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Prevalence and presentation of hepatitis C related chronic liver disease in southern India
S K Issar1, B S Ramakrishna, B Ramakrishna
1Department of Gastrointestinal Sciences, Christian Medical College Hospital, Vellore, Tamil Nadu, India.
Insights
Hepatitis C virus (HCV) is a significant cause of chronic liver disease in southern India, with 26% of patients testing positive for HCV antibodies. Hepatitis B virus (HBV) remains more prevalent, but co-infections are common.
Area of Science:
- Hepatology
- Virology
- Epidemiology
Background:
- Chronic liver disease (CLD) poses a significant health burden globally.
- Understanding the etiological agents, such as hepatitis C virus (HCV) and hepatitis B virus (HBV), is crucial for effective management and prevention strategies.
- Geographic variations in the prevalence of viral hepatitis necessitate region-specific etiological assessments.
Purpose of the Study:
- To investigate the etiological role of hepatitis C virus (HCV) in chronic liver disease (CLD) within southern India.
- To determine the prevalence of HCV antibodies and compare it with hepatitis B virus (HBV) markers in CLD patients.
- To analyze the clinical and histological characteristics of HCV-related versus HBV-related liver disease.
Main Methods:
- A case-control study was conducted involving 100 patients with CLD and 56 controls with other gastrointestinal/liver diseases.
- Hepatitis C virus (HCV) antibodies were detected using second-generation ELISA.
- Hepatitis B virus (HBV) markers (HBsAg, anti-HBc, anti-HBs, anti-D) were also assessed serologically.
Main Results:
- HCV antibodies were detected in 26% of CLD patients, versus 0% in controls.
- HBV markers were present in 72% of CLD patients and 37.5% of controls.
- Co-infection with HCV and HBV was observed in 73% of anti-HCV positive patients. HCV disease presented later (median age 60) than HBV disease (median age 40). Cirrhosis was common in HCV patients, while chronic active hepatitis was frequent in HBV patients.
Conclusions:
- Hepatitis C virus (HCV) is a significant contributor to chronic liver disease (CLD) in southern India.
- While HBV infection remains the predominant cause of CLD in the region, HCV plays a notable role.
- The high rate of co-infection highlights the need for comprehensive viral hepatitis screening and management strategies.
Abstract:
To determine the importance of hepatitis C virus (HCV) infection in the aetiology of chronic liver disease in southern India, the prevalence of HCV antibodies and HBV markers was estimated in 100 patients with chronic liver disease and in 56 patients with a variety of other gastrointestinal and liver diseases who served as controls. HCV antibody was measured by a second-generation ELISA. HBsAg, anti-HBc, anti-HBs and anti-D were also estimated. HCV antibodies were detected in 26/100 patients with chronic liver disease compared to 0/56 controls. HBV markers were present in 72 of 100 patients with chronic liver disease compared to 21/56 (37.5%) controls. Anti-D was noted in 4/100 patients with chronic liver disease and in none of the controls. Many patients had serological evidence of both B and C infection; 73% of those with anti-HCV also tested positive for HBV markers. HCV related disease presented at a median age of 60 years compared to HBV related disease which presented at a median age of 40. There was no significant difference between HCV and HBV positive patients in symptomatology, but encephalopathy was uncommon and cirrhosis the usual finding at histology in HCV positive individuals, while chronic active hepatitis was found in 30% of biopsied HBV related disease. HCV is a significant cause of chronic liver disease in this geographic region, although HBV infection continues to account for the largest proportion of cases.