Clustering of hepatitis C virus antibody positivity within households and communities in Punjab, India. (2019)

• Record Type: Journal Article
• Authors: Trickey, A.; Sood, A.; Midha, V.; Thompson, W.; Vellozzi, C.; Shadaker, S.; Surlikar, V.; Kanchi, S.; Vickerman, P.; May, M. T.; Averhoff, F.
• Is Part Of: Epidemiology and infection. Volume 147(2019)
• Publication Date: 2019
• Subjects: Epidemiology, -- hepatitis C, -- serosurvey, -- statistics; Communicable diseases -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1017/S0950268819001705
• Languages: English
• ISSNs: 0950-2688

Abstract

Abstract: To better understand hepatitis C virus (HCV) epidemiology in Punjab state, India, we estimated the distribution of HCV antibody positivity (anti-HCV+) using a 2013–2014 HCV household seroprevalence survey. Household anti-HCV+ clustering was investigated (a) by individual-level multivariable logistic regression, and (b) comparing the observed frequency of households with multiple anti-HCV+ persons against the expected, simulated frequency assuming anti-HCV+ persons are randomly distributed. Village/ward-level clustering was investigated similarly. We estimated household-level associations between exposures and the number of anti-HCV+ members in a household ( N = 1593 households) using multivariable ordered logistic regression. Anti-HCV+ prevalence was 3.6% (95% confidence interval 3.0–4.2%). Individual-level regression ( N = 5543 participants) found an odds ratio of 3.19 (2.25–4.50) for someone being anti-HCV+ if another household member was anti-HCV+. Thirty households surveyed had ⩾2 anti-HCV+ members, whereas 0/1000 ( P < 0.001) simulations had ⩾30 such households. Excess village-level clustering was evident: 10 villages had ⩾6 anti-HCV+ members, occurring in 31/1000 simulations ( P = 0.031). The household-level model indicated the number of household members, living in southern Punjab, lower socio-economic score, and a higher proportion having ever used opium/bhuki were associated with a household's number of anti-HCV+ members. Anti-HCV+ clusters within households and villages in Punjab, India. These data should be used to inform screening efforts.