Epidemiology of viral hepatitis B and C in Punjab, Pakistan: a multicenter cross-sectional study, 2017-18

Abstract

Background: Globally, approximately 240 million people are chronically infected with hepatitis B virus (HBV) and hepatitis C virus (HCV), which are responsible for 96% of all hepatitis-related mortality. Pakistan has the second highest prevalence of HCV in the world. Methods: We conducted this study to ascertain the prevalence and potential risk factors associated with HBV and HCV infections in Punjab. A multi-center cross-sectional study was conducted, involving 24 Hepatitis Prevention and Treatment Clinics of the Pakistan Kidney and Liver Institute and Research Center clinics, Lahore. A total of 141,705 individuals who visited the clinics during 2017-18 were included for seroprevalence analysis of hepatitis B (HBsAg) and C (Anti-HCV). In addition, 12,427 individuals from the main group underwent detailed face-to-face interviews based on a predesigned questionnaire for risk factor assessment. Results: The overall prevalence for HBV and HCV was 8.4% and 42.7%, respectively. Of those with HCV infection, 4.2% had a co-infection. The transgender population had a higher seroprevalence of HBV (11.8%) and HCV (58.8%). Higher HBV seroprevalence was found in a younger age group (16-30 years), while the older age group (>61 years) had a higher HCV seroprevalence. Geographically, Muzaffargarh district had the highest HBV seroprevalence at 26%, followed by Rajanpur district (20.3%). HCV seroprevalence was significantly (P value <0.05) higher in Shujabad district (66.4%), followed by Muzaffargarh (65.2%). Using multivariable logistic regression analysis, age, gender, intravenous injections, hijama therapy, dental procedure, circumcision by barbers, barber shaving, hospitalization and having had surgical procedures were all found to be significant risk factors (OR >1; p<0.05) for HBV and HCV. Conclusions: There is an urgent need for proper implementation of preventive and control strategies, as well as formal evaluation and monitoring mechanisms. Sustainable and adequate funding of public-sector hepatitis programs is also an extremely important area that should not be neglected.

Predictive factors for acquiring HCV infection in the population residing in high endemic, resource-limited settings

“…The results when compared with a similar study[ 13 ] conducted in the general population of Pakistan almost correlated with young patients of up to 40 years. However, when comparing with a second study published in 2019 at an outreach center for screening and treatment in Pakistan,[ 14 ] it was found that most older age people (>61 years) were positive. It may be due to the inability of patients to seek medical attention after appearing of symptoms due to various reasons like finances, etc., eventually seeking medical help at a later stage.…”

“…Moreover, gender trends similar to our study were observed in another study that indicated women being infected more at a ratio of 1:3. [ 14 ]…”

Evaluation of Seroprevalence of Hepatitis B Virus and Hepatitis C Virus in Reference Center Hospital in Turkey's Southeast Anatolia Among Patients Referred for Major or Minimally Invasive Surgery: Last Decade Experience in a Previously High Prevalence Area

“…The mean age of patients with positive and negative HBsAg was 48.7 ± 17.6 and 45.9 ± 21.22, respectively, and the difference was statistically significant. Studies report a strong relationship between age and HBsAg positivity (18,19). Nonetheless, a significant variation exists between regions and countries regarding the relationship of age groups with HBsAg positivity.…”

Knowledge, Attitude and Practices of Dental Practitioners against Hepatitis B in District Faisalabad

“…In every province, there are more than 28 districts which have a higher prevalence of hepatitis B. 9 This study aimed to assess the knowledge, attitude and practices of dental practitioners against Hepatitis B in district Faisalabad.…”