Hepatitis C seroprevalence: a community survey from the Gampaha district

Abstract

INTRODUCTION: Seroprevalence of Hepatitis C (HCV) infection is low among Sri Lankan blood donors and new entrant medical students, but high among renal transplant recipients and multiply transfused patients. Prevalence of infection in the general community is not known. METHODS: A community survey of HCV sero-prevalence was performed in the Gampaha district employing a multi-stage cluster sampling technique. A cluster was based in a Public Health Midwife area, and included individuals over one year of age. A pre-tested questionnaire was administered to assess risk of exposure to infection. After informed consent, 1-3 ml of blood was obtained from those recruited. Serum was separated and stored at -20°C. Sera were tested for IgG anti-HCV using a third generation ELISA. Samples giving positive or intermediate results were retested by the same ELISA, a confirmatory Reverse Immunoblot Assay, and also tested for HCV-RNA by RT-PCR. RESULTS: Of the 534 individuals included in the survey [M:F=1.1:1; median age 36yrs (inter-quartile Range 17-55)], 174 (32.6%) had at least one risk factor and 48 (9%) had more than one risk factor for exposure to HCV infection. However, only 3 (0.6%) sera were confirmed positive for anti-HCV. All samples tested were negative for HCV-RNA. CONCLUSIONS: Sero-prevalence of HCV infection was low in this community survey in the Gampaha district. This is despite a significant proportion of those surveyed having risk factors for exposure to the infection, and the previously known relatively high (2.5%) sero-prevalence of Hepatitis B infection (HBsAg) in this district.