Burden of hepatitis C virus infection in India: A systematic review and meta-analysis

Abstract

Background and aim: Burden of hepatitis C in India is not known. We therefore conducted a systematic review of the available data on anti-hepatitis C virus (HCV) seroprevalence in the Indian population. Methods: We searched several publication databases for English language papers that reported data on anti-HCV seroprevalence from India and also identified other unpublished sources of such data. Data on groups likely to represent seroprevalence in general population and in selected high-risk groups were extracted and subjected to meta-analysis. Results: Of the 3995 published papers and 94 additional data sources identified, 327 were selected; these provided 414 anti-HCV seroprevalence data points. Pooled anti-HCV seroprevalence rates in community-based studies, blood donors, and pregnant women were 0.85% (95% confidence interval: 0.00-3.98%), 0.44% (0.40-0.49), and 0.88% (0.21-1.90), respectively. Among groups considered at high risk of HCV, pooled anti-HCV seroprevalence rates were as follows: people living with HIV (40 studies from 17 states: 3.51% [2.43-4.76]), persons on maintenance hemodialysis (37, 13; 19.23% [13.52-25.65]), people who inject drugs (46, 14; 44.71% [37.50-52.03]), multi-transfused persons (38, 12; 24.06% [20.00-28.36]), persons with sexually transmitted diseases (7, 5; 4.10% [0.98-9.04]), and those with high-risk sex behavior (6, 5; 4.06% [1.79-7.10]). Conclusions: Community-based data on HCV seroprevalence in India were limited. Large amount of data on blood donors and pregnant women were identified, with pooled anti-HCV seroprevalence rates of 0.44% and 0.88%, respectively. Among high-risk groups, anti-HCV prevalence was higher among people living with HIV, those with sexually transmitted diseases, high-risk sex behavior or injection drug use, and those receiving hemodialysis or frequent transfusions.