title: Chronic hepatitis C virus infection in India: Regional demographics and distribution of viral genotypes.
abstract: OBJECTIVE
  Although chronic hepatitis C virus (HCV) infection affects millions of people in India, few studies have assessed host, viral, and disease characteristics of chronically infected patients at national and regional levels. Such information is critical to support large scale screening and treatment initiatives for chronic HCV infection in India.
  
  
  METHODS
  Patients with known chronic HCV infection making routine or for-cause visits to the participating study centers were enrolled in this observational study. Patients attended a single outpatient visit during which demographics and medical history were collected, a physical examination was performed, and blood and urine samples were collected for laboratory assessments. Samples were analyzed to determine HCV genotypes and subtypes, and genotypes of interferon lambda 3 (IFNL3) single nucleotide polymorphism. No therapeutic interventions were administered.
  
  
  RESULTS
  We enrolled 500 patients at 19 centers, categorized into four geographic regions (North, South, East, and West). All patients self-identified as Indian, and most (66 %) were male. Genotype 3 was the most common genotype overall (54 %); however, its prevalence varied greatly by region, ranging from 34 % in the South to 69 % in the East. Genotypes 1 (24 %) and 4 (6 %) were the next most common, and HCV genotype could not be determined for 16 % of patients.
  
  
  CONCLUSIONS
  This prospective survey suggests that demographics, viral, and host factors in patients with chronic HCV infection are highly variable in India and pose significant challenges for the implementation of broad-scale screening and treatment initiatives.
authors.affiliation: Global Hospitals, 35, Dr. E Borges Road, Parel, Mumbai, 400 012, India. drshahsamir@gmail.com.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Shah
authors.affiliation: Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, 500 082, India.
authors.forename: P N
authors.initials: PN
authors.lastname: Rao
authors.affiliation: Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110 070, India.
authors.forename: Shiv K
authors.initials: SK
authors.lastname: Sarin
authors.affiliation: Institute of Post Graduate Medical Education and Research, 244 A.J.C Bose Road, Kolkata, 700 020, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chowdhury
authors.affiliation: Seth GS Medical College and KEM Hospital, Acharya Donde Marg, Parel, Mumbai, 400 012, India.
authors.forename: Shobna
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Dharamsi Hospital, Chandni Chowk, South Shivaji Nagar, Nishant Colony, Sangli, 416 416, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Dharamsi
authors.affiliation: Institute of Digestive and Liver Disease, Guwahati, Assam, India.
authors.forename: B D
authors.initials: BD
authors.lastname: Goswami
authors.affiliation: Global Hospitals, Lakdikapul, Hyderabad, 500 004, India.
authors.forename: Dharmesh
authors.initials: D
authors.lastname: Kapoor
authors.affiliation: Civil Hospital, Dawrpui, Aizawl, Mizoram, 796 001, India.
authors.forename: Rosang
authors.initials: R
authors.lastname: Luaia
authors.affiliation: Liver Clinic, U-9 Jolly Plaza, Athwagate, Surat, 395 001, India.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Mehta
authors.affiliation: Midas Institute of Gastroenterology, Midas Heights, Central Bazar Road, Ramdas Peth, Ramdaspeth, Nagpur, 440 012, India.
authors.forename: Shrikant
authors.initials: S
authors.lastname: Mukewar
authors.affiliation: VGM Hospital, 2100, Trichy Road, Singanallur, Coimbatore, 641 005, India.
authors.forename: V G Mohan
authors.initials: VG
authors.lastname: Prasad
authors.affiliation: Rai Speciality Care Centre, H-6, Janpath, Shyam Nagar, Ajmer Road, Sodala, Jaipur, 302 019, India.
authors.forename: Ramesh Roop
authors.initials: RR
authors.lastname: Rai
authors.affiliation: Medanta-The Medicity, Sector 38, Gurgaon, Delhi (NCR), 122 018, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saigal
authors.affiliation: Apollo Hospital, Bilaspur, Chattisgarh, 495 001, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Singh
authors.affiliation: Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, Delhi, 110 070, India.
authors.forename: Nirupama
authors.initials: N
authors.lastname: Trehanpati
authors.affiliation: Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Chen
authors.affiliation: Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA.
authors.forename: Anuj
authors.initials: A
authors.lastname: Gaggar
authors.affiliation: Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Knox
authors.affiliation: Gilead Sciences, 333 Lakeside Dr, Foster City, CA, 94404, USA.
authors.forename: G Mani
authors.initials: GM
authors.lastname: Subramanian
authors.affiliation: Department of Gastroenterology, S.C.B. Medical College, Manglabag, Cuttack, 753 007, India.
authors.forename: Shivaram Prasad
authors.initials: SP
authors.lastname: Singh
authors.affiliation: Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Ludhiana, 141 001, India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Sood
authors.affiliation: Global Hospitals and Health City, 439, Cheran Nagar, Perumbakkam, Chennai, 600 100, India.
authors.forename: Joy
authors.initials: J
authors.lastname: Varghese
authors.affiliation: Manipal Hospitals, Bangalore, 560 017, India.
authors.forename: Raj Vigna
authors.initials: RV
authors.lastname: Venugopal
mesh_terms: D000328:Adult; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D000095022:Interferon Lambda
chemical_list: D007372:Interferons; D007378:Interleukins; C000624353:interferon-lambda, human; D000095022:Interferon Lambda
keywords: Chronic HCV; Hepatitis C prevalence in India; IL28B