Seroprevalence of hepatitis B and C virus infection among clinically suspected patients at state sector hospitals in Sri Lanka; a laboratory-based retrospective study

The public health threat posed by viral hepatitis globally is being planned to be eliminated by the year 2030 and, Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections accounts for more than 90% of the worldwide viral hepatitis burden. Sri-Lankans has an increased risk of acquiring HBV and HCV infections through travel and trade as many neighboring countries report intermediate to high HBV and HCV prevalence. Data regarding the prevalence of these infections, which is essential for planning of country specific elimination strategies are scarce and is in high demand. Hence, the current study aims at describing the prevalence and associated factors for HBV and HCV infections in patients tested at Medical Research Institute (MRI), the premier institution for diagnosis of viral hepatitis in Sri-Lanka which receives samples from all around the country. A retrospective study was conducted using all samples received and tested at MRI for HBsAg and HCV antibody from 2016 to 2018, using a commercially validated HBsAg and anti-HCV antibody ELISA kits respectively. Clinical and epidemiological data were collected using the accompanying request form. A total of 36,007 patient samples were tested for HBsAg and 15,280 for anti HCV antibodies. Overall HBsAg seroprevalence was 1.56% for the study period. Majority (65.06%) of the positives were males and majority (23.58%) was in 31-40 years age category. Highest numbers of positives (53%) were reported from the Colombo district. Most (23.8%) were chronic careers, 15.8% had acute hepatitis and 11.8% had chronic liver disease due to HBV infection. Out of all positives 5.1% were pregnant at the time of testing. Anti HCV seroprevalence for the study period was 1.81%. Males were predominant (65.9%) with mean age being 39 years (SD 16.39). Seropositive cohort consisted of multiple risk groups including patients with multiple blood transfusions, IV drug use, multiple sexual partners, and haemodialysis. Majority of positive samples were received from Colombo, which represented 54.5% of the total. The study results confirmed the HBV and HCV infection burden in Sri Lanka and the need to strengthen and expand preventive and control measures in order to achieve the WHO declared elimination goals by the year 2030.