Changing epidemiology of hepatitis A and hepatitis E in urban and rural India (1982-98).
The epidemiology of hepatitis A virus (HAV) and hepatitis E virus (HEV) was assessed among age-stratified urban high socioeconomic, lower middle socioeconomic status and rural populations from western India in 1998. When compared with previous surveys, a clear shift from high to intermediate endemicity of HAV was evident only for higher socioeconomic population (1982-98), raising the possibility of outbreaks of hepatitis A in this category. A decrease in anti-HAV positivity was noted in rural children aged 6-10 years. Lower circulation of HEV was noted among < 25-year-old urban higher socioeconomic and rural individuals. For both viruses, the lower middle socioeconomic populations were comparable in 1982 and 1998. Socioeconomic status and family size (odds ratio = 23 and 1.6, respectively) were independently associated with anti-HAV positivity. Age, lower middle socioeconomic status and well water were significant independent variables for HEV infection (odds ratio = 5.7, 2.4 and 1.9, respectively). Hence, vaccination policy for hepatitis A needs to be reviewed.
Arankalle
V A
VA
Hepatitis Division, National Institute of Virology, Pune, India. aarankalle@hotmail.com
Chadha
M S
MS
Chitambar
S D
SD
Walimbe
A M
AM
Chobe
L P
LP
Gandhe
S S
SS
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D017957:Hepatitis A Virus, Human / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D016751:Hepatitis E / Q000453:epidemiology* / Q000276:immunology; D016752:Hepatitis E virus / Q000276:immunology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D014505:Urban Population
D006508:Hepatitis Antibodies