5. Seroprevalence of hepatitis C virus antibody in the Indian population: a systematic review and meta-analysis

Abstract

Background and Aims: Burden of hepatitis C in India, a populous country, has not been estimated. We therefore undertook a systematic review of the available data on anti-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for English language papers that reported data on anti-HCV seroprevalence from India, and also identified other unpublished sources of such data.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 95 additional data sources identified, 327 were selected; these provided 414 anti-HCV seroprevalence data points. Pooled anti-HCV seroprevalence rates in community-based studies (4 studies from 3 states/union territories), blood donors (175 studies all 35 states/territories) pregnant women (15 studies from 6 states) were 0.85% (95% CI: 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 found, with pooled anti-HCV seroprevalence rates of 0.44% and 0.88%, respectively. Among groups considered at increased risk of HCV infection, anti-HCV prevalence among persons living with HIV and those with sexually-transmitted diseases or high-risk sex behavior, though higher than in the general population, were lower than those reported from other countries. By comparison, the anti-HCV prevalence rates were higher in persons with injection drug use, and those receiving hemodialysis or frequent transfusions.