2014 JOURNAL OF MEDICAL RESEARCHVol.1 No.1Vol.1Jul.–Dec. 2014ERA’S JOURNAL OF MEDICAL RESEARCHJul.–Dec. No.1ERA’S
SERoP REVAlENCE oF HEPATITIS B VIRUS IN PATIENTS ADMITTED To
ERA’S lUCKNoW MEDICAl CollEGE AND HoSPITAl
Shahi N T1, 2Shahi U, 3Shukla P, 4Singh Y I, Junior Resident 1–III Department of Microbiology,
Junior Resident–II Department of Orthopaedics, Senior Resident – Department of Microbiology,
4Prof and Head, Department of Microbiology, Era’s Lucknow Medical College and Hospital, Lucknow
Address for Correspondence
Hepatitis–B Virus infections are a serious global and public health problem. To assess the Dr. Nieha T Shahi
magnitude and dynamics of disease transmission and for its prevention and control, the study 501, Presidency Apartment,
of its seroprevalence is important. A medical college catering to the needs of a large population 305–B,Mahanagar,
uknow–226006 (U.P.), India
represents an important centre for serological surveys. Available data, on the seroprevalence LE–mail: email@example.com
of these bloodborne pathogens is also very limited. A study was undertaken to estimate the
seroprevalence of Hepatitis–B Surface Antigen (HBsAg) in both the sexes and different age
groups in a hospital–based population. Serum samples collected over a period of 24 months from
patients admitted to various IPDs of Era’s Lucknow Medical College and Hospital, Lucknow
were subjected within the hospital–based microbiology lab for the detection of HBsAg using
ELISA test. The seroprevalence of HBsAg was found to be 1.92%. The study throws light on the
magnitude of viral transmission in the community in Lucknow city and provides a reference for
Key Words: ELISA, Hepatitis B virus, Seroprevalence.
INTRoD UCTIoNtransmission of a disease in a community and for its control
Hepatitis B infection is a serious global and public health and prevention, assessment and study of its prevalence is
problem. Transmission agents for blood–borne viral very important. India has a strong private health care system
diseases by Centers for Disease Control are blood, blood catering to more than one–half ambulatory and two–thirds
products, human tissue, semen, vaginal secretions, saliva outpatient care. (5) As a result, a large amount of clinical
from dental procedures, synovial fluid, cerebrospinal fluid, information is available in a private health care setting. A
pleural fluid, peritoneal fluid, pericardial fluid, amniotic private hospital catering to the needs of a large population
fluid. hepatitis B virus (HBV) is highly infectious and can thus represents an important centre for serological surveys.
be transmitted covertly by percutaneous routes and overtly It was against the above backdrop that the present study
by blood transfusion. The HBsAg in serum is the first was undertaken to estimate the seroprevalence of HBsAg in
seromarker to indicate active HBV infection, either acute both sexes and different age groups in a medical college in
or chronic.1 Worldwide over 2 billion people have been Lucknow.
infected with HBV and more than 350 million have chronic MATERIAlS AND METHoDS
HBV infection.2 India has been placed into the intermediate
zone of prevalence of hepatitis B (2–7% prevalence rates by This study was carried out in the Immunology Unit of
WHO).3 Clinically jaundice occurs in <5 yrs in about <10% the Department of Microbiology, Eras Lucknow Medical
cases and ≥5 yr in about 30%–50% cases. Acute case–fatality College and Hospital, Lucknow after an approval from the
rate accounts to 0.5%–1% cases. Chronic infection occurring institutional review committee. Patients taken were admitted
in <5 yrs is in 30%–90% cases whereas in ≥5 yrs is about 2%–to the various IPDs of this medical college and were advised
10% cases. Premature mortality from chronic liver disease to undergo hepatitis B screening were included in the study.
