An assesment of burden of active hepatitis C virus infection in HCV seropositive individuals in Gujarat- A retrospective study.

Dr Hemanshi Rameshbhai Maheta,*
Dr.Nidhi Sood,
Dr. Asha Mandalia,
Dr. Neha Baldaniya,
Dr. Palak Rao

Abstract

Introduction : Viral hepatitis is a major public health challenge that requires an urgent response as the disease is a 2nd leading infectious cause of death globally causing 1.3 million deaths per year. Hepatitis B and C, the two main types of the five hepatitis infections are responsible for 96% of viral hepatitis related mortality. HCV is commonly associated with chronicity, cirrhosis and hepato-cellular carcinoma. Screening for HCV is done with antibody detection. Sero-positivity is not an evidence of an active HCV infection, for which viral RNA detection is necessary. As appropriate standard testing by RTPCR for active infection is not done, patients do not receive proper treatment and data pertaining to true burden of disease in community remains hidden. Objective: To determine prevalence of active hepatitis C virus infection in HCV antibody positive individuals. Material and methods: Retrospective study was conducted at Microbiology Department, GMERS Medical College and hospital, Ahmedabad, from January 2020 to March 2024. A total of 763 sero-positive samples were received and tested for active HCV infection from 18 districts of Gujarat with RTPCR assay to ascertain active infection. Results: Of 763 samples tested, 47.31% samples were positive and 48.23% samples were negative for HCV RNA. In active infection cases, 63.99% were male and 38.78% were female. Most common age group affected was 40-60 yrs. Highest prevalence was seen in South Gujarat. Regional variations in active disease burden was demonstrated. Conclusion: Sero- positivity of HCV does not inform about active infection of HCV. Active infection is very high in sero-positive individuals. To reduce chronicity and associated mortality and morbidity of HCV infection, RNA detection, a gold standard diagnostic tool should be adopted for ascertaining the active infection status. With the availability of very effective directly acting antivirals for HCV, morbidity and mortality associated with HCV can be reduced.