HEPATITIS The prevalence of hepatitis C virus antibodies among the voluntary blood donors of New Delhi, India A. Jain, S.S. Rana, P. Chakravarty, R.K. Gupta, N.S. Murthy 1 , M.C. Nath 2 , S. Gururaja 3 , N. Chaturvedi 4 , U. Verma 5 & P. Kar Department of Medicine, Maulana Azad Medical College; 1 Department of Biostatistics, Institute of Cytology and Oncology (ICPO), ICMR, Maulana Azad Medical College; 2 Blood Bank, Lok Nayak Hospital; 3 Blood Bank, GB Pant Hospital; 4 Blood Bank, Ram Manohar Lohia Hospital; 5 Blood Bank, Hindu Rao Hospital, New Delhi, India Accepted in revised form 24 January 2003 Abstract. Infection with hepatitis C virus (HCV) is a major cause of transfusion-associated hepatitis, cir- rhosis and hepatocellular carcinoma. The present study was conducted with an objective to evaluate the prevalence of anti-HCV antibody in New Delhi, In- dia using a large number of healthy voluntary blood donors. A total of 15,898 healthy voluntary blood donors were subjected to anti-HCV testing (using a commercially available third generation anti-HCV ELISA kit) and 249 were found to be reactive for anti-HCV antibody, yielding an overall prevalence of 1.57%. No significant difference was found between the HCV positivity rate of male (1.57%; 238/15,152) vs. female (1.47%; 11/746) donors, family (1.58%; 213/13,521) vs. altruistic (1.51%; 36/2377) donors and first-time (1.55%; 180/11,605) vs. repeat (1.61%; 69/4293) donors. The age distribution of anti-HCV reactivity showed a maximum prevalence rate of 1.8% in the age group of 20–29 years. In addition, there was a clear trend of decreasing positivity for anti-HCV with increasing age and this trend was statistically significant. The results of the present study show that the prevalence of anti-HCV anti- bodies in the healthy voluntary blood donors of New Delhi, India is considerably higher than the reported seroprevalence of HCV in majority of the industri- alized nations and this represents a large reservoir of infection capable of inflicting significant disease burden on the society. In addition, donors of New Delhi, India showed a trend of decreasing seropre- valence with increasing age, possibly implying a higher exposure rate to HCV in younger subjects. Key words: Anti-HCV antibodies, Hepatitis C seroepidemiology, Hepatitis C virus, Voluntary blood donors. Introduction Infection with hepatitis C virus (HCV) is a major cause of liver disease, cirrhosis and hepatocellular carcinoma worldwide. In developed countries, strin- gent screening for HBsAg by sensitive assays and vaccination against hepatitis B virus (HBV) have re- sulted in a sharp decline in the incidence of HBV infection. As a result, HCV has now emerged as the most important cause of post-transfusion non-A, non-B hepatitis [1]. The successful identification and cloning of HCV RNA by Choo et al. [2] in 1989 al- lowed the development of antibodies against this agent; such anti-HCV tests have made it possible to carry out large prevalence studies of HCV infection. In the present study, we report the results of a large survey of the prevalence of anti-HCV antibody amongst healthy voluntary blood donors from various hospitals of New Delhi, India. Since the screening of blood for antibodies to HCV is not legally mandatory in India, this information will help in formulating a strategy to provide safe blood for transfusion and to reduce the incidence of transfusion-associated hepatitis. Materials and methods The blood banks of four major hospitals of New Delhi, namely, Lok Nayak Hospital, GB Pant Hos- pital, Ram Manohar Lohia Hospital and Hindu Rao Hospital participated in the study, which was con- ducted from January 1998 to October 1998. The objective of the study was explained to all the participants and an informed consent was taken. All blood donors were screened using a questionnaire with an objective to exclude established risk factors and/or behavioural predisposition. The questionnaire sought specific information regarding the following parameters: name, age, sex, address, replacement (family) or altruistic donor, first-time or repeat do- nor, drug history, alcohol consumption, any systemic illness and previous history or current existence of risk factors (blood/blood product transfusion, intra- venous drug abuse, acupuncture, tattooing, dialysis, occupational exposure, multiple sexual partners, homosexuality, use of immuno-suppressant drugs etc.). All professional blood donors and subjects with a history of liver disease were excluded from the European Journal of Epidemiology 18: 695–697, 2003. Ó 2003 Kluwer Academic Publishers. Printed in the Netherlands.