Volume 68, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


To determine whether health-care use was associated with prevalent hepatitis C virus (HCV) infection in Chennai, India, 1,947 adults from 30 slum communities were randomly selected to be interviewed about parenteral and sexual risks for HCV infection and to provide biological specimens for HCV and sexually transmitted infection (STI) testing. Prevalent HCV infection was detected in 2.4% of non-injection drug using (IDU) participants. Controlling for other associated factors, and excluding IDU, men who used informal health-care providers were five times as likely to be HCV infected as those who did not use informal providers (Adjusted Odds Ratio, AOR = 5.83; 95% confidence interval [CI]: 1.57, 21.6), a finding not detected in women. More research is needed to determine the extent to which HCV infection is associated with reuse of contaminated injection equipment in health-care settings in developing countries.


Article metrics loading...

Loading full text...

Full text loading...



  1. Cardoso MS, Koerner K, Epple S, Dengler T, Kerowgan M, Kubanek B, 1996. HCV transmission through blood transfusion: are HCV-RNA titer in donor serum and genotype major determinants of infection outcome? Beitr Infusionsther Transfusionsmed 33 : 225–230.
  2. Comandini UV, Tossini G, Longo MA, Ferri F, Cuzzi G, Noto P, Zaccarelli M, Visco G, 1998. Sporadic hepatitis C virus infection: a case-control study of transmission routes in a selected hospital sample of the general population in Italy. Scand J Infect Dis 30 : 11–15.
  3. Esteban JI, Gomez J, Martell M, Cabot B, Quer J, Camps J, Gonzalez A, Otero T, Moya A, Esteban R, Guardia J, 1996.Transmission of hepatitis C virus by a cardiac surgeon. N Engl J Med 334 : 555–560.
  4. Forns X, Fernandez-Llama P, Pons M, Costa J, Ampurdanes S, Lopez-Labrador FX, Olmedo E, Lopez-Pedret J, Darnell A, Revert L, Sanchez-Tapias JM, Rodes J, 1997. Incidence and risk factors of hepatitis C virus infection in a haemodialysis unit. Nephrol Dial Transplant 12 : 736–740.
  5. Izopet J, Pasquier C, Sandres K, Puel J, Rostaing L, 1999. Molecular evidence for nosocomial transmission of hepatitis C virus in a French hemodialysis unit. J Med Virol 58 : 139–144.
  6. Natov SN, Lau JY, Bouthot BA, Murthy BV, Ruthazer R, Schmid CH, Levey AS, Pereira BJ, 1998. Serologic and virologic profiles of hepatitis C infection in renal transplant candidates. New England Organ Bank Hepatitis C Study Group. Am J Kidney Dis 31 : 920–927.
  7. Donahue JG, Munoz A, Ness PM, Brown DE Jr., Yawn DH, McAllister HA Jr., Reitz BA, Nelson KE, 1992. The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med 327 : 369–373.
  8. Klein HG, 2000. Will blood transfusion ever be safe enough? JAMA 284 : 238–240.
  9. Moriya T, Koyama T, Tanaka J, Mishiro S, Yoshizawa H, 1999. Epidemiology of hepatitis C virus in Japan. Intervirology 42 : 153–158.
  10. Crofts N, Jolley D, Kaldor J, van Beek I, Wodak A, 1997. Epidemiology of hepatitis C virus infection among injecting drug users in Australia. J Epidemiol Community Health 51 : 692–697.
  11. Garfein RS, Vlahov D, Galai N, Doherty MC, Nelson KE, 1996.Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health 86 : 655–661.
  12. Smyth BP, Keenan E, O’Connor JJ, 1998. Bloodborne viral infection in Irish injecting drug users. Addiction 93 : 1649–1656.
  13. Kumar MS, Mudaliar S, Daniels D, 1998. Community-based outreach HIV intervention for street-recruited drug users in Madras, India. Public Health Rep 113 Suppl 1 : 58–66.
  14. Saha MK, Chakrabarti S, Panda S, Naik TN, Manna B, Chatterjee A, Detels R, Bhattacharya SK, 2000. Prevalence of HCV & HBV infection amongst HIV seropositive intravenous drug users & their non-injecting wives in Manipur, India. Indian J Med Res 111 : 37–39.
