Poster Presentation

1
The epidemiology of HCV infection Dr Yogesh K
ChawlaChandigarh
2
Prevalence

• Low lt 1 0.01 0.1 UK, Scandinavia
• 0.2 0.5 W. Europe, N. America, Australia, S.
  Africa
• Intermediate 1 5 Brazil, Middle East, Africa,
  Asia, Indian subcontinent
• High gt 5 7 Libya 17-26 Egypt

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Age HCV endemicity
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HCV prevalence in India
Community 0.15-0.78
Calcutta (2001) Preschool children 0.64, gt 60
years 1.88
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Voluntary blood donors
0.2-1.85
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Non liver disease group
Health Care workers
0 -1.7
7
Hemodialysis 3.7-44
Non liver disease group (contd.)
8
Thalassemics 25.4 -68
Non liver disease group (contd.)
9
Anti HCV prevalence in other countries
10
Anti HCV in non liver disease groups
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Declining prevalence

• United States
• Selecting safer blood donors
• Screening for anti HCV 1989 1st generation
• 1992 2nd generation
• 1993 3rd generation
• Safer needle using practices
• Anti HCV 0.6 (1992) to 0.4 (1996)
• Liver disease x 4 Lag phase 20 years

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Year wise anti HCV in VBD
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Changing scenario of transfusion related viral
infections
Calcutta JAPI 200250879-81
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The trend of anti HCV positivity at PGI

• 1997 20
• 1998 62
• 1999 75
• 2000 125
• 2001 140
• 2002 138

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Mode of Transmission

• Paucity of experimental data
• Transmission model Chimpanzee
• HCV RNA present in most body fluids highest
  level in blood
• HCV viability affect by pH, salt and RNA
  degrading enzymes
• Replication Hepatocytes, ? RE cells

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Transmission

• Blood Transfusion
• Immunoglobulin
• Clotting factors
• I V drug abuse
• developed countries
• gt 80 anti HCV in 5 years

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Transmission contd..

• Sexual HCV RNA Semen, Saliva
• Mother to infant
• Perinatal transmission 2 8
• Higher with HIV increased viral load
• Patient to patient
• Hemodialysis, colonoscopy
• Patient to HCW
• Needle stick exposure 3 8

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Transmission contd..

• Acupuncture
• Tattooing
• Sharing Razors
• Tooth brushes
• Incision with unsterilized knives

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Modes of transmission
PGI, Chandigarh (n153)

• Blood transfusion 31
• Surgery 18
• Hemodialysis 12
• Dental treatment 5
• Tattoo, acupuncture 3
• IVDU 3
• Sexual 3
• Unidentified 25

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Risk factors in the US
lt1990s
1995-2000
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Risk factors in UK
Risk factors in Japan
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Conclusions

• HCV prevalence in India
• General population 0.15-0.78
• Blood donors 0.2-1.85
• No apparent decline in HCV prevalence
• Risk factors
• India Blood and components,
• US/UK IVDU
• Japan Blood, Folk remedies