Tackling the Hepatitis C Disease Burden in Punjab, India

Abstract

Hepatitis C virus (HCV) is a globally prevalent pathogen and is a major cause of healthcare burden in India. HCV poses a significant problem in the state of Punjab, India owing to the higher prevalence of risk factors like unsafe medical practices (including unsafe injections and dental procedures) and intravenous drug use. The reported prevalence of HCV in this part of the country was 5.2% in 2012, while a recent study has shown the prevalence to be 3.2% in 2016. Similar to the other geographic belts in India, genotype 3 predominates in the state of Punjab. Control of HCV infection in Punjab requires focusing on several strategies. There is a need to formulate a health educational curriculum targeting not only the high-risk population but also the general population regarding the transmission of HCV. Training of family physicians who form the first link to patients in the community is imperative in the success of healthcare programmes. Adopting the dual approach of treating the old cases (decreasing the reservoir pool of HCV) and decreasing the incidence of new ones would help curtail the disease and decrease liver related mortality. A commendable initiative has been launched by the Punjab state government to eliminate HCV from Punjab. However, besides the initiative by the government, a concerted effort by all other stakeholders in managing the HCV burden in India, namely the doctors, the drug companies and the non-government organizations is required for control of HCV.

Keywords: BPL, below poverty line; DNDi, drugs for neglected diseases initiative; ECHO, Extension for Community Healthcare Outcomes; HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HCW, health care worker; HD, hemodialysis; INASL, Indian National Association for study of the Liver; IVDU, intravenous drug user; MMPHCRF, Mukh Mantri Punjab Hepatitis-C Relief Fund; NAT, nucleic acid testing; NGO, non-government organization; PSACS, Punjab State AIDS Control Society; Punjab; control; hepatitis C; prevalence.

Figure 1

Prevalence of HCV seropositivity across surveyed districts in Punjab.

Figure 2

Hotspots of HCV in Punjab.

Figure 3

Methods to tackle HCV infection in India. NGOs, non-governmental organizations; DNDi, drugs for neglected diseases initiative.