Seroprevalence of IgG antibodies against hepatitis-A infection among individuals aged 6–30 years in India, 2021: a nationwide population-based cross-sectional study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: India accounts for one-fifth of the global hepatitis A virus (HAV) infections and half of HAV-related deaths. There is a lack of nationally representative population-based data on the endemicity of HAV to inform vaccination policy. We aimed to estimate the age-specific seroprevalence of HAV infection among individuals aged 6-30 years. Methods: We used serum samples collected during the fourth national COVID-19 serosurvey conducted between 14 June and 6 July 2021 to estimate the seroprevalence of HAV infection. The survey was conducted in 70 randomly selected districts across 20 Indian states and one union territory. We tested the serum samples from individuals aged six to 30 years for IgG antibodies against HAV. We estimated the overall and state-specific seroprevalence, along with 95% CIs, for the age groups of 6-10, 11-15 and 16-30 years. We classified the HAV endemicity in India using WHO classification (high, intermediate, low and very low). Findings: We tested 14,778 serum samples from individuals aged six to 30 years for IgG antibodies against HAV. Of these, 12,236 (90.0%, 95% CI 88.5-91.4) were found to be reactive. The seroprevalence increased with age, from 74.7% (71.1-77.9) among children aged 6-10 years to 85.2% (82.7-87.4) among those aged 11-15 years and 96.9% (96.3-97.5) among individuals aged 16-30 years. India was categorized as having intermediate endemicity for HAV infection as per the WHO classification. Of the 21 states or union territories included in the survey, 18 had intermediate endemicity. Interpretation: Our study findings indicate an intermediate level of endemicity for HAV infection in India. While these findings support consideration of hepatitis-A vaccination, further evidence on disease burden and cost-effectiveness is needed to inform policy decisions. Funding: Gates Foundation & Indian Council of Medical Research.
Authors: Muthusamy Santhosh Kumar, Chethrapilly Purushothaman Girish Kumar, Velusamy Saravanakumar, Thiyagarajan Karunakaran, Jeromie Wesley Vivian Thangaraj, Sriram Selvaraju, Kiran Rade, Ramasamy Sabarinathan, Surendran Parvathi, Smita Asthana, Rakesh Balachandar, Sampada Dipak Bangar, Avi Kumar Bansal, Jyothi Bhat, Debjit Chakraborty, Vishal Chopra, Dasarathi Das, Kangjam Rekha Devi, Gaurav Raj Dwivedi, S Muhammad Salim Khan, M Sunil Kumar, Avula Laxmaiah, Major Madhukar, Amarendra Mahapatra, Talluri Ramesh, Chethana Rangaraju, Jyotirmayee Turuk, Suresh Yadav, Tarun Bhatnagar, Balram Bhargava, Manoj V. Murhekar, Alka Turuk, Manjula Singh, Abdul Mabood Khan, Samiran Panda, Nivethitha N. Krishnan, Aby Robinson, Nivetha Srinivasan, Rushikesh Andhalkar, Anshuman Chaudhury, Prathiksha Giridharan, Vijayan Geetha Vinod Kumar, Naga Bhushanam Kotala, Krithikaa Sekar, Surabhi Yadav, Padmapriyadarshini Chandrasekaran, Anand Praveen Kumar, Vikas Dhikav, Ramesh Kumar Sangwan, Mahendra Thakor, Nimmathota Arlappa, Babu Jagjeevan, Hemalatha Rajkumar, Khalid Bashir, Inaamul Haq, Mariya Amin Qurieshi, Praveen K. Bharti, Pushpendra Singh, Debdutta Bhattacharya, Srikanta Kanungo, Jaya Singh Kshatri, Subrata Kumar Palo, Sanghamitra Pati, Rajni Kant, Hirawati Deval, Niraj Kumar, Rajeev Singh, Sthita Pragnya Behera, Ashok Kumar Pandey, Ashrafjit S. Chahal, Alok Kumar Deb, Shanta Dutta, Sarang Dhatrak, Ankit Viramgami, Amit Chakrabarti, Rakesh Dayal, Anindya Mitra, Arshad Kalliath, Anbarasi Kalaiselvan, Senthil Kumar Mayandi, Sreelakshmy Thalappil Naduvilethil, Neelima Devi Akula, Bhuvaneswari Anandhan, Sekar Dhanapriya Vadhani, Monisha Anbu, Pavithra Murugan, Prashant Kumar Singh, Shalini Singh, Hari Bhan Singh, Agam Jain, A.R. Nirmala, Seema Sahay, Kanwar Narain, Somashekar Narasimhaiah, Krishna Pandey
Institutions: Government of Kerala, National Institute of Epidemiology, National Institute of Research in Tuberculosis, World Health Organization - India, National Institute of Cancer Prevention and Research, National Institute of Occupational Health, National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Indian Council of Medical Research, National Institute for Research in Tribal Health, Regional Medical Research Center, Regional Medical Research Centre, Government Medical College, National Institute of Nutrition, Rajendra Memorial National Institute of Health Research, Government of Andhra Pradesh, National Tuberculosis Institute, National Institute for Implementation Research on Non-Communicable Diseases
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,250
OpenAlex ID: W4414497536