  15. Shrestha SM, Shrestha DM, Gafney TE, Maharjan KG, Tsuda F, Okamoto H, 1996. Hepatitis B and C infection among drug abusers in Nepal. Trop Gastroenterol 17 : 212–213.
  16. Kao JH, Chen DS, 2000. Transmission of hepatitis C virus in Asia: past and present perspectives. J Gastroenterol Hepatol 15 Suppl : E91–E96.
  17. Reeler AV, 1990. Injections: a fatal attraction? Soc Sci Med 31 : 1119–11125.
  18. Reeler AV, 2000. Anthropological perspectives on injections: a review. Bull World Health Organ 78 : 135–143.
  19. Simonsen L, Kane A, Lloyd J, Zaffran M, Kane M, 1999. Unsafe injections in the developing world and transmission of blood-borne pathogens: a review. Bull World Health Organ 77 : 789–800.
  20. Khan AJ, Luby SP, Fikree F, Karim A, Obaid S, Dellawala S, Mirza S, Malik T, Fisher-Hoch S, McCormick JB, 2000. Unsafe injections and the transmission of hepatitis B and C in a peri-urban community in Pakistan. Bull World Health Organ 78 : 956–963.
  21. Singh J, Bhatia R, Gandhi JC, Kaswekar AP, Khare S, Patel SB, Oza VB, Jain DC, Sokhey J, 1998. Outbreak of viral hepatitis B in a rural community in India linked to inadequately sterilized needles and syringes. Bull World Health Organ 76 : 93–98.
  22. Hutin YJ, Harpaz R, Drobeniuc J, Melnic A, Ray C, Favorov M, Iarovoi P, Shapiro CN, Woodruff BA, 1999. Injections given in healthcare settings as a major source of acute hepatitis B in Moldova. Int J Epidemiol 28 : 782–786.
  23. Kane M, 1998. Unsafe injections. Bull World Health Organ 76 : 99–100.
  24. Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M, 1999. Transmission of hepatitis B, hepatitis C, and human immunodefficiency viruses through unsafe injections in the developing world: model-based regional estimates. Bull World Health Organ 77 : 801–807.
  25. Pasha O, Luby SP, Khan AJ, Shah SA, McCormick JB, Fisher-Hoch SP, 1999. Household members of hepatitis C virus-infected people in Hafizabad, Pakistan: infection by injections from health care providers. Epidemiol Infect 123 : 515–518.
  26. Luby SP, Qamruddin K, Shah AA, Omair A, Pahsa O, Khan AJ, McCormick JB, Hoodbhouy F, Fisher-Hoch S, 1997. The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan. Epidemiol Infect 119 : 349–356.
  27. Huraib S, al-Rashed R, Aldrees A, Aljefry M, Arif M, al-Faleh FA, 1995. High prevalence of and risk factors for hepatitis C in haemodialysis patients in Saudi Arabia: a need for new dialysis strategies. Nephrol Dial Transplant 10 : 470–474.
  28. Michel JM, 1985. Why do people like medicines? A perspective from Africa. Lancet 1 : 210–211.
  29. Vishnu-Priya S, Lee C, 2001. Injection Practices in Tamil Nadu, Rapid Assessment and Proposed Plan of Action, January 2001. Geneva: World Health Organization.
  30. Lakshman M, Nichter M, 2000. Contamination of medicine injection paraphernalia used by registered medical practitioners in south India: an ethnographic study. Soc Sci Med 51 : 11–28.
  31. Singh J, Gupta S, Khare S, Bhatia R, Jain DC, Sokhey J, 2000. A severe and explosive outbreak of hepatitis B in a rural population in Sirsa district, Haryana, India: unnecessary therapeutic injections were a major risk factor. Epidemiol Infect 125 : 693–699.
  32. Anand K, Pandav CS, Kapoor SK, 2001. Injection use in a village in north India. Natl Med J India 14 : 143–144.
  33. Shev S, Hermodsson S, Lindholm A, Malm E, Widell A, Norkrans G, 1995. Risk factor exposure among hepatitis C virus RNA positive Swedish blood donors–the role of parenteral and sexual transmission. Scand J Infect Dis 27 : 99–104.

Data & Media loading...

  • Received : 12 Jun 2002
  • Accepted : 04 Nov 2002

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error