Screening, defining high-risk subjects, and providing optimal antiviral selleck treatment are also important to reduce mortality and morbidity from chronic HBV infection. This study had some limitations. First, bias from the self-reported questionnaire cannot be excluded. Second, HBsAg detection methods differed between KNHANES I, II, III, IV, and V. An automated enzyme immunoassay (ELISA; Bio-Rad Elite microplate) was used in surveys I and II, whereas an ECLIA was used in later tests. Enzyme immunoassays are reliable and easy to perform for mass screening programs, and display a high level of performance [17,18]. The ECLIA is an additional highly sensitive and specific screening assay for HBsAg, including HBV mutants [19], and is widely used in HBsAg screening.

The sensitivity of ELISA and ECLIA testing is over 99% [20] and the concordance rate between the two methods is reportedly as high as 97% [21]. Although the methods used in KNHANES have not been compared directly, differences in HBsAg sensitivity are likely to be minimal. In summary, HBV infection rates have decreased since the adoption of HBV vaccination programs in Korea. The dramatic reduction of HBV infection is more prevalent in the younger population. Among subjects aged 30 to 49 years, HBV infection decreased over the 12-year study period, while the overall prevalence of HBsAg carriers remains around 4%. Additionally, HBV infection remains prevalent in the older Korean population (�� 50 years). Thus, the detection of HBV infection, optimal antiviral treatment, and cost-effective surveillance strategies are still required for the middle-aged and elderly Koreans where HBV prevalence remains high.

KEY MESSAGE 1. Hepatitis B virus (HBV) infection has decresed in the Korean population since the advent of vaccination programs. 2. In our study, the decrease is limited to the younger population, and viral persistence remained in the middle-aged and older population. 3. Therefore, effective surveillance strategies to detect HBV infection in the general adult population are still required for the middle-aged and older population. Footnotes No potential conflict of interest relevant to this article is reported.
To ensure recognition of a broad variety of pathogens, the innate immune system has evolved, through a number of receptors, a strategy to recognize a limited number of conserved pathogen-associated molecular patterns.

These receptors include the Toll-like receptors (TLRs), which are transmembrane receptors expressed in a variety of immune, but also epithelial and transformed cells (1). TLRs are connected to the cell signaling machinery via intracellular adaptor molecules. The first such adaptor molecule to be discovered was MyD88, which has an N-terminal death domain (DD), which recruits Drug_discovery downstream signaling molecules (2). MyD88 is also an adaptor of the interleukin 1 receptor (IL-1R) family signaling.