Spectrum of Incidentally Detected Hepatitis C Virus Infection in Southern India- A Prospective Study

Abstract

 Purpose/Aims: The relationship between viral replication, genotypes, host biochemical characteristics, clinical outcomes and mode of transmission in Indian subjects with incidental detection of hepatitis C virus (HCV) infection is yet to attain. We evaluated the above parameters in incidentally detected asymptomatic subjects seropositive for HCV antibody (anti-HCV). Methods: Incidentally detected 96 anti-HCV positive subjects were evaluated by clinical, endoscopic, ultrasound and demographic parameters. Blood samples were assessed for biochemical and serological markers. Serum HCV RNA and genotypes were assessed by real time PCR and line probe assay respectively. Results: Majority (57%) of the subjects had non specific symptoms followed by detection during pre surgical checkup (20%) and blood donation (16%). Previous history of dental procedures (41.3%), surgical procedures (33.7%) and blood transfusions (25%) were identified as major risk factors. Genotype 3 was predominant (47%), followed by 1 (37%) 4 (15%) respectively while genotype 5 was identified in a single cirrhotic subject. Type 2 diabetes and esophageal varices were observed in 22% and 18% subjects respectively. Significant alterations of serum albumin, platelets count, AST and INR were evident in older subjects (>50 years). Cirrhotic features were observed in a number of subjects having both low and high viral load. Conclusion: The probable risk factors for acquisition of HCV infection identified in almost all study subjects of which one fifth were though apparently asymptomatic had cirrhosis. The predominant HCV genotype was 3.Genotype 5 has been identified for the first time from southern India.