Medicine - Medicine
The epidemiology of chronic hepatitis B, infant HBV vaccination, and HBV-associated liver disease in the Tibetan population in India
Chronic hepatitis B virus infection (CHB) is considered one of the major causes of morbidity and mortality among the Tibetan population-in-exile in India. However, data on the prevalence of CHB among this population is lacking. In addition, the success of infant vaccination programs is uncertain, despite the availability of infant vaccination for this population since 2004. The immediate goal of this study is to define hepatitis B epidemiology, including prevalence of CHB among children and childhood immunization. The longer-range goal is to develop a platform and relationship to complete further grant-supported work on hepatitis B biology, transmission, and prevention strategies among the Tibetan population. The proposed study has been developed in partnership with the Central Tibetan Administration Department of Health (CTA DOH). We propose to survey a cross-section of the Tibetan population living in camps, schools, and monasteries in Bylakuppe Settlement in Karnataka, India. Basic demographic characteristics will be collected from all participants, health cards will be reviewed for HBV vaccination status or other HBV testing (when available), and testing for hepatitis B surface antigen and total core antibody. Testing for hepatitis B e antigen, HBV DNA, and liver function testing will be performed when indicated by a study algorithm. This study will estimate CHB prevalence, HBV transmission patterns (by prevalence of sAg and cAb by age group), and infant vaccination coverage. Completion of the proposed study will generate valuable programmatic data for immediate use by the CTA DOH and essential data for designing further studies and funding applications.