{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:25:03Z","timestamp":1783596303970,"version":"3.55.0"},"reference-count":18,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Cancer Center, Republic of Korea","award":["NCC-2310710"],"award-info":[{"award-number":["NCC-2310710"]}]},{"name":"National Cancer Center, Republic of Korea","award":["NCC-2610400"],"award-info":[{"award-number":["NCC-2610400"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,4,30]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hepatitis C virus (HCV), a major cause of chronic liver disease, shows decreasing prevalence in Korea, yet regional disparities persist. This study aimed to examine the impact and temporal changes in individual characteristics and regional health inequalities on HCV infection to provide a framework for HCV elimination and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nationwide population-based multilevel case\u2013control study analysed 252\u2009993 patients with HCV and 4\u2009000\u2009000 controls using National Health Insurance Service (NHIS) and population census data from 2005, 2010, 2015 and 2020. The Area Deprivation Index (ADI) was calculated for each area (region\/town) using population census data. Sex-standardised and age-standardised HCV prevalences were estimated for each area using NHIS data. The association between area-level HCV and ADI was examined using correlation and linear regression analyses. Individual-level and area-level HCV infection risks were estimated using logistic regression and multilevel logistic regression models incorporating sex, age, HCV prevalence and ADI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The HCV prevalence (per 100 000) decreased from 151 to 117 (2005\u20132020). The maximum inter-area ADI gap decreased modestly (34.64 to 32.50). Although the correlation between ADI and HCV prevalence was weak across all areas, it was markedly stronger in high-prevalence areas (\u2265200\/100 000). In logistic regression, residents of the most deprived areas had elevated risks vs the least deprived (2020 adjusted OR 1.37). Multilevel models showed age (individual level) and area HCV prevalence (area level) were dominant determinants. Deprivation increased an individual\u2019s odds of HCV case status in ADI-only models; however, this association was not statistically significant after adjusting for area-level HCV prevalence and individual factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Effective HCV elimination requires tailored screening and treatment strategies that prioritise socioeconomically vulnerable areas among the high-prevalence areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003993","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:00:17Z","timestamp":1783594817000},"page":"e003993","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Area deprivation and hepatitis C infection in Korea: a multilevel case\u2013control study using the National Health Insurance Database"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8195-9250","authenticated-orcid":false,"given":"Hwa Young","family":"Choi","sequence":"first","affiliation":[{"name":"Public Health & AI, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7112-3740","authenticated-orcid":false,"given":"Dahye","family":"Baik","sequence":"additional","affiliation":[{"name":"Public Health & AI, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8892-7104","authenticated-orcid":false,"given":"Moran","family":"Ki","sequence":"additional","affiliation":[{"name":"Public Health & AI, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Korea (the Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"2026070904000920000_4.3.e003993.1","doi-asserted-by":"crossref","unstructured":"World Health Organization . Global Hepatitis Report 2024: Action for Access in Low-And Middle-Income Countries. Geneva: World Health Organization, 2024.","DOI":"10.54394\/CJQU6666"},{"key":"2026070904000920000_4.3.e003993.2","unstructured":"Korea Disease Control and Prevention Agency . Infectious disease portal: infectious disease statistics, 2026. Available: https:\/\/dportal.kdca.go.kr\/pot\/is\/summaryEDW.do [Accessed 17 Mar 2026]."},{"key":"2026070904000920000_4.3.e003993.3","doi-asserted-by":"crossref","first-page":"249","DOI":"10.3350\/cmh.2015.21.3.249","article-title":"Comparison and analysis of the prevalence of hepatitis C virus infection by region in the Republic of Korea during 2005-2012","volume":"21","author":"Shon","year":"2015","journal-title":"Clin Mol Hepatol"},{"key":"2026070904000920000_4.3.e003993.4","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s12072-019-09975-y","article-title":"The change in the nationwide seroprevalence of hepatitis C virus and the status of linkage to care in South Korea from 2009 to 2015","volume":"13","author":"Jang","year":"2019","journal-title":"Hepatol Int"},{"key":"2026070904000920000_4.3.e003993.5","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1111\/liv.12108","article-title":"A nationwide seroepidemiology of hepatitis C virus infection in South Korea","volume":"33","author":"Kim","year":"2013","journal-title":"Liver Int"},{"key":"2026070904000920000_4.3.e003993.6","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1080\/09603123.2019.1566522","article-title":"Association of social deprivation and outdoor air pollution with pulmonary tuberculosis in spatiotemporal analysis","volume":"29","author":"Sohn","year":"2019","journal-title":"Int J Environ Health Res"},{"key":"2026070904000920000_4.3.e003993.7","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmph.2023.101580","article-title":"Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors","volume":"25","author":"Lee","year":"2024","journal-title":"SSM Popul Health"},{"key":"2026070904000920000_4.3.e003993.8","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S43926"},{"key":"2026070904000920000_4.3.e003993.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0135656","article-title":"The Spatial Distribution of Hepatitis C Virus Infections and Associated Determinants--An Application of a Geographically Weighted Poisson Regression for Evidence-Based Screening Interventions in Hotspots","volume":"10","author":"Kauhl","year":"2015","journal-title":"PLoS One"},{"key":"2026070904000920000_4.3.e003993.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-13089-w","article-title":"Analysis of the association between areal socioeconomic deprivation levels and viral hepatitis B and C infections in Japanese municipalities","volume":"22","author":"Okui","year":"2022","journal-title":"BMC Public Health"},{"key":"2026070904000920000_4.3.e003993.11","first-page":"99","article-title":"Comparative analysis of official population statistics","volume":"28","author":"Kim","year":"2017","journal-title":"J Korean Data Inf Sci Soc"},{"key":"2026070904000920000_4.3.e003993.12","doi-asserted-by":"crossref","first-page":"27","DOI":"10.14367\/kjhep.2015.32.2.27","article-title":"Relationship between local authority deprivation and activity limitation in adults aged 50 or over","volume":"32","author":"Yoon","year":"2015","journal-title":"Korean Journal of Health Education and Promotion"},{"key":"2026070904000920000_4.3.e003993.13","first-page":"54","article-title":"Relative regional deprivation in Korea: current state and trends","volume":"272","author":"Choi","year":"2019","journal-title":"Health Welf Forum"},{"key":"2026070904000920000_4.3.e003993.14","unstructured":"Kim DJ , Kim MH , Kim YM , et al . Health inequality indicators and policy tasks in korea: strategies for reducing health inequality research report 2015-04. Sejong: Korea Institute for Health and Social Affairs; 2015."},{"key":"2026070904000920000_4.3.e003993.15","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyw253"},{"key":"2026070904000920000_4.3.e003993.16","unstructured":"National Health Insurance Statistical Yearbook . Wonju: health insurance review and assessment service. NHIS, Health Insurance Review and Assessment Service, National Health Insurance Service 2023; 2024."},{"key":"2026070904000920000_4.3.e003993.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-025-21777-6","article-title":"Temporal and geospatial patterns of hepatitis C virus prevalence: a longitudinal examination using national health insurance service data in the Republic of Korea (2005-2022)","volume":"25","author":"Choi","year":"2025","journal-title":"BMC Public Health"},{"key":"2026070904000920000_4.3.e003993.18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.annepidem.2021.04.011","article-title":"Inverse probability weighting for selection bias in a Delaware community health center electronic medical record study of community deprivation and hepatitis C prevalence","volume":"60","author":"Goldstein","year":"2021","journal-title":"Ann Epidemiol"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003993","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:00:27Z","timestamp":1783594827000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003993"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,7,9]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjph-2025-003993"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003993","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}