Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

doi:10.1016/j.jceh.2014.05.006

Journal of Clinical and Experimental Hepatology

Volume 4, Issue 2, June 2014, Pages 106-116

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https://doi.org/10.1016/j.jceh.2014.05.006 Get rights and content

Globally, around 150 million people are infected with hepatitis C virus (HCV). India contributes a large proportion of this HCV burden. The prevalence of HCV infection in India is estimated at between 0.5% and 1.5%. It is higher in the northeastern part, tribal populations and Punjab, areas which may represent HCV hotspots, and is lower in western and eastern parts of the country. The predominant modes of HCV transmission in India are blood transfusion and unsafe therapeutic injections. There is a need for large field studies to better understand HCV epidemiology and identify high-prevalence areas, and to identify and spread awareness about the modes of transmission of this infection in an attempt to prevent disease transmission.

Section snippets

Epidemiology of Hepatitis C Virus in India

Population-based studies on prevalence of HCV infection in India are scarce. Most of the available data on the issue thus are based on blood bank screening, which may not be a reliable indicator of the true infection rate. The data from these studies show wide geographic variations, which may represent a true variation in prevalence due to differences in socio-economic status or cultural and healthcare practices in different regions, or variations in donor populations studied or test kits used

Risk Factors and Transmission in High-risk Persons

Parenteral transmission is the most important route of transmission of HCV. This most commonly occurs through transfusion of infected blood or blood products, intravenous drug use, unsafe therapeutic injections, occupational (needle-stick) injuries or nosocomial transmission during healthcare related procedures such as surgery, hemodialysis and organ transplantation. Injection drug use, which is the predominant mode of transmission of HCV infection in several developed countries, is not as

Prevention of HCV Infection

Treatment of HCV is costly, associated with significant adverse events, and has limited efficacy, making prevention particularly important. Currently, no vaccine against HCV infection is available. High-risk individuals include IVDUs, persons who receive blood transfusions, acupuncture, tattooing, unsafe injection practices, etc. HCV transmission in hospitalized patients may follow blood transfusions, medical procedures, unsafe medical practices and needle-stick injuries. Reuse of single-use

Genotypes Distribution of HCV in India

Genotype of HCV is a major predictor of response to anti-viral therapy. In published studies genotype 3 is the commonest genotype in India, accounting for 54%–80% of cases.135, 136, 137, 138, 139, 140, 141, 142, 143 Within genotype 3, subtype 3a has been the most frequent in most studies, but a recent report found subtype 3b to be the most prevalent.¹⁴⁴ Studies from northern, eastern and western India have uniformly shown predominance of genotype 3; however, in southern India, both genotype 1

Natural History of HCV in India

Majority of acute HCV infections are asymptomatic. Persistent HCV infection occurs in 50%–90% of those with acute infection. Mortality associated with CH–C infection results mainly from the development of liver cirrhosis and its complications.¹⁵⁰ The predominant genotype in India is genotype 3. In a Swiss study, genotype 3 HCV infection was associated with accelerated fibrosis progression compared to infection with other HCV genotypes.¹⁵¹

Comparison of natural history of HCV infection in United

Conclusions

The data on prevalence of HCV infection and routes of its transmission in India is highly inadequate. Based on limited available data, the prevalence of HCV appears to be between 0.5% and 1.5%. The prevalence appears to be higher in the northeast, in tribal populations and in Punjab, and lower in Western India and Eastern India. Blood transfusion and unsafe therapeutic injections appear to be the predominant modes of transmission. Genotype 3 HCV is the most prevalent viral genotype. Data on

Conflicts of interest

All authors have none to declare.

References (154)

C.W. Shepard et al.
Global epidemiology of hepatitis C virus infection
Lancet Infect Dis
(2005)
A. Chowdhury et al.
Hepatitis C infection in the general population: a community based study in West Bengal, India
Hepatology
(2003)
M. Singh et al.
Sero-epidemiological and behavioural survey of HIV, HBV and HCV amongst Indian Armed Forces trainees
MJAFI
(2010)
A. Olithselvan et al.
Prevalence of hepatitis B and C in Puducherry
J Clin Exp Hepatol
(2013)
M.N. Khaja et al.
High prevalence of hepatitis C virus infection and genotype distribution among general population, blood donors and risk groups
Infect Genet Evol
(2006)
R.N. Makroo et al.
Prevalence of anti-HCV antibodies among healthy asymptomatic Indian blood donors and the current role of anti-HBc screening as a surrogate marker for HCV infection
Apollo Med
(2010)
R. Parthiban et al.
Transmission of hepatitis C virus from asymptomatic mother to child in southern India
Int J Infect Dis
(2009)
V. Di Marco et al.
Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel
Blood
(2010)
M.V. Murhekar et al.
Assessment of injection-related practices in a tribal community of Andaman and Nicobar islands, India
Public health
(2005)
M. Rajasekaran et al.
Injection practices in southern part of India
Public Health
(2003)

K. Sarkar et al.

Rapid spread of hepatitis C and needle exchange programme in Kolkata, India

Lancet

(2003)

U.K. Baveja et al.

