Shaun Shadaker1, Ajit Sood2, Francisco Averhoff1, Anil Suryaprasad3, Subodh Kanchi4, Vandana Midha2, Saleem Kamili1, Muazzam Nasrullah1, Adam Trickey5, Ravinder Garg6, Pramod Mittal7, Suresh K Sharma8, Peter Vickerman5, Paige A Armstrong1. 1. Division of Viral Hepatitis, Centers for Disease Control and Prevention, NCHHSTP, Atlanta, GA, 30333, USA. 2. Dayanand Medical College, Department of Gastroenterology, Civil Lines, Tagore Nagar, Ludhiana, Punjab, 141001, India. 3. Mayo Clinic, Jacksonville, FL, 32224, USA. 4. MSD India Pvt. Ltd., Mumbai, India. 5. School of Social and Community Medicine, University of Bristol, Bristol, UK. 6. Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, 151203, India. 7. Mittal Liver and Gastroenterology Centre, Patiala, Punjab, India. 8. College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249201, India.
Abstract
Background: The prevalence of hepatitis B virus (HBV) infection in Punjab, India, is unknown. Understanding the statewide prevalence and epidemiology can help guide public health campaigns to reduce the burden of disease and promote elimination efforts. Methods: A cross-sectional, population-based survey was conducted from October 2013 to April 2014 using a multistage stratified cluster sampling design. All members of selected households aged ≥5 years were eligible. Participants were surveyed for demographics and risk behaviors; serum samples were tested for total antibody to hepatitis B core (total anti-HBc), hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (anti-HCV), and HCV RNA. HBsAg-positive specimens were tested for HBV genotype. Results: A total of 5543 individuals participated in the survey and provided serum samples. The prevalence of total anti-HBc was 15.2% (95% confidence interval [95% CI]: 14.1-16.5) and HBsAg was 1.4% (95% CI: 1.0-1.9). Total anti-HBc positivity was associated with male sex (adjusted odds ratio [aOR] 1.46; 95% CI: 1.21-1.75), older age (aOR 3.31; 95% CI: 2.28-4.79 for ≥60 vs. 19-29 years), and living in a rural area (aOR 2.02; 95% CI: 1.62-2.51). Receipt of therapeutic injections in the past 6 months also increased risk (4-8 injections vs. none; aOR 1.39; 95% CI: 1.05-1.84). Among those positive for total anti-HBc, 10.4% (95% CI: 8.1-13.2) were also anti-HCV positive. Conclusion: Punjab has a substantial burden of HBV infection. Hepatitis B vaccination programs and interventions to minimize the use of therapeutic injections, particularly in rural areas, should be considered.
Background: The prevalence of hepatitis B virus (HBV) infection in Punjab, India, is unknown. Understanding the statewide prevalence and epidemiology can help guide public health campaigns to reduce the burden of disease and promote elimination efforts. Methods: A cross-sectional, population-based survey was conducted from October 2013 to April 2014 using a multistage stratified cluster sampling design. All members of selected households aged ≥5 years were eligible. Participants were surveyed for demographics and risk behaviors; serum samples were tested for total antibody to hepatitis B core (total anti-HBc), hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (anti-HCV), and HCV RNA. HBsAg-positive specimens were tested for HBV genotype. Results: A total of 5543 individuals participated in the survey and provided serum samples. The prevalence of total anti-HBc was 15.2% (95% confidence interval [95% CI]: 14.1-16.5) and HBsAg was 1.4% (95% CI: 1.0-1.9). Total anti-HBc positivity was associated with male sex (adjusted odds ratio [aOR] 1.46; 95% CI: 1.21-1.75), older age (aOR 3.31; 95% CI: 2.28-4.79 for ≥60 vs. 19-29 years), and living in a rural area (aOR 2.02; 95% CI: 1.62-2.51). Receipt of therapeutic injections in the past 6 months also increased risk (4-8 injections vs. none; aOR 1.39; 95% CI: 1.05-1.84). Among those positive for total anti-HBc, 10.4% (95% CI: 8.1-13.2) were also anti-HCV positive. Conclusion: Punjab has a substantial burden of HBV infection. Hepatitis B vaccination programs and interventions to minimize the use of therapeutic injections, particularly in rural areas, should be considered.
Entities:
Keywords:
CI, confidence interval; HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; India; OR, odds ratio; Punjab; STI, sexually transmitted infection; WHO, World Health Organization; aOR, adjusted odds ratio; anti-HBc, antibody to hepatitis B core; anti-HCV, antibody to hepatitis C; hepatitis B; prevalence; risk factors
Authors: Ajit Sood; A Suryaprasad; A Trickey; S Kanchi; V Midha; M A Foster; E Bennett; S Kamili; F Alvarez-Bognar; S Shadaker; V Surlikar; R Garg; P Mittal; S Sharma; M T May; P Vickerman; F Averhoff Journal: PLoS One Date: 2018-07-26 Impact factor: 3.240