Hepatitis C virus infection in the general population: a community-based study in West Bengal, India

Limited information is available about the prevalence and genotype distribution of hepatitis C virus (HCV) in the general population of India. A community-based epidemiologic study was carried out in a district in West Bengal, India. By a 1:3 sampling method, 3,579 individuals were preselected from 10,737 inhabitants of 9 villages of the district, of whom 2,973 (83.1%) agreed to participate. Twenty-six subjects (0.87%) were HCV antibody positive. The prevalence increased from 0.31% in subjects <10 years of age to 1.85% in those >or=60 years. No difference in prevalence between men and women was observed. Serum alanine aminotransferase (ALT) levels were elevated in 30.8% (8 of 26) of anti-HCV-positive subjects compared with 3.2% (94 of 2,947) anti-HCV-negative subjects (P <.001). HCV RNA was detectable in 80.8% (95% CI, 65.6%-95.91%) of the anti-HCV-positive subjects by reverse transcription-primed polymerase chain reaction (RT-PCR). The participants were HCV types 1b in 2 (9.5%), 3a in 8 (38.1%), 3b in 6 (28.6%), and unclassified in 5 (23.8%). Nucleotide sequencing and phylogenetic analysis assigned the unclassified type to genotype 3e. In conclusion, this study provides general population-based estimates of HCV prevalence, including genotypes, from a South Asian country. Although the prevalence of HCV infection in this population was lower than that reported from industrialized countries of the west, the total reservoir of infection is significant and calls for public health measures, including health education to limit the magnitude of the problem.