A cross sectional serological study of the co-infection of hepatitis b virus, hepatitis c virus and human immunodeficiency virus amongst a cohort of IDUs at Delhi

Indian J Med Microbiol

(2003)

D. Basu et al.

Seroprevalence of Anti-HCV) antibody and HCV-related risk in injecting drug users in northern India: comparison with non-injecting drug users

Asian J Psy

(2013)

K.S. Devi et al.

Seroprevalence of hepatitis B virus and hepatitis C virus among hepatic disorders and injection drug users in Manipur – a preliminary report

Indian J Med Microbiol

(2004)

D. Pal et al.

Prevalence of HIV and HCV amongst intravenous drug users of Kolkata

Indian J Med Microbiol

(2004)

K.F. Mohd Hanafiah et al.

Global epidemiology of hepatitis C virus Infection: new estimates of age-specific antibody to HCV seroprevalence

Hepatology

(2013)

Global surveillance and control of hepatitis C. Report of a WHO consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium

J Viral Hepat

(1999)

A. Wasley et al.

Epidemiology of hepatitis C: geographic differences and temporal trends

Semin Liver Dis

(2000)

T. Sy et al.

Epidemiology of hepatitis C virus (HCV) infection

Int J Med Sci

(2006)

M.J. Alter

Epidemiology of hepatitis C virus infection

World J Gastroenterol

(2007)

T. Yen et al.

The epidemiology of hepatitis C virus infection

J Clin Gastroenterol

(2003)

A. Mukhopadhya

HCV in India

J Biosci

(2008)

W. Sievert et al.

A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt

Liver Int

(2011)

Indian National Association for the study of liver HCV registry....

G.H. Guyatt et al.

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

BMJ

(2008)

A. Sood et al.

Prevalence of hepatitis C in a selected geographical area of northern India: a population based survey

Ind J Gastroenterol

(2012)

S. Sachdeva et al.

Population based hepatitis C survey in a rural block

North Am J Med Sci

(2012)

M.S. Chadha et al.

Insignificant prevalence of antibodies to hepatitis C in a rural western area of western Maharashtra

Indian J Gastroenterol

(1999)

A.C. Phukan et al.

HCV activity in an isolated community in north east India

Indian J Pathol Microbiol

(2001)

M. Chandra et al.

Prevalence, risk factors and genotype distribution of HCV and HBV infection in the tribal population: a community based study in south India

Trop Gastroenterol

(2003)

Rao VG. Epidemiology of Viral Hepatitis in Tribal Populations of Orrisa, Madhya Pradesh/Chattisgarh and Jharkhand....

M. Meena et al.

Prevalence of hepatitis C virus among blood donors at a tertiary care hospital in India: a five year study

Transfusion

(2011)

A.K. Panigrahi et al.

Magnitude of hepatitis C virus infection in India: prevalence in healthy blood donors, acute and chronic liver diseases

J Med Virol

(1997)

S. Pahuja et al.

Prevalence and trends of markers of hepatitis C virus, hepatitis B virus and human immunodeficiency virus in Delhi blood donors: a hospital based study

Jpn J Infect Dis

(2007)

A. Jain et al.

The prevalence of hepatitis C virus antibodies among the voluntary blood donors of New Delhi

Eur J Epidemiol

(2003)

B. Singh et al.

Infectious markers in blood donors of east Delhi: prevalence and trends

Indian J Pathol Microbiol

(2004)

R. Gupta et al.

The prevalence and the trends of transfusion transmittable infections in a regional blood transfusion centre

Asian J Transfus Sci

(2011)

D. Arora et al.

Seroprevalence of HIV, HBV, HCV and syphilis in the blood donors in southern Haryana

Indian J Pathol Microbiol

(2010)

N. Gupta et al.

Seroprevalence of HIV, HBV, HCV and syphilis in voluntary blood donors

Indian J Med Sci

(2004)

P.K. Bagga et al.

