Epidemiology of hepatitis B and C viral infections in Ladakh region
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Little is known about the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Ladakh, a mountainous region with low population density. We, therefore, determined these and tried to identify risk factors associated with these infections.
Randomly selected residents of Ladakh region were tested for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc) and antibodies to HCV (anti-HCV). A subset of HBsAg-positive persons were tested for hepatitis B e-antigen (HBeAg) and HBV DNA and those with anti-HCV for HCV RNA. Viral genotype was also determined.
Of the 2674 subjects, 141 (5.3%) tested positive for HBsAg, i.e. had current HBV infection and 339 (12.7%) tested positive for either HBsAg and or anti-HBc, i.e. had either current or past infection with HBV. Anti-HCV antibody was detected in 22 (0.8%) subjects. The HBsAg positivity rate was higher in Kargil district (8.3%) than in Leh district (3.3%). No particular risk factor was identified for either infection. Of the 141 and 22 specimens that contained HBsAg and anti-HCV, respectively (one had both), 74 and none tested positive for HBV DNA and HCV RNA, respectively. Of the 29 specimens that had sufficient HBV DNA for genotyping, 21, 7, and 1 specimens had HBV genotypes D, C, and A, respectively.
The overall prevalence of HBV infection seems to be higher in Ladakh region, especially the Kargil district. The prevalence of anti-HCV was similar to that in other parts of India.
KeywordsEpidemiology Hepatitis B virus Hepatitis C virus Ladakh
We are thankful to Directorate of Health Services, Kashmir, Health Departments of Leh and Kargil Districts, and paramedical staff of Gastroenterology Laboratories, SKIMS and SGPGI especially Mr. Bashir Ahmad (Technical Officer, GE Laboratory, SKIMS), Mr. Mustafa (Sr. Techonologist, GE Laboratory SKIMS), and Mr. Ashiq Altaf Dar.
The project was funded by Indian Council of Medical Research, New Delhi (ICMR) (Ref. No. VIR/20/2011/ECD-1).
Compliance with ethical standards
Conflict of interest
MAK, SAZ, JU, TAL, RA, GB, MA, SR, TN, and ZAW declare that they have no conflict of interest.
An informed consent was obtained from each study subject. The results of the tests were kept confidential.
The study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.
The study was conducted after obtaining proper ethical clearance from the institutional ethics committee.
The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.
- 1.World Health Organization. Prevention of hepatitis B in India: An overview. In: Technical Report. World Health Organization. 2002. http://apps.searo.who.int/PDS_DOCS/B3368.pdf. Accessed 3 January 2018.
- 2.Murhekar MV, Murhekar KM, Das D, Arankalle VA, Sehgal SC. Prevalence of hepatitis B infection among the primitive tribes of Andaman and Nicobar islands. Indian J Med Res. 2000;111:199–203.Google Scholar
- 4.Irshad M, Acharya SK, Joshi YK. Prevalence of hepatitis C virus antibodies in the general population & in selected groups of patients in Delhi. Indian J Med Res. 1995;102:162–4.Google Scholar
- 6.Das BR, Kundu B, Khandapkar R, Sahni S. Geographical distribution of hepatitis C virus genotypes in India. Indian J Pathol Microbiol. 2002;45:323–8.Google Scholar
- 7.Singh S, Sarin SK. Distribution of hepatitis C virus genotypes in patients with chronic hepatitis C infection in India. Indian J Med Res. 2004;119:145–8.Google Scholar
- 8.Chadha MS, Tungatkar SP, Arankalle V. Insignificant prevalence of antibodies to hepatitis C in a rural area of western Maharashtra. Indian J Gastroenterol. 1999;18:22–3.Google Scholar
- 9.Batham A, Narula D, Toteja T, Sreenivas V, Puliyel JM. Sytematic review and meta-analysis of prevalence of hepatitis B in India. Indian Pediatr. 2007;44:663–74.Google Scholar
- 13.Kumar A, Kumar SI, Pandey R, Naik S, Aggarwal R. Hepatitis B virus genotype a is more often associated with severe liver disease in northern India than is genotype D. Indian J Gastroenterol. 2005;24:19–22.Google Scholar
- 14.Banerjee A, Datta S, Chandra PK, Roychowdhury S, Panda CK, Chakravarty R. Distribution of hepatitis B virus genotypes: phylogenetic analysis and virological characteristics of genotype C circulating among HBV carriers in Kolkata, eastern India. World J Gastroenterol. 2006;12:5964–71.CrossRefGoogle Scholar
- 15.Banerjee A, Kurbanov F, Datta S, et al. Phylogenetic relatedness and genetic diversity of hepatitis B virus isolates in eastern India. J Med Virol. 2006;78:1164–74.Google Scholar
- 19.Kato H, Orito E, Sugauchi F, et al. Determination of hepatitis B virus genotype G by polymerase chain reaction with hemi-nested primers. J Virol Methods. 2001;98:153–9.Google Scholar
- 21.Chakravarty R, Chowdhury A, Chaudhuri S, et al. Hepatitis B infection in eastern Indian families. Need for screening of adult siblings and mothers of adult index cases. Public Health. 2005;119:647–54.Google Scholar
- 23.NCDC. Hepatitis in India: Burden, strategies and plans. In: NCDC Newsletter 2014; volume 3: issue 1,page 3. http://www.ncdc.gov.in/showfile.php?lid=122. Accessed 2 January 2018.