McKayla Sheriff

BIO 1615 Summary

Seroprevalence and Risk Factors for Hepatitis C Virus Infection Among Female Commercial Sex
Workers in South Korea Who Are Not Intravenous Drug Users
Hepatitis C Virus, otherwise known as HCV, is an infection that is caused by a virus that
attacks the liver and leads to inflammation. (Mayo Clinic). It is a fairly common infection with
more than 200,000 cases in the United States each year. This virus is most commonly spread by
contact to contaminated blood. This is why intravenous drug users are at such a high risk for the
disease.
Although there is a good amount of research on the topic in the United States, there is a
lack of information on the virus and its risk factors in South Korea. In previous studies, it has
been suggested that the prevalence of HCV may be higher among commercial sex workers
(CSW) than the general population. However, because of the small group of people and small
area that was tested, the results of this study are very limited.
The study was done to estimate the prevalence among female commercial sex workers
who were not intravenous drug users and who were seronegative for human immunodeficiency
virus (HIV). Researchers also evaluated the independent contribution of sexual activity to
hepatitis C virus transmission.
Between January and July 2004, a cross-sectional survey was performed in South Korea.
More specifically, the study was performed in the Jeollanam-do Province. Participants were
recruited from three local seaside areas as well as two inland areas nearby. Researchers used the
public health centers list of female CSW to choose potential participants. Each participant was
required to be older than nineteen, and been identified as trading sex for money. 68.4% of the
2,234 eligible participants agreed to take part in the study.

Blood samples from participants were collected in jelly vacuum tubes and were tested for
syphilis and HIV at each health center lab, as well as HCV and hepatitis B virus. Third
generation enzyme-linked immunosorbent assays were performed to detect antibodies of HCV
and HBV. ELISA plate processors helped identify previous HIV infection as well. In order to
determine the results of the syphilis and HIV testing, researchers traced the lab data of each
health center and the registered data of that time. Participants who had been exposed to potential
risk factors such as acupuncture more than once, were considered positive for that risk factor. If
hepatitis C was found in the history of an immediate family member of the subject, it was
considered to be the presence of HCV.
Variables such as years spent as a commercial sex worker, age, etc. were grouped as
categorical variables. Chi-square test, students t-test, and Fishers exact test were used to
compare for associations of HCV status. Significant previously identified risk factors were
included in the model. All of these factors were used to obtain the results of the study.
There were not any significant differences in ago or seropositivity for syphilis between
those from South Korea that participated, and those that did not. No cases of intravenous drug
use or cases of HIV were found. Only 1.4% of subjects were positive for antibodies to HCV. The
study showed that age, history of hemodialysis, use of acupuncture, and diabetes mellitus were
associated with increased risk of being positive to HCV. Factors such as family history of HCV,
prior surgery and blood transfusion, were not associated with the risk of HCV. Only 2.7% of
participants were seropositive for syphilis, which may have been associated primarily with those
who had been CSW for more than three years. Studies also showed that HCV was significantly
associated with diabetes.

The results suggest that the prevalence of antibodies to HCV in female CSWs without
HIV or a history of IDU was no higher than the general population in South Korea. Although
evidence indicated the sexual transmission is the second highest risk factor for HCV, its
debatable whether it is an independent risk factor because of the puzzling effect of coexisting
intravenous drug use. Sexual activity is less of a risk factor than acupuncture and diabetes in
female CSWs who are not already IDUs. The results from this study may differ as compared to
other countries results because none of the participants were previously IDUs because illicit drug
use is strictly banned in South Korea.