Clinical profile of hepatitis C virus infection in a developing country: India

• Published in: Journal of gastroenterology and hepatology 2018-04, Vol.33 (4), p.926-933
• Main Authors: Mahajan, Ramit, Midha, Vandana, Goyal, Omesh, Mehta, Varun, Narang, Vikram, Kaur, Kirandeep, Singh, Arshdeep, Singh, Dharmatma, Bhanot, Rishu, Sood, Ajit
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Cirrhosis; clinical; clinical profile; Demography; Dental Care - adverse effects; Developing countries; Epidemiology; Female; Genotypes; Health risk assessment; Hepatitis; Hepatitis B; Hepatitis C; Hepatitis C - epidemiology; Hepatitis C - etiology; Hepatitis C - transmission; HIV; Human immunodeficiency virus; Humans; India - epidemiology; Infections; LDCs; Liver cirrhosis; Liver diseases; Male; Middle age; Middle Aged; Needle Sharing - adverse effects; Needles; Prevalence; Risk Factors; Rural areas; Rural Population; Sex Factors; Social Class; Socioeconomic factors; Syringes; viral hepatitis; Young Adult
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.13995

Background and Aim The epidemiology and clinical profile of hepatitis C virus (HCV) varies worldwide, and data from developing countries are sparse. The aim of the present study was to assess the clinical profile of HCV infection in a developing country in South‐East Asia (India). Methods This observational study assessed patient demographics, viral characteristics, risk factors for virus acquisition, and disease characteristics in HCV patients diagnosed between January 2004 and December 2015. Results Of 8035 patients who were diagnosed with HCV infection, a majority were men (68.3%), middle aged (52.2%), and from low (34%) to middle (46%) socioeconomic status and rural population (69.8%). Eighty‐two percent had identifiable risk factors, the most common being history of dental treatment (52%) and therapeutic injections with reusable syringes/needles (45%). Household contacts of index patients had high prevalence of HCV (15.3%). Common genotypes were genotype 3 (70.4%) and genotype 1 (19.3%). Although a majority of patients were either asymptomatic (54.8%) or had non‐specific symptoms (6.7%) at presentation, a significant proportion (9.3%) had advanced liver disease. Presentation with cirrhosis (38.8%) was associated with male gender, higher age at time of virus detection, rural residence, alcohol or opium intake, and coinfections with hepatitis B virus or human immunodeficiency virus. Conclusions Hepatitis C virus infection in northern India is seen more commonly in men, the middle aged and people from rural background and low to middle socioeconomic status. The common possible risk factors are dental treatment and exposure to reused syringes and needles. Although the most common presentation is incidental detection, a large number of patients present with advanced liver disease.