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Chronic hepatitis C virus infection in India: Regional demographics and distribution of viral genotypes

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Abstract

Background and Aims

Although chronic hepatitis C virus (HCV) infection affects millions of people in India, few studies have assessed host, viral, and disease characteristics of chronically infected patients at national and regional levels. Such information is critical to support large scale screening and treatment initiatives for chronic HCV infection in India.

Methods

Patients with known chronic HCV infection making routine or for-cause visits to the participating study centers were enrolled in this observational study. Patients attended a single outpatient visit during which demographics and medical history were collected, a physical examination was performed, and blood and urine samples were collected for laboratory assessments. Samples were analyzed to determine HCV genotypes and subtypes, and genotypes of interferon lambda 3 (IFNL3) single nucleotide polymorphism. No therapeutic interventions were administered.

Results

We enrolled 500 patients at 19 centers, categorized into four geographic regions (North, South, East, and West). All patients self-identified as Indian, and most (66 %) were male. Genotype 3 was the most common genotype overall (54 %); however, its prevalence varied greatly by region, ranging from 34 % in the South to 69 % in the East. Genotypes 1 (24 %) and 4 (6 %) were the next most common, and HCV genotype could not be determined for 16 % of patients.

Conclusions

This prospective survey suggests that demographics, viral, and host factors in patients with chronic HCV infection are highly variable in India and pose significant challenges for the implementation of broad-scale screening and treatment initiatives.

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Acknowledgments

This study was sponsored by the Gilead Sciences, Inc.

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Authors and Affiliations

  1. Global Hospitals, 35, Dr. E Borges Road, Parel, Mumbai, 400 012, India

    Samir R. Shah

  2. Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India

    P. N. Rao

  3. Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110 070, India

    Shiv K. Sarin & Nirupama Trehanpati

  4. Institute of Post Graduate Medical Education and Research, 244 A.J.C Bose Road, Kolkata, 700 020, India

    Abhijit Chowdhury

  5. Seth GS Medical College and KEM Hospital, Acharya Donde Marg, Parel, Mumbai, 400 012, India

    Shobna Bhatia

  6. Dharamsi Hospital, Chandni Chowk, South Shivaji Nagar, Nishant Colony, Sangli, 416 416, India

    Rajesh Dharamsi

  7. Institute of Digestive and Liver Disease, Guwahati, Assam, India

    B. D. Goswami

  8. Global Hospitals, Lakdikapul, Hyderabad, 500 004, India

    Dharmesh Kapoor

  9. Civil Hospital, Dawrpui, Aizawl, Mizoram, 796 001, India

    Rosang Luaia

  10. Liver Clinic, U-9 Jolly Plaza, Athwagate, Surat, 395 001, India

    Rajiv Mehta

  11. Midas Institute of Gastroenterology, Midas Heights, Central Bazar Road, Ramdas Peth, Ramdaspeth, Nagpur, 440 012, India

    Shrikant Mukewar

  12. VGM Hospital, 2100, Trichy Road, Singanallur, Coimbatore, 641 005, India

    V. G. Mohan Prasad

  13. Rai Speciality Care Centre, H-6, Janpath, Shyam Nagar, Ajmer Road, Sodala, Jaipur, 302 019, India

    Ramesh Roop Rai

  14. Medanta—The Medicity, Sector 38, Gurgaon, Delhi (NCR), 122 018, India

    Sanjiv Saigal

  15. Apollo Hospital, Bilaspur, Chattisgarh, 495 001, India

    Devendra Singh

  16. Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA

    Sandra Chen, Anuj Gaggar, Steven J. Knox & G. Mani Subramanian

  17. Department of Gastroenterology, S.C.B. Medical College, Manglabag, Cuttack, 753 007, India

    Shivaram Prasad Singh

  18. Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana, 141 001, India

    Ajit Sood

  19. Global Hospitals and Health City, 439, Cheran Nagar, Perumbakkam, Chennai, 600 100, India

    Joy Varghese

  20. Manipal Hospitals, Bangalore, 560 017, India

    Raj Vigna Venugopal

Authors
  1. Samir R. Shah
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  2. P. N. Rao
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  3. Shiv K. Sarin
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  4. Abhijit Chowdhury
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  5. Shobna Bhatia
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  6. Rajesh Dharamsi
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  7. B. D. Goswami
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  8. Dharmesh Kapoor
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  9. Rosang Luaia
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  10. Rajiv Mehta
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  11. Shrikant Mukewar
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  12. V. G. Mohan Prasad
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  13. Ramesh Roop Rai
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  14. Sanjiv Saigal
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  15. Devendra Singh
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  16. Nirupama Trehanpati
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  17. Sandra Chen
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  18. Anuj Gaggar
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  19. Steven J. Knox
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  20. G. Mani Subramanian
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  21. Shivaram Prasad Singh
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  22. Ajit Sood
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  23. Joy Varghese
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  24. Raj Vigna Venugopal
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Corresponding author

Correspondence to Samir R. Shah.

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Conflicts of Interest

Samir R Shah has served on advisory boards for Myland, Emcure, Alkem, Gilead Sciences, and Biocon. P N Rao has served on advisory boards and as a speaker for Roche, Abbott, BMS, and Dr. Reddy’s Laboratories. Dharmesh Kapoor has served on advisory boards for Dr. Reddy’s Laboratories, Emcure Pharma, and Alkem Pharma, and has served as a speaker for Roche, Novartis, Sanofi, Astra Zeneca, and Biocon. Shivaram Prasad Singh owns stock for Sun Pharmaceutical Industries Ltd., Torrent Pharmaceuticals Ltd., Dr. Reddy’s Laboratories, and Panacea Biotec. Sandra Chen, Anuj Gaggar, Steven J Knox, G Mani Subramanian are employees and/or own stock for Gilead Sciences. SKS, AC, SB, RD, BDG, RL, RM, SM, VGMP, RRR, SS, DS, NT, AS, JV, and RVV declare no conflicts of interest.

Ethical Statement

This study was approved by the institutional review board or independent ethics committee at each participating site and was conducted in compliance with Good Clinical Practice Guidelines and Declaration of Helsinki and local regulatory requirements. This study was designed and conducted according to protocol in collaboration with the principal investigators. All patients provided written informed consent.

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Cite this article

Shah, S.R., Rao, P.N., Sarin, S.K. et al. Chronic hepatitis C virus infection in India: Regional demographics and distribution of viral genotypes. Indian J Gastroenterol 35, 469–477 (2016). https://doi.org/10.1007/s12664-016-0709-1

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  • DOI: https://doi.org/10.1007/s12664-016-0709-1

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