Seroprevalence and risk factors of hepatitis B virus infection in tribal population of Himalayan district Lahaul and Spiti, India

ABSTRACT

Hepatitis B virus (HBV) infection is an important health issue across the world. With 4% to 7% prevalence of HBV, India is designated as an intermediate endemic country. However, HBV prevalence is significantly high in some pockets of the country, especially among tribal populations. HBV prevalence and associated risk factors in residents of far-flung two Himalayan valleys, Lahaul and Spiti of Himachal Pradesh (HP), were estimated. This was a community-based cross-sectional study. Blood samples were collected and tested for the presence of hepatitis B surface antigen (HBsAg) using ELISA. Data was collected in a predesigned semi-structured format. Univariate and multivariate analyses of risk factors were done using software SPSS 25. Samples from 1,327 individuals residing in 32 villages were tested, of these 141 (10.6%) were found positive for HBsAg. High prevalence (17.2%) of HBV was recorded in Spiti valley but not in Lahaul valley (3.1%). Both sexes were equally affected. Positivity was higher in adults than in children. High risk sexual behavior (OR = 2.0; 95% CI: 1.1–3.6), having an HBV positive person in the family (OR = 2.4; 95% CI: 1.4–4.3), being a student (OR: 11.2; 95% CI 3.9–32.1) and preacher (OR = 9.0; 95% CI: 3.6–22.4) were the most prominent risk factors associated with HBsAg positivity. Mass immunization for HBV along with information, education, communication and behavior change communication for curtailing risk behavior for avoiding risk factors is essential in the area.

KEYWORDS:

• Hepatitis B virus
• Hepatitis C virus
• HBsAg ELISA
• India
• Prevalence
• Risk factors
• Spiti valley
• Tribal population

Acknowledgments

The authors are grateful to the Secretary of the Government of India, DHR, MoH & FW, and The Director General, ICMR (Grant No. VIR/43/2011-ECD-I) and Director, ICMR-NIRTH, Jabalpur for financial support. The authors thank Dr. Aparup Das, Director ICMR-NIRTH, Jabalpur for support and encouragement during the study. The authors thank Participants, CMO Keylong for his support and staffs of Keylong Field Station of ICMR-NIRTH for their active participation in the study. The MS was reviewed by the institute publication committee and was given number ICMR-NIRTH/PSC/14/2019.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Indian Council of Medical Research [VIR/43/2011-ECD-I].