적: 급성 A형간염의 발생은 1990년대 후반부터 2000년대에 전국적으로 특히 10-30세 연령에서 점차 증가하고 있으며, 이는 그 연령의 항체 보유율과 연관성이 있으나 최근 항체 보유율의 변화에 대한 보고는 적다. 이에 저자들은 최근 5년간의 A형간염 항체 양성률을 두 지역에서 각 연령대별로 조사하고, 이를 두 지역 간, 성별, 및 검사연도 간에 차이가 있는지를 비교하고자 하였다. 방법: 2002년 1월부터 2006년 12월까지 한양대학교 서울병원과 구리병원을 방문한 4,299명(서울병원 2,380명, 구리병원 1,919명)을 대상으로 IgG anti-HAV (HAV Ab; Roche diagnostic, IN, USA)검사를 이용하여 항체 양성률을 각 연령대별로 지역별, 성별, 검사연도별로 비교 분석하였다. 결과: 피검자의 IgG anti-HAV 양성률은 서울병원과 구리병원에서 각각 1세 미만 52.7%와 57.1%, 1-4세 40.7%와 42.2%, 5-9세 31.8%와 30.3%, 10-14세 24.8%와 27.1%, 15-19세 11.6%와 18.2%, 20-24세 23.0%와 20.3%, 25-29세 40.5%와 42.9%, 30-34세 67.5%와 75.0%, 35-39세 86.5%와 88.1%, 40-44세 95.3%와 93.6%, 45-49세 97%와 98.7%, 50세 이상에서 98.5%와 98.6%였다. 두 지역 간 항체 양성률은 차이가 없었고, 성별에서도 차이가 없었다. 검사년도별 비교에서 2002- 2004년 기간보다 2005-2006년도 기간에 1-9세 연령에서만 항체 양성률이 높았다. 결론: 최근 젊은 연령층 특히 10-24세 연령에서 항체 보유율이 낮아져 있는 것이 확인되었으며 이는 최근 증가한 현증 급성 A형간염의 주요 발생 연령층과 상응하였다. 향후 이러한 연령층에서 A형간염 항체검사와 예방접종의 필요성에 대하여 비용-효과 측면을 고려한 연구가 있어야 한다.
Abstract
Background/Aims: Recently, the incidence of acute hepatitis A has increased nationwide and is related to the low rate of IgG anti-HAV. This study compared the prevalence of IgG anti-HAV in two university hospitals located in a large city and in a small city including a rural region according to age, gender, and the year of diagnosis. Methods: IgG anti-HAV was measured in a total of 4299 patients, who visited Seoul or Guri Hanyang University Hospital between January 2002 and December 2006. Results: The positive rates of the antibody in Seoul and Guri hospitals were 52.7% vs 57.1% in under the age of 1, 40.7% vs 42.2% in age of 1 to 4, 31.8% vs 30.3% in age of 5 to 9, 24.8% vs 27.1% in age of 10 to 14, 11.6% vs 18.2% in age of 15 to 19, 23.0% vs 20.3% in age of 20 to 24, 40.5% vs 42.9% in age of 25 to 29, 67.5% vs 75.0% in age of 30 to 34, 86.5% vs 88.1% in age of 35 to 39, 95.3% vs 93.6% in age of 40 to 44, 97.0% vs 98.7% in age of 45 to 49, and 98.5% vs 98.6% in patients who were more than 50, respectively. The positive rates of the antibody were not significantly different between two sites according to each age group and gender. Conclusions: The results confirmed the low rates of IgG anti-HAV, particularly in the ages of 10-24 that match the age group of recently increased incidence of acute hepatitis A nationwide. Therefore, measurement of the antibody and vaccination should be considered in this age group. (Korean J Hepatol 2007;13:363-369)
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