Abstract
INTRODUCTION: Like a silent contagion, the hepatitis B virus (HBV), if it remains undiagnosed, may subsequently lead to the development of chronic liver disease. The HBV spread is often observed in various ethnicities and can also be related to the socioeconomic status and habits of people. Our subject is a population of tribes and non-tribesmen belonging to the northern plains of the Brahmaputra valley to the foothills of Arunachal Pradesh, India, and therefore, the study of the spread of HBV in this area can be an interesting case in itself. This study aims to assess the prevalence of HBV retrospectively and to describe the epidemiology of disease symptoms. METHODOLOGY: The selected population ranged from 0 to >80 years and included patients who attended outpatient departments or wards with suspected HBV infection, presenting with six disease-related symptoms. Serum samples were subjected to an enzyme-linked immunosorbent assay (ELISA) for preliminary screening, followed by reverse transcription-polymerase chain reaction (RT-PCR) to estimate viral load among positive cases. Statistical analysis and a prevalence study were conducted to correlate physical symptoms with HBV positivity and ethnic diversity. RESULTS: ELISA and subsequent RT-PCR analysis confirmed 165 positive cases. The positivity rates among males and females were 62.19% and 37.80%, respectively, with the highest proportion of cases originating from Sonitpur district, Assam. The most affected age groups were 21-40 and 41-60 years. Positive likelihood ratio analysis (baseline 2000 IU/mL) showed that diarrhea, pain, and vomiting were strongly associated with higher viral loads. Conclusions: Data on HBV cases across different ethnic groups revealed seasonal spikes from mid-spring to summer, with male predominance in the 21-60 age range. Diarrhea, dysentery, and abdominal pain were common symptoms, affecting both tribal and non-tribal populations equally. Although most cases are serologically positive irrespective of viral load, studies tracking associated prevalent symptoms and likelihood ratios may help identify predictive therapeutic approaches to prevent HBV infection from becoming epidemic.