Hepatitis B Prevalence and Risk Factors in Punjab, India: A Population-Based Serosurvey

Shaun Shadaker; Ajit Sood; Francisco Averhoff; Anil Suryaprasad; Subodh Kanchi; Vandana Midha; Saleem Kamili; Muazzam Nasrullah; Adam J W Trickey; R Garg; Pramod Mittal; Suresh Sharma; Peter T Vickerman; Paige Armstrong

doi:10.1016/j.jceh.2022.04.014

Hepatitis B Prevalence and Risk Factors in Punjab, India: A Population-Based Serosurvey

Shaun Shadaker^*
, Ajit Sood
, Francisco Averhoff
, Anil Suryaprasad
, Subodh Kanchi
, Vandana Midha
, Saleem Kamili
, Muazzam Nasrullah
, Adam J W Trickey
, R Garg
, Pramod Mittal
, Suresh Sharma
, Peter T Vickerman
, Paige Armstrong

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

6 Citations (Scopus)

104 Downloads (Pure)

Abstract

Background
The prevalence of hepatitis B virus (HBV) infection in Punjab, India is unknown. Understanding the statewide prevalence and epidemiology can help guide public health campaigns to reduce the burden of disease and promote elimination efforts.

Methods
A cross-sectional, population-based survey was conducted from October 2013–April 2014 using a multi-stage stratified cluster sampling design. All members of selected households aged ≥5 years were eligible. Participants were surveyed for demographics and risk behaviors; serum samples were tested for total antibody to hepatitis B core (total anti-HBc), hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (anti-HCV) and HCV RNA. HBsAg-positive specimens were tested for HBV genotype.

Results
A total of 5,543 individuals participated in the survey and provided serum samples. The prevalence of total anti-HBc was 15.2% (95% confidence interval [95%CI]: 14.1–16.5) and HBsAg was 1.4% (95%CI: 1.0–1.9). Total anti-HBc positivity was associated with male sex (adjusted odds ratio [aOR] 1.46; 95%CI: 1.21–1.75), older age (aOR 3.31; 95%CI: 2.28–4.79 for ≥60 vs. 19–29 years), and living in a rural area (aOR 2.02; 95%CI: 1.62–2.51). Receipt of therapeutic injections in the past 6 months also increased risk (4–8 injections vs. none; aOR 1.39; 95%CI: 1.05–1.84). Among those positive for total anti-HBc, 10.4% (95%CI: 8.1–13.2) were also anti-HCV positive.

Conclusions
Punjab has a substantial burden of HBV infection. Hepatitis B vaccination programs and interventions to minimize use of therapeutic injections, particularly in rural areas should be considered.

Original language	English
Pages (from-to)	1310-1319
Number of pages	10
Journal	Journal of Clinical and Experimental Hepatology
Volume	12
Issue number	5
Early online date	18 Apr 2022
DOIs	https://doi.org/10.1016/j.jceh.2022.04.014
Publication status	Published - 1 Sept 2022

Bibliographical note

Funding Information:
S.K. and M.N. are, or have been, employees of Merck. A.S. has also received funding from Merck. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.

Funding Information:
This population survey was sponsored by MSD Pharmaceuticals India Private Limited, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, USA; sponsoring corporations do not contribute to writing of manuscripts.

Publisher Copyright:
© 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Research Groups and Themes

GEM-B

Keywords

Punjab
India
Hepatitis B
Prevalence
Risk Factors

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Shadaker, S., Sood, A., Averhoff, F., Suryaprasad, A., Kanchi, S., Midha, V., Kamili, S., Nasrullah, M., Trickey, A. J. W., Garg, R., Mittal, P., Sharma, S., Vickerman, P. T., & Armstrong, P. (2022). Hepatitis B Prevalence and Risk Factors in Punjab, India: A Population-Based Serosurvey. Journal of Clinical and Experimental Hepatology, 12(5), 1310-1319. https://doi.org/10.1016/j.jceh.2022.04.014

