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바이러스간염의 예방과 예방접종

Prevention of Viral Hepatitis and Vaccination

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초록

최근에 급성A형간염이 급격하게 증가하고 있고 특히 20대 이하의 연령에서 발병이 많다. 최근 우리나라에서는 1-3세 사이 연령의 소아에서 A형간염 예방접종을 권장하고 있으나 기타 접종군으로 분류하고 있다. 그러나 소아 연령에서의 무증상 A형간염인 환자가 가장 중요한 감염원임을 고려하여 필수 예방접종 사업으로 분류되어야 한다. 우리나라에는 만성 B형간염을 포함한 만성 간질환자가 많고 이들에게서 급성A형간염이 동반되는 경우 예후가 매우 불량하므로 이들에 대한 예방접종도 필수라고 하겠다. HBV의 경우 모든 신생아를 대상으로 필수 접종 사업으로 시행되고 있으나, 아직도 성인 일부에서 HBV에 대한 혈청지표가 모두 음성인 경우가 드물지 않다. 특히 B형간염의 주 감염원이 수직감염과 성행위를 통한 감염임을 고려할 때 anti-HBS 음성인 20대 미만 청소년들에게 체계적인 B형간염 예방접종에 대한 계획이 있어야 할 것이다. 또한 10-20대 청소년들은 현재 우리나라에서 급성A형간염 혹은 급성B형간염의 위험도가 가장 높은 연령대로 이들에게 간염 예방 방법 및 예방접종의 중요성에 대한 홍보가 정책적으로 필요하다고 하겠다. 그러나 C, E형간염은 현재까지 사용 가능한 백신이 없는 관계로 위험인자를 피하는 것이 중요하고 환자 개개인에 감염 전파를 방지하기 위한 교육이 매우 중요할 것이다.

Abstract

Hepatitis viruses are most important cause of acute and chronic hepatitis. In past, hepatitis B virus was one of the major causes of acute hepatitis. Recently, around 60-70% of acute hepatitis is attributed to hepatitis A virus infection. In this article, we will discuss the route of hepatitis virus infection, how to prevent transmission of viral hepatitis and who should be immunized to each hepatitis viruses.

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