Spectrum of hepatitis B infection in Southern India: A cross-sectional analysis

Balasubramanian, S; Velusamy, Arulselvan; Krishnan, Arunkumar; Venkatraman, J

doi:10.4103/0972-9747.193288

Cited by 5 publications

(4 citation statements)

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“…The spectrum of liver damage ranges from mild (approximately 20 to 40%) to moderate or severe chronic hepatitis (approximately 40 to 60%) or active cirrhosis (approximately 10 to 25%) [25]. In about two-thirds of the disease burden in India, it is represented by inactive/immunotolerant phase thus not requiring any treatment [26,27]. Our study also confirms the same findings, as 76% were chronic hepatitis B but in inactive carrier state thus not requiring any treatment.…”

Section: Discussionsupporting

confidence: 87%

Haryana- Hotspot of Hepatitis B in India

Malhotra

2021

ARGH

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Introduction:Approximately one third of the world's population has serological evidence of past or present infection with the hepatitis B virus (HBV). An estimated 350-400 million people are surface HBV antigen (HBsAg) carriers. Thus, HBV infection is one of the most important infectious diseases worldwide. India is facing major burnt of this deadly disease and has 40 million HBV carriers i.e., 10-15% share of total pool of HBV carriers of the world. In India, 100,000 patients die due to HBV infection. Aims and Objectives:To determine epidemiological profile, clinical presentation, risk factors, co-infection, use of alternative medications, need and compliance on antiviral treatment in patients of Hepatitis B virus infection. Materials & Methods:This retrospective study was done at Post Graduate Institute of Medical Sciences, Rohtak over a period of ten years i.e., 01.09.2010 to 31.08.2020, on all HbsAg positive patients who reported for consultation and treatment on outdoor basis i.e., on OPD basis who were not admitted or were admitted in indoor wards of hospital. In our study total 4850 patients were identified but 22 patients refused to get enrolled in the study, hence total 4828 patients were finally enrolled and their records were collected regarding their detailed epidemiological profile and clinical spectrum. In accordance with estimated prevalence of Hepatitis B in Haryana, sample size was calculated. At inclusion time, detailed history of the patient was recorded, clinical examination and detailed investigations were done Conclusion: Hepatitis B is a major health issue in India with non-uniform distribution and certain geographical areas are hotspots like Haryana. The young males belonging to rural background are most vulnerable due to lack of safe injection practices and proper health care facilities. Majority of patients of Chronic hepatitis B are in inactive stage, thus not requiring treatment but on regular follow up. Only 10% of patients presented with acute hepatitis B. The history of use of parenteral injections, surgical interventions and dental procedures has been found to be important risk factor. We cannot rely on blood bank data for determining the prevalence of it but screening of high-risk population in at least hotspots will reflect true picture. Moreover, it will lead to early detection of cases and thus will substantially decrease the development of long-term complications like cirrhosis and hepatocellular carcinoma, as shown in our this study.

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Section: Discussionsupporting

confidence: 87%

Haryana- Hotspot of Hepatitis B in India

Malhotra

2021

ARGH

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“…Review of the full-text articles led to the exclusion of 303, and the inclusion of 162 articles in the analysis ( Figure 1 , Figure 2 ). 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ,…”

Section: Resultsunclassified

“…The pooled estimate of eligibility according to any criteria was 19% (95% CI 18-20), but there was considerable heterogeneity. Stratified analysis led to pooled estimates of treatment eligibility of 12% (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) among studies done in community settings and 25% (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) in studies from health facilities (hospital or clinic settings). Studies done in health-care facilities that included older partici pants tended to have a lower proportion of eligibility (p=0•006; appendix p 15).…”

Section: Pollack Et Al (2014) 131mentioning

confidence: 99%

Estimating the proportion of people with chronic hepatitis B virus infection eligible for hepatitis B antiviral treatment worldwide: a systematic review and meta-analysis

