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

A. Trickey, A. Sood, V. Midha, W Thompson, C. Vellozzi, S. Shadaker, V. Surlikar, S. Kanchi, P. Vickerman, M. T. May, F. Averhoff

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

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=1,593 households) using multivariable ordered logistic regression. Anti-HCV+ prevalence was 3.6% (95% confidence interval 3.0%-4.2%). Individual-level regression (N=5,543 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<.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=.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.
Original languageEnglish
Article numbere283
Number of pages10
JournalEpidemiology and Infection
Volume147
DOIs
Publication statusPublished - 7 Oct 2019

Keywords

  • Epidemiology
  • hepatitis C
  • serosurvey
  • statistics

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