@article{5a6eb399fd994f32a237469eca364b58,

title = "Hepatitis B Prevalence and Risk Factors in Punjab, India: A Population-Based Serosurvey",

abstract = "Background The prevalence of hepatitis B virus (HBV) infection in Punjab, India is unknown. Understanding the statewide prevalence and epidemiology can help guide public health campaigns to reduce the burden of disease and promote elimination efforts. Methods A cross-sectional, population-based survey was conducted from October 2013–April 2014 using a multi-stage stratified cluster sampling design. All members of selected households aged ≥5 years were eligible. Participants were surveyed for demographics and risk behaviors; serum samples were tested for total antibody to hepatitis B core (total anti-HBc), hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (anti-HCV) and HCV RNA. HBsAg-positive specimens were tested for HBV genotype. Results A total of 5,543 individuals participated in the survey and provided serum samples. The prevalence of total anti-HBc was 15.2\% (95\% confidence interval [95\%CI]: 14.1–16.5) and HBsAg was 1.4\% (95\%CI: 1.0–1.9). Total anti-HBc positivity was associated with male sex (adjusted odds ratio [aOR] 1.46; 95\%CI: 1.21–1.75), older age (aOR 3.31; 95\%CI: 2.28–4.79 for ≥60 vs. 19–29 years), and living in a rural area (aOR 2.02; 95\%CI: 1.62–2.51). Receipt of therapeutic injections in the past 6 months also increased risk (4–8 injections vs. none; aOR 1.39; 95\%CI: 1.05–1.84). Among those positive for total anti-HBc, 10.4\% (95\%CI: 8.1–13.2) were also anti-HCV positive. Conclusions Punjab has a substantial burden of HBV infection. Hepatitis B vaccination programs and interventions to minimize use of therapeutic injections, particularly in rural areas should be considered.",

keywords = "Punjab, India, Hepatitis B, Prevalence, Risk Factors",

author = "Shaun Shadaker and Ajit Sood and Francisco Averhoff and Anil Suryaprasad and Subodh Kanchi and Vandana Midha and Saleem Kamili and Muazzam Nasrullah and Trickey, \{Adam J W\} and R Garg and Pramod Mittal and Suresh Sharma and Vickerman, \{Peter T\} and Paige Armstrong",

note = "Funding Information: S.K. and M.N. are, or have been, employees of Merck. A.S. has also received funding from Merck. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article. Funding Information: This population survey was sponsored by MSD Pharmaceuticals India Private Limited, a subsidiary of Merck \& Co. Inc., Kenilworth, NJ, USA; sponsoring corporations do not contribute to writing of manuscripts. Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = sep,

day = "1",

doi = "10.1016/j.jceh.2022.04.014",

language = "English",

volume = "12",

pages = "1310--1319",

journal = "Journal of Clinical and Experimental Hepatology",

issn = "2213-3453",

publisher = "Elsevier B.V.",

number = "5",

}

Shadaker, S, Sood, A, Averhoff, F, Suryaprasad, A, Kanchi, S, Midha, V, Kamili, S, Nasrullah, M, Trickey, AJW, Garg, R, Mittal, P, Sharma, S, Vickerman, PT & Armstrong, P 2022, 'Hepatitis B Prevalence and Risk Factors in Punjab, India: A Population-Based Serosurvey', Journal of Clinical and Experimental Hepatology, vol. 12, no. 5, pp. 1310-1319. https://doi.org/10.1016/j.jceh.2022.04.014

TY - JOUR

T1 - Hepatitis B Prevalence and Risk Factors in Punjab, India

T2 - A Population-Based Serosurvey

AU - Shadaker, Shaun

AU - Sood, Ajit

AU - Averhoff, Francisco

AU - Suryaprasad, Anil

AU - Kanchi, Subodh

AU - Midha, Vandana

AU - Kamili, Saleem

AU - Nasrullah, Muazzam

AU - Trickey, Adam J W

AU - Garg, R

AU - Mittal, Pramod

AU - Sharma, Suresh

AU - Vickerman, Peter T

AU - Armstrong, Paige

N1 - Funding Information: S.K. and M.N. are, or have been, employees of Merck. A.S. has also received funding from Merck. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article. Funding Information: This population survey was sponsored by MSD Pharmaceuticals India Private Limited, a subsidiary of Merck & Co. Inc., Kenilworth, NJ, USA; sponsoring corporations do not contribute to writing of manuscripts. Publisher Copyright: © 2022

