Persistent hepatitis burden in a geographically isolated and medically underserved population: a community-based study

Abstract

Abstract Ulleung County is a geographically isolated and medically underserved region in South Korea with a persistently high incidence of liver cancer. Using a community-based approach, this study aimed to estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and to identify associated risk factors. As part of the Ulleung Liver Cancer Prevention and Management Project, an interagency workgroup implemented community-based screening and health behavior surveys. Between 2019 and 2022, a total of 1,792 residents aged ≥ 40 years voluntarily participated, and data from 1,684 participants were analyzed. The prevalence of hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) positivity was 7.19% and 1.37%, respectively. Lower educational attainment and lifetime smoking were significantly associated with HBsAg positivity, whereas cupping therapy performed at non-medical institutions was associated with anti-HCV positivity. HBsAg positivity was lower among individuals with tattoos. Although the high prevalence of HBV infection alone may not fully explain the elevated incidence of liver cancer in Ulleung County, it likely represents an important contributing factor. These findings highlight the value of community-based screening strategies for informing tailored hepatitis prevention efforts in geographically isolated populations.