Clustering of hepatitis C virus antibody positivity within households and communities in Punjab, India

To better understand hepatitis C virus (HCV) epidemiology in Punjab state, India, we estimated the distribution of HCV antibody positivity (anti-HCV+) using a 2013-2014 HCV household seroprevalence survey. Household anti-HCV+ clustering was investigated (a) by individual-level multivariable logistic...

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Bibliographic Details
Published in:Epidemiology and infection 2019-10, Vol.147, p.e283-e283, Article e283
Main Authors: Trickey, A, Sood, A, Midha, V, Thompson, W, Vellozzi, C, Shadaker, S, Surlikar, V, Kanchi, S, Vickerman, P, May, M T, Averhoff, F
Format: Article
Language:English
Subjects:
Adult
Cluster Analysis
Family Characteristics
Female
Hepatitis C - epidemiology
Hepatitis C Antibodies - blood
Humans
India - epidemiology
Male
Middle Aged
Original Paper
Rural Population
Seroepidemiologic Studies
Urban Population
Young Adult
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Summary:To better understand hepatitis C virus (HCV) epidemiology in Punjab state, India, we estimated the distribution of HCV antibody positivity (anti-HCV+) using a 2013-2014 HCV household seroprevalence survey. Household anti-HCV+ clustering was investigated (a) by individual-level multivariable logistic regression, and (b) comparing the observed frequency of households with multiple anti-HCV+ persons against the expected, simulated frequency assuming anti-HCV+ persons are randomly distributed. Village/ward-level clustering was investigated similarly. We estimated household-level associations between exposures and the number of anti-HCV+ members in a household (N = 1593 households) using multivariable ordered logistic regression. Anti-HCV+ prevalence was 3.6% (95% confidence interval 3.0-4.2%). Individual-level regression (N = 5543 participants) found an odds ratio of 3.19 (2.25-4.50) for someone being anti-HCV+ if another household member was anti-HCV+. Thirty households surveyed had ⩾2 anti-HCV+ members, whereas 0/1000 (P < 0.001) simulations had ⩾30 such households. Excess village-level clustering was evident: 10 villages had ⩾6 anti-HCV+ members, occurring in 31/1000 simulations (P = 0.031). The household-level model indicated the number of household members, living in southern Punjab, lower socio-economic score, and a higher proportion having ever used opium/bhuki were associated with a household's number of anti-HCV+ members. Anti-HCV+ clusters within households and villages in Punjab, India. These data should be used to inform screening efforts.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268819001705