Tan

Bhadoria

Cui³

et al. 2021

The Lancet Gastroenterology & Hepatology

126

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Summary Background In 2016, of the estimated 257 million people living with chronic hepatitis B virus (HBV) infection worldwide, only a small proportion was diagnosed and treated. The insufficiency of information on the proportion of people infected with HBV who are eligible for treatment limits the interpretation of global treatment coverage. We aimed to estimate the proportion of people with chronic HBV infection who were eligible for antiviral treatment worldwide, based on the WHO 2015 guidelines. Methods In this systematic review and meta-analysis, we searched Medline, EMBASE, and the Cochrane databases from Jan 1, 2007, to Jan 31, 2018, for studies describing HBsAg-positive people in the population or health-care facilities. We extracted information from published studies using a standardised form to estimate the frequency of cirrhosis, abnormal alanine aminotransferase (ALT), HBV DNA exceeding 2000 IU/mL or 20 000 IU/mL, presence of HBeAg, and eligibility for treatment as per WHO and other guidelines as reported in the studies. We pooled proportions through meta-analysis with random effects. The study was registered with PROSPERO, CRD42020132345. Findings Of the 13 497 studies, 162 were eligible and included in our analysis. These studies included 145 789 participants. The pooled estimate of the proportion of cirrhosis was 9% (95% CI 8–10), ranging from 6% (4–8) in community settings to 10% (9–11) in clinic settings. Examining the proportion of participants who had characteristics used to determine eligibility in the WHO guidelines, 1750 (10·1%) of 17 394 had HBV DNA exceeding 20 000 IU/mL, and 20 425 (30·8%) of 66 235 had ALT above the upper limit of normal. 32 studies reported eligibility for treatment according to WHO or any other guidelines, with a pooled estimate of eligibility at 19% (95% CI 18–20), ranging from 12% (6–18) for studies in community settings to 25% (19–30) in clinic settings. Interpretation Many studies described people with HBV infection, but few reported information in a way that allowed assessment of eligibility for treatment. Although about one in ten of the 257 million people with HBV infection (26 million) might be in urgent need of treatment because of cirrhosis, a larger proportion (12–25%) is eligible for treatment in accordance with different guidelines. Future studies describing people with HBV infection should report on treatment eligibility, according to broadly agreed definitions. Funding WHO and US Centers for Disease Control and Prevention.

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“…HBsAg negative patients were advised for vaccination against HBV infection. Based on the viral profile and transaminase levels and ultrasound findings, patients were categorized as , , HBeAg negative chronic infection, 7 HBeAg negative chronic hepatitis and acute hepatitis B.…”

Section: Methodsmentioning

confidence: 99%

Spectrum of Hepatits B Infection Among Patients Attending Liver Unit in Nepalgunj Medical College – Kohalpur

Khadka¹,

Kc²,

Karki³

et al. 2018

J. Nepalgunj Med. College

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Introduction: Hepatitis B infection is a global problem. Hepatitis B virus (HBV) infection related liver disease is also not an uncommon problem in our country too. Reports regarding pattern of chronic HBV infection are also lacking. The aim of the present study was to determine the spectrum of chronic HBV infection among patients attending the liver clinic in a tertiary care center. Method: A hospital based descriptive cross-sectional study was carried out in Liver unit of Nepalgunj Medical College, Kohalpur, from April 2018 to November 2018. All patients with HBsAg positive were further tested for HBeAg, HBeAb, HBV DNA quantitative and liver function test. Ultrasound examination was advised for any evidence of chronic liver disease. Staging was done according to viral serology, liver biochemistry and ultrasonography of liver Results: Total patients enrolled were 119. Majority of patents were in between 30-60 years (51.3%) with male predominance 59.7%. Most of patients were in the stage of HBeAg negative chronic infection 66.4% with normal transaminase and HBV DNA <2000 IU/ML. Majority of patients having unknown source of infection 90.8%. Incidental detection (67.2%) was common mode of detection. Conclusions: Majority of patients were in HBeAg negative chronic hepatitis B infection phase with normal transaminase and low HBV DNA not requiring treatment.

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Spectrum of hepatitis B infection in Southern India: A cross-sectional analysis

Cited by 5 publications

References 0 publications

Haryana- Hotspot of Hepatitis B in India

Haryana- Hotspot of Hepatitis B in India

Estimating the proportion of people with chronic hepatitis B virus infection eligible for hepatitis B antiviral treatment worldwide: a systematic review and meta-analysis

Spectrum of Hepatits B Infection Among Patients Attending Liver Unit in Nepalgunj Medical College – Kohalpur

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