Background: Sero-surveillance of Hepatitis B virus infection in the Jammu province of J and K, India.

Objectives: The study was envisaged with the objective to (1) Study the Hepatitis B burden in the Jammu province (2) To further formulate the regional management policy, study the Genotypes and conduct Phylogenetic analysis based on this study.

Methods: Referred patient’s blood specimens were collected for HBsAg ELISA and tested. The test results were shared with both patients and the clinicians. 

Results: The prospective study was conducted from January 2014 to December 2016 wherein a total of 27,703 ELISA tests were performed and 678 patients were positive (2.44%). Male (64.60%) preponderance was observed over females (35.39%) with an overall positivity of 1.58% and 0.86% respectively. Highest prevalence of 54.71% was observed in the age group of 41-60 years followed by a prevalence of 29.20% in 19 to 40 years, 14.45% in 61-80 and 1.44% in the age group above 80. Of the 27,703 samples screened 449 (1.62%) were from the HIV-ART clinic and 7(1.55%) were found to be co-infected.

Conclusion: A seroprevalence of 2.44% was reported with male predominance (58.35%) with the maximum number of affected population being in the age group of 41-60 years (54.71%). The co prevalence of HBsAg and HIV was found to be 1.55%.

Keywords: Hepatitis B virus, HBsAg ELISA, seroprevalence, preponderance, co- infection.

