Limited information is available about the prevalence and genotype distribution of hepatitis C virus (HCV) in the general population of India. A community-based epidemiologic study was carried out in a district in West Bengal, India. By a 1:3 sampling method, 3,579 individuals were preselected from 10,737 inhabitants of 9 villages of the district, of whom 2,973 (83.1%) agreed to participate. Twenty-six subjects (0.87%) were HCV antibody positive. The prevalence increased from 0.31% in subjects <10 years of age to 1.85% in those >60 years. No difference in prevalence between men and women was observed. Serum alanine aminotransferase (ALT) levels were elevated in 30.8% (8 of 26) of anti-HCV-positive subjects compared with 3.2% (94 of 2,947) anti-HCV-negative subjects (P < .001). HCV RNA was detectable in 80.8% (95% CI, 65.6%-95.91%) of the anti-HCV-positive subjects by reverse transcription-primed polymerase chain reaction (RT-PCR). The participants were HCV types 1b in 2 (9.5%), 3a in 8 (38.1%), 3b in 6 (28.6%), and unclassified in 5 (23.8%). Nucleotide sequencing and phylogenetic analysis assigned the unclassified type to genotype 3e. In conclusion, this study provides general population-based estimates of HCV prevalence, including genotypes, from a South Asian country. Although the prevalence of HCV infection in this population was lower than that reported from industrialized countries of the west, the total reservoir of infection is significant and calls for public health measures, including health education to limit the magnitude of the problem. (HEPATOLOGY 2003;37: 802-809.)H epatitis C virus (HCV) infection is an evolving public health problem globally. 1,2 This virus infects approximately 3% of the world population, placing approximately 170 million people at risk for developing HCV-related chronic liver disease. 3 The natural history of HCV infection is characterized by an often clinically unapparent acute phase, followed by chronic infection in over half of those infected. [4][5][6] It is an important etiologic agent for hepatic cirrhosis and hepatocellular carcinoma and is the most common indication for liver transplantation in the United States, northern Europe, and Japan. [7][8][9][10] In the developing countries of Asia and Africa, although hepatitis B virus (HBV) remains the most common cause of chronic necroinflammatory and neoplastic liver disease, HCV is emerging rapidly as an infection warranting attention. 11 Epidemiologic assessment of the magnitude of the problem and the factors influencing HCV transmission in these countries is essential for public health planning for preventing the spread of the infection.Although a number of blood donor studies are available, 12,13 the relatively few population-based studies from the United States, 14 Europe, [15][16][17] and Egypt 18 have provided detailed information on the dynamics of HCV transmission and other facets of descriptive and analytic epidemiology of the infection. The prevalence rate as well as the significance of HCV infection varies consid...

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