Prevalence of hepatitis B and C virus infections among Buddhist tribes of Kaza health block, Lahaul and Spiti district of Himachal Pradesh.

Abstract

Background Infection of hepatitis B virus (HBV) and/ or hepatitis C virus (HCV) is a global public health concern. We aimed to estimate the prevalence of viral hepatitis B and C in the Buddhist tribal area of Kaza health block in Lahaul and Spiti district in Himachal Pradesh, India, and to identify the determinants. Methods The study was conducted by the departments of Gastroenterology, Community Medicine and Microbiology, Indira Gandhi Medical College, Shimla between June 2015 and October 2017. Using a two-stage sampling method, 4231 participants in 40 clusters were enrolled. For each subject, a pre-tested interview schedule was administered, and blood was tested for hepatitis B surface antigen (HBsAg) and antibodies to HCV (anti-HCV). Those samples which tested positive for HBsAg were further tested for hepatitis B core antigen (HBeAg) and antibody to HBeAg (anti-HBe). Results Among the 4231 participants, HBsAg and anti-HCV were detected in 961 (22.7%) and 33 (0.9%), respectively, including 6 (0.1%) who tested positive for both. HBsAg positivity was not associated with religion (p=0.07), caste (p=0.16), level of education (p=0.58) or marital status (p=0.73). Of all the participants, 588 (13.9%) reported a history of HBV vaccination. Of those who were HBsAg positive (961), 21.6% were positive for HBeAg and 58.3% were positive for anti-HBe. Conclusion The prevalence of HBV infection in the Kaza health block was high, and no specific associations were identified. Interventions such as public health education and universal childhood immunization at birth may help reduce the high rate of transmission of HBV in this population.