HYDERABAD: With approximately a 150% increase in Hepatitis B cases and a 100% increase in Hepatitis C cases, Telangana has witnessed a significant rise in viral hepatitis infections over the last three years.
According to the Factsheet-2021 on the seroprevalence (the level of a pathogen in a population) of Hepatitis B and Hepatitis C by the National Programme for Surveillance of Viral Hepatitis (NPSVH) under the Ministry of Health and Family Welfare (MoH&FW), Telangana recorded the highest number of Hepatitis B infections in the country.
Dr Mithun Sharma, director of Hepatology and Regenerative Medicine and consultant in Transplant Hepatology at the Centre for Hepatology, AIG Hospitals, told TNIE that Hepatitis B infections are more prevalent than Hepatitis C. He emphasised that both infections remain leading causes of liver cancer in the country.
The NPSVH tested and analysed 1,45,912 dried blood spots (DBS) samples from the National Family Health Survey-4 (NFHS-4), focusing on women aged 15-49 years and men aged 15-54 years across 11 groups of states and Union Territories. Telangana and Andhra Pradesh were included in group 1.
The report highlighted that testing was conducted for the presence of Hepatitis B surface antigen (HBsAg) and antibodies to Hepatitis C virus (anti-HCV) as biomarkers for Hepatitis B and Hepatitis C, respectively.
The findings revealed that the seroprevalence of Hepatitis B was highest in group 1 at 2.39%, followed by the north-eastern states in group 12 at 1.65% and group 7 at 1.6%. Regarding Hepatitis C, the seroprevalence in group 1 states (Telangana and Andhra Pradesh) was the third highest in the country at 0.44%.
The study also noted that individuals engaging in higher-risk sexual intercourse showed greater seroprevalence of both Hepatitis B and Hepatitis C compared to those without such risk factors.
Demand for special screening programmes
State health department data indicates a sharp rise in the number of individuals testing positive for Hepatitis B since 2022. The number of positive cases increased by around 100% in 2023 and by 150% in 2024. Between April 2022 and March 2023, 902 cases were reported, rising to 2,200 between April 2023 and March 2024, and 5,268 cases from April to October 2024. This amounts to a total of 8,370 positive cases over the last three years.
Viral load screening for Hepatitis B also saw a significant increase, with 481 screenings in 2022, 1,800 in 2023 and 4,624 in 2024, totaling 6,905 screenings. The number of individuals receiving treatment for Hepatitis B rose from 674 in 2022 to 906 in 2024, despite a slight dip to 620 in 2023, resulting in a total of 2,200 treated patients.
Similarly, Hepatitis C cases showed an overall increase. Positive cases were 939 in 2022-2023, 999 in 2023-2024, and 2,132 from April to October 2024, totalling 4,070 cases. Viral load screenings for Hepatitis C rose from 792 in 2022-2023 to 1,990 in 2024, summing up to 3,660 screenings over three years. The number of individuals receiving treatment for Hepatitis C stood at 753 in 2022-2023, dropped to 519 in 2023-2024, and rose again to 715 in 2024, amounting to 1,987 treated patients.
Shortcomings of underreporting
Dr Mithun highlighted the challenges in tracking hepatitis infections, citing the lack of a national database to record and track cases and insufficient screening programmes. He stressed the need for priority screening initiatives given the asymptomatic nature of these infections. “Hepatitis C can persist in the body for over 30 years, and individuals can remain carriers without realising it,” he explained.
He pointed out that Hepatitis B is preventable through vaccination, whereas no preventive vaccine exists for Hepatitis C. For post-infection scenarios, Hepatitis B has only a 1% chance of being treated within the first six months, while Hepatitis C is 95% treatable post-infection. Despite available treatments reducing cases, Hepatitis B remains a more serious concern due to its higher prevalence and mortality rate, surpassing even HIV in its impact.
Dr Mithun called for a systematic protocol to address Hepatitis B and C infections, recommending extensive screening programmes, particularly among high-risk populations. He also advocated for a decentralised approach at the community level, emphasising awareness and screening initiatives at Primary Health Centres (PHCs) and Community Health Centres (CHCs).