Hepatitis B and Hepatitis C in Pakistan: prevelence and risk factors

Institute for Global Health, Division of Pediatric Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, 37203-1738, USA.
International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases (Impact Factor: 1.86). 11/2008; 13(1):9-19. DOI: 10.1016/j.ijid.2008.06.019
Source: PubMed


Pakistan carries one of the world's highest burdens of chronic hepatitis and mortality due to liver failure and hepatocellular carcinomas. However, national level estimates of the prevalence of and risk factors for hepatitis B and hepatitis C are currently not available.
We reviewed the medical and public health literature over a 13-year period (January 1994-September 2007) to estimate the prevalence of active hepatitis B and chronic hepatitis C in Pakistan, analyzing data separately for the general and high-risk populations and for each of the four provinces. We included 84 publications with 139 studies (42 studies had two or more sub-studies).
Methodological differences in studies made it inappropriate to conduct a formal meta-analysis to determine accurate national prevalence estimates, but we estimated the likely range of prevalence in different population sub-groups. A weighted average of hepatitis B antigen prevalence in pediatric populations was 2.4% (range 1.7-5.5%) and for hepatitis C antibody was 2.1% (range 0.4-5.4%). A weighted average of hepatitis B antigen prevalence among healthy adults (blood donors and non-donors) was 2.4% (range 1.4-11.0%) and for hepatitis C antibody was 3.0% (range 0.3-31.9%). Rates in the high-risk subgroups were far higher.
Data suggest a moderate to high prevalence of hepatitis B and hepatitis C in different areas of Pakistan. The published literature on the modes of transmission of hepatitis B and hepatitis C in Pakistan implicate contaminated needle use in medical care and drug abuse and unsafe blood and blood product transfusion as the major causal factors.

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Available from: Sten H Vermund, Oct 05, 2015
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    • "The prevalence of HBsAg in limited and specific groups of Afghans has been reported between 1.23% and 8.3% (6-11). In studies from Pakistan, the prevalence of hepatitis B infections is between 1.7% and 5.5% in the children (13). There is no data available concerning the prevalence of HIV or HCV in Pakistan or Afghanistan. "
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    ABSTRACT: Hepatitis B virus (HBV), hepatitis C Virus (HCV), and human immunodeficiency virus (HIV) infections are significant causes of morbidity and mortality all over the world, especially in underdeveloped countries like Afghanistan. Limited data are available concerning the seroprevalence of HBV, HCV and HIV in the pediatric age group in Afghanistan . The aim of the study was to assess HBV, HCV and HIV serology among children at an outpatient clinic in Kabul. A total number of 330 children were included to the study from outpatient clinics of Ataturk Kabul ISAF Role II Military Hospital from May to November 2012. Hepatitis B surface antigen (HBsAg), hepatitis C antibody (anti-HCV), and human immunodeficiency virus antibody (anti-HIV) were measured. The mean age of children was 6.5 ± 4.2 years. The frequency of positive results for HBsAg, anti-HBs and anti-HCV in all age groups were 12 (3.6%), 47 (14.2%) and 2 (0.6%), respectively. Anti-HIV was not detected in any of the children's serum samples. The frequency of positive results for HBsAg was significantly higher in children older than six years than in other age groups. Vaccination program including HBV has begun during the last five years in Afghanistan. The continuation of the vaccination program is of great importance. Vaccination program and implementation steps should be revised and the deficiencies, if any, should be overcome without delay.
    Hepatitis Monthly 03/2014; 14(3):e16154. DOI:10.5812/hepatmon.16154 · 1.93 Impact Factor
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    • "Among IDUs in USA and Europe, transmissions occur via sharing injection equipments such as syringes, needles and other paraphernalia (Mathei et al. 2006). Both modes of HCV transmission (unsafe blood transfusion and IDUs) are significant for certain communities [studies indicate prevalence percentages of 48.67 ± 1.75 % and 57 ± 17.7 %, respectively, in Pakistan (Waheed et al. 2009) see also Ali et al. (2009)]. "
    Theory in Biosciences 01/2014; 133(2):91-109. · 1.23 Impact Factor
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    • "Prevalence of HCV has been noticed to be highly variable in different regions and even in different groups of the same community [9]. According to various studies, the presence of HCV infections among different categories (excluding chronic liver disease patients), was 5.31% in Islamabad [10], 0.4-31.9% in various regions of Punjab province [6,7,11-13], 4-6% in Sindh province [6,7,13,14], 1.1-9% in Khyber Pakhtunkhwa province [6,7,13,15-17], 1.5% in Quetta region [12,13] and 25.7% in Gilgit Baltistan province [18,19]. While in Lahore, the second largest city of Pakistan with a population of more than 7 million [20], HCV prevalence was estimated from 0.58-17.78% "
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    ABSTRACT: To find out the prevalence of active hepatitis C virus (HCV) infections among general public in Lahore city, since data concerning the prevalence of active HCV in this city is currently unavailable. Blood samples were collected randomly from individuals visiting different clinical laboratories in Lahore. Serum was separated and processed by nested PCR qualitative assay for the detection of HCV RNA. The samples were categorized into different age groups on the basis of pre-test questionnaires in order to record the age-wise differences regarding the prevalence of active HCV. Data were analyzed statistically using Chi-Square test. Out of the 4246 blood samples analyzed in this study, 210 were confirmed to be positive for active HCV infection. Gender-wise active HCV prevalence revealed no significant difference [OR = 1.10 CI = (0.83-1.46), p > 0.05]. However, among the age groups the highest prevalence was observed in the age groups 20-29 (7.7%) and 30-39 years (6.4%) with odds of prevalence of 14.8% (OR = 2.48, CI = (1.40-4.38), p < 0.05) and 10.3% (OR = 2.03, CI = (1.10-3.71), respectively. In age groups above 40 years (40-49, 50-59 and >59 years), a decrease in levels of active HCV prevalence was observed. Among tested samples, 4.9% of the subjects were confirmed to harbour active HCV infections and the "middle aged" population in Lahore was found to be at a higher risk of the HCV ailments compared to both their younger and older peers.
    Virology Journal 12/2013; 10(1):351. DOI:10.1186/1743-422X-10-351 · 2.18 Impact Factor
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