Seroprevalence of hepatitis C Antibodies in healthy blood donors – a prospective study

Indian J Pathol Microbiol

(2007)

H. Kaur et al.

Prevalence of markers of hepatitis C virus among the blood donors

J Clin Diagnostic Res

(2012)

S. Garg et al.

Comparison of seropositivity of HIV, HBV, HCV and syphilis in replacement and voluntary blood donors in western India

Indian J Pathol Microbiol

(2001)

B. Thakral et al.

Prevalence and significance of hepatitis C virus (HCV) seropositivity in blood donors

Indian J Med Res

(2006)

R. Jaiswal et al.

Prevalence of HBV and HCV in blood donors in Kanpur during the period 1997 through 2005

Indian J Hematol Blood Transfus

(2007)

T. Chandra et al.

Prevalence of transfusion transmitted infections in blood donors: an Indian experience

Transfusion

(2009)

S.P. Jaiswal et al.

Prevalence of anti-HCV antibodies in central India

Indian J Med Res

(1996)

B.R. Sonwane et al.

Prevalence of seroreactivity among blood donors in rural population

Indian J Med Sci

(2003)

S.V. Shinde et al.

A study-screening of blood donors for transmissible diseases

Indian J Hematol Blood Transfus

(2007)

M.S. Gosavi et al.

Prevalence of hepatitis C virus (HCV) infection in Mumbai

Indian J Med Sci

(1997)

J. Nandi et al.

Detection of HIV-1, HBV and HCV antibodies in blood donors from Surat, western India

Vox Sang

(1994)

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^a: Coordinator, HCV Task Force.

^b: Convener, HCV Task Force.

^c: Members of the core group, HCV Task force.

^d: List of members in alphabetical order.

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INASL Consensus StatementConsensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India

Section snippets

Epidemiology of Hepatitis C Virus in India

Risk Factors and Transmission in High-risk Persons

Prevention of HCV Infection

Genotypes Distribution of HCV in India

Natural History of HCV in India

Conclusions

Conflicts of interest

Lancet Infect Dis

Hepatology

MJAFI

J Clin Exp Hepatol

Infect Genet Evol

Apollo Med

Int J Infect Dis

Blood

Public health

Public Health

Lancet

Indian J Med Microbiol

Asian J Psy

Indian J Med Microbiol

Indian J Med Microbiol

Global epidemiology of hepatitis C virus Infection: new estimates of age-specific antibody to HCV seroprevalence

Hepatology

Global surveillance and control of hepatitis C. Report of a WHO consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium

J Viral Hepat

Epidemiology of hepatitis C: geographic differences and temporal trends

Semin Liver Dis

Epidemiology of hepatitis C virus (HCV) infection

Int J Med Sci

Epidemiology of hepatitis C virus infection

World J Gastroenterol

The epidemiology of hepatitis C virus infection

J Clin Gastroenterol

HCV in India

J Biosci

A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt

Liver Int

GRADE: an emerging consensus on rating quality of evidence and strength of recommendations

BMJ

Prevalence of hepatitis C in a selected geographical area of northern India: a population based survey

Ind J Gastroenterol

Population based hepatitis C survey in a rural block

North Am J Med Sci

Insignificant prevalence of antibodies to hepatitis C in a rural western area of western Maharashtra

Indian J Gastroenterol

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Indian J Pathol Microbiol

Prevalence, risk factors and genotype distribution of HCV and HBV infection in the tribal population: a community based study in south India

Trop Gastroenterol

Prevalence of hepatitis C virus among blood donors at a tertiary care hospital in India: a five year study

Transfusion

Magnitude of hepatitis C virus infection in India: prevalence in healthy blood donors, acute and chronic liver diseases

J Med Virol

Prevalence and trends of markers of hepatitis C virus, hepatitis B virus and human immunodeficiency virus in Delhi blood donors: a hospital based study

Jpn J Infect Dis

The prevalence of hepatitis C virus antibodies among the voluntary blood donors of New Delhi

Eur J Epidemiol

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Indian J Pathol Microbiol

The prevalence and the trends of transfusion transmittable infections in a regional blood transfusion centre

Asian J Transfus Sci

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Indian J Pathol Microbiol

Seroprevalence of HIV, HBV, HCV and syphilis in voluntary blood donors

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Prevalence of markers of hepatitis C virus among the blood donors

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INASL Consensus Statement
Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part I: Status Report of HCV Infection in India