1. Global burden of Disease 2016: The Lancet: September 16, 2017
2. Michitaka K, Nishiguchi S, Aoyagi Y, Hiasa Y, Tokumoto Y, Onji M. Etiology of liver cirrihosis in Japan a Nationwide survey. J Gastroenterol. 2010; 45: 86-4.
3. Aspinall EJ, Hawkins G, Fraser A, Hutchinson SJ, Goldberg D. Hepatitis B prevention, diagnosis, treatment and care: a review. Occup Med. 2011;61:531–540.
4. Yim HJ, Lok AS. Natural history of chronic hepatitis B virus infection: what we knew in 1981 and what we know in 2005. Hepatol. 2006; 43:173–81.
5. Hoofnagle JH, Doo E, Liang TJ, Fleischer R, Lok ASF. Management of hepatitis B: summary of a clinical research workshop. Hepato.l 2007; 45:1056–75.
6. EMI Guidelines - Appendix 21 Hepatitis B virus: epidemiology and transmission risks (updated May 2016)
7. Raimondi S, Maisonneuve P, Bruno S et al. Is response to antiviral treatment influenced by hepatitis B virus genotype? J Hepatol. 2010; 52:441–449.
8. Dutta S. An overview of molecular epidemiology of hepatitis B virus (HBV) in India. Virology J. 2008;5:156.
9. Yadav K, Biswas D, Baruah P, Borkakoty B, Mahanta J. Hepatitis B Endemicity in Some Parts of Arunachal Pradesh, Northeast India . Indian J Community Med. [Epub ahead of print] [cited 2018 Mar 23]. Available from: http://www.ijcm.org.in/preprintarticle.asp?id=173502.
10. Singh H, Aggarwal R, Singh RL, Naik SR, Naik S. Frequency of infection by hepatitis B virus and its surface mutants in a northern Indian population. Ind J Gastroenterol. 2003;22 (4):132-137.
11. Chowdhury A, Santra A, Chakravorty R, Banerji A, Pal S, Dhali GK, Datta S, Banerji S, Manna B, Chowdhury SR, Bhattacharya SK, Mazumder DG. Community-based epidemiology of hepatitis B virus infection in West Bengal, India: prevalence of hepatitis B e antigen-negative infection and associated viral variants J Gastroenterol Hepatol. 2005 Nov; 20:1712-20.
12. Kurien T, Thyagarajan SP, Jeyaseelan L, et al. Hepatitis B Infection in Tamil Nadu, India. Ind J Med Res. 2005;121(5):670-675.
13. Sodhi JS, Raja W, Zargar SA, Javid G, Aejaz S, Khan MA, Showkat A, Parveen S, Jan, A, Nisar S, Yattoo GN, Shah A. Screening for Occult and Overt Hepatitis B Virus Infection in Patients of Cancer before Receiving Chemotherapy: Looking Beyond HBsAg Testing. Int.J. Adv. Res. 2015; 3(1):458-465.
14. Wani MI, Rashid A, Tanvir M, Ajaz S. Prevalence of Hepatitis B in Kargil, Ladakh; Community Based study from a Rural area of Jammu and Kashmir. Ann. Int. Med. Dent Res. 2015; 3(5).
15. Chalana H, Kundal T, Malhari AS. Changing Trends in Drug Abuse Patterns and Seroprevalence of HIV, Hepatitis B Surface Antigen, and Hepatitis C in Substance Abusers Admitted to A Tertiary Hospital in Amritsar, India. Int J High Risk Behav Addict. 2017.
16. Thacker SB. Field Epidemi-ology. Edited by: Gregg MB. 2002, New York: Oxford University Press, 26-50.
17. Rubin E. Acute and chronic viral hepatitis. Federation Proceedings 1979; 38: 2665-73.
18. Bhatta CP, Thapa B, Rana BB. Seroprevalence of Hepatitis B in Kathmandu Medical College Teaching Hospital. Kathmandu UnivMed J(KUMJ). 2003;1:113-6.
19. Quadri SA, Dadapeer HJ, Arifulla KM, Khan N. Prevalence of Hepatitis B Surface Antigen in hospital based population in Bijapur, Karnataka. Al Ameen J Med Scie. 2013; 6(2):180-182.
20. Hatkar S, Baviskar J, Kotgire S. Sero-Prevalence of Hepatitis ‘B’ Virus Infection: A Teaching Hospital Based Study. Int.J.Curr.Microbiol.App.Sci. 2016; 5(12): 524-52.
21. Parimala TV. A Retrospective Study on Seroprevalence of Hepatitis B Surface Antigen among Patients in a Tertiary Care Hospital, South India. Int. J. Curr. Microbiol. App.Sci. 2016; 5 (11):329-333.
22. Bhatta B, Thapa R, Pant P, Pandeya DR. A Retrospective Hospital Based Study In Kathmandu to Assess the Seroprevalence of Hepatitis B Virus. JMMIHS 2016; 2:3-6
23. Isa I, Aminu M, Abdullahi SA, Sani MA and Akafyi DE. Seroprevelance of hepatitis b virus in a tertiary institution in North Western Nigeria. Afr. J. Microbiol. Res. 2015; 9(3): 171-179.
24. Makroo RN, Hegde V, Chowdhry M, Bhatia A, Rosamma NL. Seroprevalence of infectious markers & their trends in blood donars in a hospital based blood bank in north India. Indian J. Med. Res. 2015; 142: 317-322.
25. Batham A, Narula D, Toteja T, Sreenivas V, Puliyel JM. Sytematic review and meta-analysis of prevalence of hepatitis B in India. Indian Pediatr. 2007; 44:663-74.
