Current status of liver disease in Korea: hepatitis C

Chronic hepatitis C (CHC) is the third most common cause of chronic liver disease and hepatocellular carcinoma (HCC) in Korea, following hepatitis B virus (HBV) infection and alcohol. HCV prevalence among Koreans older than 40 years of age has been estimated to be 1.29%. The prevalence of CHC increases with age, with the peak prevalence at the age of 60 or older. Blood transfusions have generated no risk of HCV infection since April 1991, when routine screening for anti-HCV in blood donors was adopted in Korea. Although injection drug use seems to be one of the most important risk factors of HCV infection among young adults in urban areas, the majority of CHC patients are not associated with injection drug use. Exposure to acupuncture was identified as a significant risk factor among older adults in rural areas. The mean age of patients with HCV-related cirrhosis and HCC was consistently about 10 years above that of patients associated with HBV. Genotypes 1b and 2a are the two most common types with almost equal proportions, and other genotypes are extremely rare. Korean patients with CHC have a high likelihood of responding to combination therapy with pegylated interferon and ribavirin, with a sustained virological response rate of 60-70% in patients with genotype 1 and 85-90% in those with genotype 2.