Epidemiology of HBsAg carriers in India. A holistic approach to control of hepatitis-B reservoir

Morbidity and mortality due to hepatitis B virus (HBV) infection is a matter of concern all over the world. The incidence of HBV infection depends upon the human reservoir particularly located in Asian Pacific and some of the African countries. Knowledge of the epidemiology of HBV infection is essential to formulate a strategy for its control. Six thousand and twenty-four persons of different categories which included urban, rural, pregnant, non-pregnant, diabetic, alcoholic and occupational high-risk groups were tested for HBsAg. Personal and environmental factors contributing to the development of the HBsAg carrier state were studied. It was found that hospital environment, blood transfusion, perinatal transmission and urbanization were the major factors responsible for the spread of the HBV infection. A holistic approach for the control of HBV infection, which should include an improvement of the hospital and urban environment, complete exclusion of commercial blood donors and HBsAg screening of the voluntary blood donors is recommended, while immunoprophylaxis should be reserved for the protection of high-risk groups and to prevent perinatal transmission.