occurs in 15%–25% cases have been observed.(WHO data). The study extended over a period of 24 months from
This infection is a leading cause of morbidity and mortality, March 2010 to February 2012. A 5–ml venous blood sample
not only because of the acute illness but also due to its chronic was collected in a vial from all patients who came with
sequelae like chronic hepatitis, cirrhosis, and hepatocellular lab requisitions for the testing of HBsAg. The blood was
carcinoma, accountingEJMR for more than a million deaths allowed to clot for 45 min at room temperature and the
worldwide. (4) An effective vaccine is available for over two serum was separated after centrifugation at 3000 rpm. The
decades and has brought about remarkable changes in the serum sample was then subjected for ELISA test. All the
global epidemiology of HBV infection. Community–based tests were performed in accordance with the manufacturer's
seroprevalence studies are difficult to conduct in a developing instructions with adequate controls .ELISA test was done by
country due to socioeconomic hurdles and logistic difficulties. ERBA LISA HEPATITIS B kit 6.
Understanding and assessing the magnitude and dynamics of
1819 2014 JOURNAL OF MEDICAL RESEARCHVol.1 No.1Vol.1Jul.–Dec. 2014ERA’S JOURNAL OF MEDICAL RESEARCHJul.–Dec. No.1ERA’S
RESUlT SA study conducted in a hospital–based population at
In all, 12219 serum samples were processed for HBsAg Kathmandu Medical College Hospital, Nepal, showed viral
detection over the 24–month period. Table 1,Table 2 and Table hepatitis B prevalence to be 2.5%. (28) whereas HBsAg
3 show the age and sex distribution, ward wise distribution and patients attending a surgical OPD in Rawalpindi, Pakistan,
year wise distribution of the hospital–based population with reported a prevalence of 2.28%. (29)
hepatitis B seropositivity, respectively. The seroprevalence of The prevalence of hepatitis B varies from country to country,
HBsAg was found to be 1.92%. The seroprevalence for HBsAg depending upon behavioural, environmental, and host
among males and females was 1.95% and 1.86%, respectively. factors. In general, it is lowest in countries or areas with high
The highest seroprevalence of HBsAg was found in males standards of living are seen like in Australia, North America,
between the age of 20 –40 years. The lowest seroprevalence North Europe. Increasing prevalence seen in countries or
for HBsAg was found in the females of age less than 20 years. areas with low socioeconomic levelslike India, China, South
There is a marginal increment in the seropositivity of Hepatitis East Asia, South America. The seroprevalence for HBsAg
B From year 2010–11 to year 2011–12 in both sexes. In males among males and females was 1.95% and 1.86%, respectively.
this is about 0.04% whereas in females it is 0.02%. In females, In a study on hospitalized patients in Manipal, Dutta et al.
the highest seroprevalence of HBsAg was found in females observed HBsAg positivity of 35.3% in males versus 19.3%
medicine ward. The lowest seroprevalence for HBsAg was in females. (30) No plausible explanation has been given for
found in the females ENT ward. Among males the highest the higher prevalence in males in the general population but
seroprevalence was found in Male Medicine Ward, whereas probably females clear the HBV more efficiently as compared
lowest prevalence was found in male ENT ward. Overall the to males. (3)
highest seroprevalence was found in Female medicine ward