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Background The prevalence of hepatitis B virus (HBV) infection in Punjab, India is unknown. Understanding the statewide prevalence and epidemiology can help guide public health campaigns to reduce the burden of disease and promote elimination efforts. Methods A cross-sectional, population-based survey was conducted from October 2013–April 2014 using a multi-stage stratified cluster sampling design. All members of selected households aged ≥5 years were eligible. Participants were surveyed for demographics and risk behaviors; serum samples were tested for total antibody to hepatitis B core (total anti-HBc), hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (anti-HCV) and HCV RNA. HBsAg-positive specimens were tested for HBV genotype. Results A total of 5,543 individuals participated in the survey and provided serum samples. The prevalence of total anti-HBc was 15.2% (95% confidence interval [95%CI]: 14.1–16.5) and HBsAg was 1.4% (95%CI: 1.0–1.9). Total anti-HBc positivity was associated with male sex (adjusted odds ratio [aOR] 1.46; 95%CI: 1.21–1.75), older age (aOR 3.31; 95%CI: 2.28–4.79 for ≥60 vs. 19–29 years), and living in a rural area (aOR 2.02; 95%CI: 1.62–2.51). Receipt of therapeutic injections in the past 6 months also increased risk (4–8 injections vs. none; aOR 1.39; 95%CI: 1.05–1.84). Among those positive for total anti-HBc, 10.4% (95%CI: 8.1–13.2) were also anti-HCV positive. Conclusions Punjab has a substantial burden of HBV infection. Hepatitis B vaccination programs and interventions to minimize use of therapeutic injections, particularly in rural areas should be considered.

AB - Background The prevalence of hepatitis B virus (HBV) infection in Punjab, India is unknown. Understanding the statewide prevalence and epidemiology can help guide public health campaigns to reduce the burden of disease and promote elimination efforts. Methods A cross-sectional, population-based survey was conducted from October 2013–April 2014 using a multi-stage stratified cluster sampling design. All members of selected households aged ≥5 years were eligible. Participants were surveyed for demographics and risk behaviors; serum samples were tested for total antibody to hepatitis B core (total anti-HBc), hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (anti-HCV) and HCV RNA. HBsAg-positive specimens were tested for HBV genotype. Results A total of 5,543 individuals participated in the survey and provided serum samples. The prevalence of total anti-HBc was 15.2% (95% confidence interval [95%CI]: 14.1–16.5) and HBsAg was 1.4% (95%CI: 1.0–1.9). Total anti-HBc positivity was associated with male sex (adjusted odds ratio [aOR] 1.46; 95%CI: 1.21–1.75), older age (aOR 3.31; 95%CI: 2.28–4.79 for ≥60 vs. 19–29 years), and living in a rural area (aOR 2.02; 95%CI: 1.62–2.51). Receipt of therapeutic injections in the past 6 months also increased risk (4–8 injections vs. none; aOR 1.39; 95%CI: 1.05–1.84). Among those positive for total anti-HBc, 10.4% (95%CI: 8.1–13.2) were also anti-HCV positive. Conclusions Punjab has a substantial burden of HBV infection. Hepatitis B vaccination programs and interventions to minimize use of therapeutic injections, particularly in rural areas should be considered.

KW - Punjab

KW - India

KW - Hepatitis B

KW - Prevalence

KW - Risk Factors

U2 - 10.1016/j.jceh.2022.04.014

DO - 10.1016/j.jceh.2022.04.014

M3 - Article (Academic Journal)

C2 - 36157147

SN - 2213-3453

VL - 12

SP - 1310

EP - 1319

JO - Journal of Clinical and Experimental Hepatology

JF - Journal of Clinical and Experimental Hepatology

IS - 5

ER -

Hepatitis B Prevalence and Risk Factors in Punjab, India: A Population-Based Serosurvey

Abstract

Bibliographical note

UN SDGs

Research Groups and Themes

Keywords

Access to Document

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