SEROEPIDEMIOLOGY OF HBV AND HCV IN INDIA - STRATEGY FOR CONTROL OF MATERNAL TRANSMISSION OF HBV AND ITS EFFECT - SCREENING METHODS OF BLOOD-DONORS FOR CONTROL OF POSTTRANSFUSION HEPATITIS AND THEIR EFFECTS

The HBV prevalence rate in India is 2-8 percent with an approximate ca rrier pool of 36 million. India being a large country, the HBV carrier and infection rate varies in different regions of the country. HBV pr evalence is highest in South India (5.5%). The high risk population fo r HBV carrier state as well as for HBV infection includes professional blood donors (10-11%), patients undergoing hoemodialysis (65.8%), res idential population of orphanage (15.3%), and parenteral drug abusers (8.5%). Medical and paramedical personnel dealing with dental surgery, and truck drivers in North India also carry a higher HBV prevalence. Vertical or perinatal transmission of HBV in India, unlike in South-Ea st Asia, is infrequent due to a low HBeAg positivity rate (7.8%) among pregnant females with HBV infection. On he other hand, horizontal tra nsmission in early childhood due to crowded and unhygienic living cond itions is the major role of spread for HBV infection in India. Amongst adults, transfusion of blood collected from professional blood donors constitutes another important mode of HBV transmission. HBV is an imp ortant cause of liver disease in India and is responsible for 42% of a cute hepatitis, 33% of acute liver failure, 34% of subacute liver fail ure, 68% of chronic hepatitis, 80% of cirrhosis and 61% of Hepatocellu lar carcinoma. HCV related liver disease is infrequent and anti HCV an tibody positivity rates are low in the general population (0.9%). HCV antibody positivity in patients with chronic liver disease is approxim ately 13%. At present there is no national strategy for HBV prevention in India and motivated clinicians are making individual efforts to pr omote HBV immunization. Post transfusion hepatitis related to professi onal blood use continues to be an important cause of HBV and HCV relat ed liver disease in India. Screening of blood for HBsAg and anti HCV a ntibody needs to be widely practised to control the frequency of trans fusion related liver disease in India.