HCV genotyping in India--quo vadis?

HCV is transmitted principally through parenteral routes. The parenteral modes of transmission include blood transfusions, blood product infusions and organ transplantation. Vertical transmission of HCV has also been described. Though reports on the sexual transmission have been controversial, a fact that clearly emerges is that transmission of HCV through this route occurs at a very low efficiency, lower than that for hepatitis B virus and human immunodeficiency virus. However, in a significant proportion of patients the route of HCV transmission is unknown. In developing countries, nonconventional routes such as acupuncture, tattooing, circumcision, commercial barbering and dental extractions are potential routes of transmission. In addition, the commonly held belief that an injection is more effective than oral medication can expose people to HCV through the use of unsterilised needles. Controlling such sources of infection is also difficult. A large pool of viraemic carriers coupled with the unrecognized routes of transmission indicate that HCV infection in the Indian subcontinent is poised to become a silent epidemic in the coming years posing major health problems.