New insights into hepatitis C virus infection in the tribal-dominant part of Northeast India.

Northeast India is known for the demographic heterogeneity of its tribal population, but there is no information about hepatitis C virus infection and associated risk factors. Anti-HCV was measured, HCV-RNA was detected based on the 5' UTR-core region, and genotyping was done by direct sequencing of the NS5b region. Antibodies to HCV were found in 13.7 % of the samples tested (96 out of 700), while HCV-RNA was positive in 73 % of the samples (70 out of 96) and in 5 out of 385 cases of occult HCV infection. Genotypes 1 to 4 were found respectively in 14.6, 7.3, 20, 30.8 %, and genotype 6 in 13.6 %, of the 75 HCV isolates. In acute viral hepatitis (AVH), the most prevalent genotype was 2a (28.6 %), while it was 4a (28 %) in chronic hepatitis C (CHC) and 29.4 % in cirrhosis. Males were more prone than females to HCV infection, and the highest numbers of cases of HCV infection were recorded in the age group of 40-49 years. The major risk factors were intravenous drug abuse (IVDU) (34.6 %), multiple sexual partners (20 %) and contact with professional barbers (38.6 %). The seroprevalence of HCV in Northeast India is higher than in the rest of India. This study highlights the fact that geographical variations occur with respect to HCV genotypes, which could influence the course and progress of different type of liver diseases seen in India.

Metabolic abnormalities in human immunodeficiency virus patients with protease inhibitor-based therapy.

CONTEXT: Several studies have reported metabolic abnormalities in patients taking protease inhibitor (PI) based therapy from several parts of the world. But there is no prospective study in India after switching from PI sparing regimen to PI based regimen. AIMS: To assess whether North-East Indian Human Immunodeficiency Virus (HIV) patients also develop similar metabolic abnormalities to PI. SETTINGS AND DESIGN: This prospective study was conducted in Anti-retroviral therapy (ART) Centre of Excellence, at a tertiary care Medical Institute. MATERIALS AND METHODS: Fifty-five patients taking PI based ART were taken for the study. These patients were started on Ritonavir based therapy, after treatment with first line drugs had failed according to National AIDS Control Organization (NACO) guidelines 2008. Glucose and lipid profiles were evaluated. American Diabetes Association (ADA) and NCEP ATP III criteria were used to categorize glucose and lipid abnormalities. International Diabetes Federation (IDF) 2006 cut-off was used for waist circumference and blood pressure. STATISTICAL ANALYSIS USED: Paired t-test was done whenever applicable. RESULTS: There was a significant increase in waist circumference after 6 months of 2(nd) line ART from 78.0 cm to 80.2 cm (P value < 0.001). There was significant increase in both systolic and diastolic blood pressure after 6 months. In 29.8% of patients blood pressure rose to hypertensive level after 6 months. Total cholesterol, triglyceride and low density lipoprotein cholesterol also rose significantly after 6 months but not high density lipoprotein cholesterol. CONCLUSIONS: Our study showed that North-Eastern Indian patients also develop metabolic abnormalities to protease inhibitors similar to people of other races.