26. Batham A, Gupta MA, Rastogi P, Garg S, Sreenivas V, Puliyel JM. Calculating prevalence of hepatitis B in India: using population weights to look for publication bias in conventional meta-analysis. Indian J Pediatr. 2009;76:1247–1257.
27. Prevention of Hepatitis B in India – An Overview. New Delhi: World Health Organization South-East Asia Regional Office; 2002
28. Puri P. Tackling the Hepatitis B Disease Burden in India. J clin exp hepatol. 2014;4:312–319.
29. Balamurugan, Gopal R, Saleem M, Kaviraj M, Shivekar SA, Mangaiyarkarasi T. Prevalence of Hepatitis B Surface Antigen among Patients Attending a Rural Teaching Hospital at Puducherry. Indian J Microbiol Res. 2016; 3 :74-6.
30. Sood S and Malvankar S. Seroprevalence of Hepatitis B Surface Antigen, Antibodies to Hepatitis C virus and Human immunodeficiency virus in a Hospital Based Population in Jaipur, Rajasthan, Indian J Community Med. 2010; 35(1):165-169.
31. Singh K, Bhat S, Shastry S. Trend in seroprevalence of Hepatitis B virus infection among blood donors of coastal Karnataka. India J Infect Dev Ctries. 2009; 3(5):376-379.
32. Ahmad B, Grover R, Ratho RK, Mahajan RC. Prevalence of hepatitis B virus infection in Chandigarh over a six year period. Trop Gastroenterol. 2001;22:18-9.
33. Dutta S, Shivanand PG, Chatterjee A. Prevalence of hepatitis B surface antigen and antibody among hospital admitted patients in Manipal. Indian J Public Health. 1994; 38: 108-12.
34. Tessema B, Yismaw G, Kassu A et al. Seroprevalence of HIV, HBV, HCV and syphilis infections among blood donors at Gondar University Teaching Hospital, Northwest Ethiopia: declining trends over a period of five years. BMC Infect Dis. 2010; 10(111).
35. Ayele AG, Gebre-Selassie S. Prevalence and Risk Factors of Hepatitis B and Hepatitis C Virus Infections among Patients with Chronic Liver Diseases in Public Hospitals in Addis Ababa, Ethiopia ISRN ISRN Trop Med. 2013; Article ID 563821, http://dx.doi.org/10.1155/2013/563821.
36. Pennap GR, Yakubu A, Oyige O, Forbi J. Prevelance of hepatitis B and C virus infection among people of a local community in Keffi, Nigeria. Afr. J. Microbiol. Res 2010; 4(4) :274-278.
37. Okonko IO, Okerentugba PO and Akinpelu AO. Prevelance of HBsAg among attendees of ARFH centre in Ibandan, Southwestern Nigeria. Am- Eurasian J Sci Res. 2012; 7(3):100-105.
38. Seoung-Ae L, Hong K, You-Sub W, Seung-Hyeok S, YiRang N, Han-Bo S, Kyung-Soo I, Bum-Joon K. Male-specific hepatitis B virus large surfaceprotein variant W4P potentiates tumorigenicity and induces gender disparity Mol. Cancer Biol. 2015; 14:23.
39. Giri PA, Deshpande JD, Phalke DB and Karle LB. Seroprevalence of Transfusion Transmissible infections among voluntary blood donars at a tertiary care teaching hospital in rural area of India. J Family Med Prim Care. 2012; 1:1.
40. Naik TB, Sathish JV, Wadekar MD. Seroprevalence of Hepatitis B Surface Antigen (HBsAg) among Patients Attending a Tertiary Care Hospital at Chamarajanagar, Karnataka, India. Int. J. Curr. Microbiol.App.Sci. 2018; 7(01): 1279-1284.
41. Beltagy EL, Al Balawi KE, Almuneef IAM, Memish ZA. Prervelance of hepatitis B virus markers among blood donors in a tertiary hospital in Tabuk, North Western Saudi Arabia. Int. J. Infect. Dis. 2008; 12: 495-499.
42. Thomas K, Thyagarajan SP, Jeyaseelan L, Varghese JC, Krishnamurthy P, Lakshmibai, et al. Community prevalence of sexually transmitted disease and human immunodeficiency virus infection in Tamilnadu, India:A probability proportional to size cluster survey. Nat Med J India. 2002;15:135-40.
43. Tankhiwale SS, Khadase RK, Jalgoankar SV. Seroprevalence of anti-HCV and hepatitis B surface antigen in HIV infected patients. Ind J Med Microbial. 2003;21:268-70.
44. Rogers MC, Kumarasamy N, Chaguturu SK, Flanigan TP, Mayer KH, Balakrishnan P, et al. Hepatitis B, Hepatitis C and HIV coinfection in Chennai, India. XI CROI, San Fransico, February 2004, Abstract No. 796
45. Saha MK, Chakrabarti S, Panda S, Naik TN, Manna B, Chatterjee A, et al. Prevalence of HCV and HBV infection among HIV seropositive intravenous drug users and their non-injecting wives in Manipur, India. Ind J Med Res. 2000; 111:37-9.

Dr Shashi S Sharma

Prof, PI and Nodal Officer

VRDL Dept. of Microbiology, GMC Jammu, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.