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Indian Journal of Community Medicine

Seroprevalence of anti-hepatitis C virus antibody in a hospital-based population of Jaipur, Rajasthan

Author(s): Sharma Rajni, Sinha Parul, Bachiwal Rekha, Rishi Suman

Vol. 32, No. 2 (2007-04 - 2007-06)

LETTER TO EDITOR

Year : 2007 | Volume : 32 | Issue : 2 | Page : 158-159

Seroprevalence of anti-hepatitis C virus antibody in a hospital-based population of Jaipur, Rajasthan

Sharma Rajni, Sinha Parul, Bachiwal Rekha, Rishi Suman
Department of Microbiology and Immunology, Sawai Man Singh Medical College, Jaipur, India
Date of Submission 30-May-2006

Correspondence Address:
Sinha Parul
Department of Microbiology and Immunology, Sawai Man Singh Medical College, Jaipur
India

Source of Support: None, Conflict of Interest: None
How to cite this article:
Sharma R, Sinha P, Bachiwal R, Rishi S. Seroprevalence of anti-hepatitis C virus antibody in a hospital-based population of Jaipur, Rajasthan. Indian J Community Med 2007;32:158-9
How to cite this URL:
Sharma R, Sinha P, Bachiwal R, Rishi S. Seroprevalence of anti-hepatitis C virus antibody in a hospital-based population of Jaipur, Rajasthan. Indian J Community Med [serial online] 2007 [cited 2007 Nov 30];32:158-9. Available from: http://www.ijcm.org.in/text.asp?2007/32/2/158/35670

Chronic hepatitis C is a ubiquitous disease affecting around 200 million people worldwide.[1] Infection is usually through contaminated blood and blood products. It may remain silent for many years before manifesting in serious ailments. Only 50% of patients recover; 30% develop persistent viremia with chronic hepatitis and the remaining 20% develop cirrhosis and are at risk of developing hepatocellular carcinoma.[2] The screening test is aimed at detection of anti-hepatitis C virus antibody (Anti-HCV Ab), the presence of which indicates previous exposure to HCV. The antibody is present in only 40% of acute infections but in more than 95% of chronic infections.[2] In India, a carrier rate of 0.12-4% has been found.[1] The global prevalence ranges between 0.2-2%.[2]

The present study was conducted over a period of two years in the clinical microbiology laboratory of Sawai Man Singh Hospital (SMSH) Jaipur to evaluate the seroprevalence of anti-HCV Ab. Study subjects included all the individuals whose blood samples had been received in the laboratory for Anti HCV Ab screening, irrespective of their presenting symptoms. The kits used were HCV Microlisa and HCV Tridot (J. Mitra and Company Limited) for detection of antibodies against HCV core antigens viz NS3, NS4, and NS5. Patients who tested positive were divided into three age-groups: 0 £12 years, 12-35 years, and >35 years. Liver function tests were performed for all positive subjects.

A total of 4014 samples were screened for anti-HCV Ab, out of which 1.7% (72/4014) were found to be positive: 1.6% (28) in 2003 and 1.93% (44) in 2004. A male preponderance of 3:1 and 4:1 was seen in 2003 and 2004, respectively. A seroprevalence of around 1.57% has been found in a hospital-based study in Cuttack, Orissa and 1.4% prevalence has been reported from Delhi.[1]

The maximum proportion of seropositive individuals was seen in the higher age-groups; 76.38% of seropositive individuals were above 35 years of age, 18.05% were between 12-35 years, and 5.55% were under 12 years of age. The prevalence seems to increase with age, either because of the continuing risk of exposure or due to a cohort effect, with a decline in risk in recent times.[3] Moderate elevations of serum glutamic pyruvic transaminase (SGPT) were seen in all anti-HCV Ab positive patients less than 12 years of age, in 61% of those between 12-35 years, and in 77% of those above 35 years of age.

In the present study, 5.5% (4/72) of all the positive samples were also found to be positive for HBsAg, indicating a coinfection. This was similar to the findings of a study in Manipur [4] but higher than that found in other studies. Coinfection with hepatitis B virus implies an increased risk for developing aggressive liver disease and hepatocellular carcinoma.[5]

Transfusion of blood or blood products is a well-documented mode of HCV transmission, but only 12.5% (9) of our cases gave a previous history of blood transfusion. In contrast to hepatitis B, perinatal and sexual transmission rates seem to be very low in hepatitis C. Only one patient in our study appeared to have been infected through sexual transmission: her husband had been HCV positive since a few years and other modes of transmission could be ruled out.

At present there is no vaccine available against hepatitis C. It is necessary that medical and health-care personnel are educated about the dangers and consequences of HCV infections. All anti-HCV Ab positive patients must be considered infectious and must be prohibited from donating blood organs, tissues, and semen. [1] Considering the asymptomatic nature of the infection and its potentially lethal consequences, all blood donors and blood-product recipients must be screened for anti-HCV Ab.

References

1. Mishra S, Chayani N, Sarangi G, Mallick B, Pati SB. Seroprevalence of anti HCV antibody in and around Cuttack, Orissa. Indian J Med Microbiol 2002;20:40-1.
2. Baheti R, Gehlot RS, Baheti R. Seroprevalence of anti HCV Ab in healthy voluntary blood donors and in high-risk individuals. JIACM 2000;1:230-2.
3. Bhattacharya S, Badrinath S, Hamide A, Sujatha S. Seroprevalence of Hepatitis C virus in a hospital based general population in South India. Indian J Med Microbiol 2003;21:43-5.
4. Devi KS, Singh NB, Mara J, Singh TB, Singh YM. Seroprevalence of hepatitis B virus and hepatitis C virus among hepatic disorders and injecting drug users in Manipur: A preliminary report. Indian J Med Microbiol 2004;22:136-7.
5. Hauser SC, Pardi DS, Poterucha JJ. Mayo clinic gastroenterology and hepatology board review. CRC Press: p. 323.

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