and lowest in female ENT ward. The possible explanation of AGE GRoUP MAlE PoSITIVEMAlEFEMAlE PoSITIVE FEMAlEToTAl
higher seropositivity in Medicine wards can be because of LESS THAN 20 826 14 (1.69%) 564 8 (1.42%) 22
the fact the most of the patients of liver complaints at first (1.58%)
seek medical help from department of medicine, whereas 20–402812 56 (1.99%) 2111 41 (1.94%) 97
the patients in Surgery and allied surgical specialties can be (1.97%)
considered as a true representative of community without 41–602755 54 (1.96%) 1421 28 (1.97%) 82
any higher risk of seropositivity. (1.96%)
DISCUSSIoN MORE THAN 60 1313 26 (1.98%) 417 7 (1.68%) 33(1.91%)
The seroprevalence of Hepatitis B Surface Antigen recorded TOTAL7706 150 (1.95%) 4513 84 (1.86%) 234
in our hospital–based population was 1.92%. Similar results (1.92%)
were obtained by researchers like Nanu A et al (7) (1.92%), Table 1: Age and Sex Distribution of patients having Seropositivity for
Kaur H et al8 (1.7%), Mohite J B et al (9) (2.11%), Nijhawan S Hrpatitis B
(10) (2.1%) and Singh B 11 (1.77%). Another study conducted WARD MAlE PoSITIVE FEMAlE PoSITIVE ToTAl
in Lucknow by Singh H et al (12) gives 2.06 % seroprevalence MAlEFEMAlE
of HbsAg. CASUALTY 2911 54 (1.86%) 1254 22 (1.75%) 76 (1.82%)
Studies from Delhi give seroprevalences ranging from 1.77% MEDICINE 1771 40 (2.26%) 867 20 (2.31%) 60 (2.27%)
to 2.6%. These studies include contributions from Singh B PULMONARY 323 7 (2.17%) 64 1 (1.56%) 8 (2.07%)
et al11 (1.77%), Nanu A et al (7) (1.92%), Tandon B N (13)MEDICINE
(2.14%), Sahni M (14) (2.23%), Panda S K 15 (2.27%) and PAEDIATRICS 164 3 (1.83%) 258 5 (1.94%) 8 (1.90%)
Irshad M (16) (2.6%). The HBsAg seroprevalence in studies SURGERY1705 33 (1.94%) 642 10 (1.56%) 43 (1.81%)
from Chandigarh ranges from 1% to 2.93%. These include ORTHOPADICS631 10 (1.85%) 313 6 (1.92%) 16 (1.69%)
contributions from Sharma R R (17) (1.0%), Joshi R M (18)ENT201 3 (1.49%) 154 2 (1.30%) 5 (1.41%)
(2.01%), Gupta I (19) (2.48%) and Kaur U (20) (2.93%). OB & GNANA961 18 (1.87%) 18 (1.87%)
TOTAL7706 150 (1.95%) 4513 84 (1.86%) 234
Studies from other parts of India include Ahmad B et al (21) (1.92%)
( Jodhpur – 2.43%), Chowdhury A et al (22) ( West Bengal Table 2: Ward Distribution of patients having Seropositivity for Hrpatitis B
– 2.97%), Elavia A J et al 23 ( Mumbai – 2.02%), Makroo R
N et al (24) (Srinagar – 1.11%), Singhvi A et al (25) ( Vellore– TIME DURATIoN MAlE PoSITIVE FEMAlE PoSITIVE ToTAl
2.84%) and Thakur T S (26) ( Himachal Pradesh – 2.59%). MAlEFEMAlE
EJMRMAR 2010–FEB 3015 58 (1.92%) 2217 41 (1.85%) 99
Lodha et al. (2001) in their review article on hepatitis B 2011(1.89%)
epidemiology have suggested, the true prevalence rate in MAR 2011–FEB 4691 92 (1.96%) 2296 43 (1.87%) 135
India to be 1–2%. (27) There is a wide variation of prevalence 2012(1.93%)
in different regions of our country the highest prevalence TOTAL7706 150 (1.95%) 4513 84 (1.86%) 234
being reported among the aborigines of Andaman and people (1.92%)
of Arunachal Pradesh. Table 3: Year wise percentage of results
2021 2014 JOURNAL OF MEDICAL RESEARCHVol.1 No.1Vol.1Jul.–Dec. 2014ERA’S JOURNAL OF MEDICAL RESEARCHJul.–Dec. No.1ERA’S
This is a study defining rates of infection with all these 15. Panda SK, Ramesh R, Rao KVS, Gupta A, Zuckerman AJ,
bloodborne agents among the hospital–based population Nayak NC. Comparative evaluation of the immunogenicity of
in Lucknow. The observed rates likely reflect the patient yeast derived (recombinant) and plasma derived Hepatitis B
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