Estimate of vertical transmission of Hepatitis C virus in Pakistan in 2007 and 2012 birth cohorts

Beňová, Lenka; Awad, Susanne F.; Abu‐Raddad, Laith J.

doi:10.1111/jvh.12748

Cited by 15 publications

(14 citation statements)

References 24 publications

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“…Despite some suggestive evidence for community-based exposures [ 152 ], such as visiting roadside barbers [ 161 ], this mode of exposures remains to be clarified with concrete analytical studies. Though HCV vertical transmission appears to account for a quarter of HCV infections among children under 5 years of age in Pakistan [ 181 ], only one study appears to have investigated this mode of exposure in this country [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses

et al. 2018

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To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations, we systematically reviewed all available records of HCV incidence and/or prevalence from 1989 to 2016, as informed by the Cochrane Collaboration Handbook. This systematic review was reported following the PRISMA guidelines. Populations were classified into six categories based on the risk of exposure to HCV infection. Meta-analyses were performed using DerSimonian and Laird random-effects models with inverse variance weighting. The search identified one HCV incidence study and 341 prevalence measures/strata. Meta-analyses estimated the pooled mean HCV prevalence at 6.2% among the general population, 34.5% among high-risk clinical populations, 12.8% among populations at intermediate risk, 16.9% among special clinical populations, 55.9% among populations with liver-related conditions and 53.6% among people who inject drugs. Most reported risk factors in analytical epidemiologic studies related to healthcare procedures. Pakistan is enduring an HCV epidemic of historical proportions—one in every 20 Pakistanis is infected. HCV plays a major role in liver disease burden in this country, and HCV prevalence is high in all-risk populations. Most transmission appears to be driven by healthcare procedures. HCV treatment and prevention must become a national priority.

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Section: Discussionmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses

et al. 2018

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“…There are still gaps in our understanding of HCV epidemiology in this country. Conduct of a nationally-representative population-based survey is strongly recommended to provide a better estimate of HCV prevalence in the whole population, delineate the spatial variability in prevalence, identify specific modes of exposure, and assess HCV knowledge and attitudes, as has been recently conducted in Egypt 10 , 99 – 103 and Pakistan 6 , 15 , 104 .…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses

Mahmud

Akbarzadeh

Abu‐Raddad

2018

Sci Rep

104

112

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The aim of this study was to characterize hepatitis C virus (HCV) epidemiology in Iran and estimate the pooled mean HCV antibody prevalence in different risk populations. We systematically reviewed and synthesized reports of HCV incidence and/or prevalence, as informed by the Cochrane Collaboration Handbook, and reported our findings following the PRISMA guidelines. DerSimonian-Laird random effects meta-analyses were implemented to estimate HCV prevalence in various risk populations. We identified five HCV incidence and 472 HCV prevalence measures. Our meta-analyses estimated HCV prevalence at 0.3% among the general population, 6.2% among intermediate risk populations, 32.1% among high risk populations, and 4.6% among special clinical populations. Our meta-analyses for subpopulations estimated HCV prevalence at 52.2% among people who inject drugs (PWID), 20.0% among populations at high risk of healthcare-related exposures, and 7.5% among populations with liver-related conditions. Genotype 1 was the most frequent circulating strain at 58.2%, followed by genotype 3 at 39.0%. HCV prevalence in the general population was lower than that found in other Middle East and North Africa countries and globally. However, HCV prevalence was high in PWID and populations at high risk of healthcare-related exposures. Ongoing transmission appears to be driven by drug injection and specific healthcare procedures.

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“…We did not incorporate disease‐related mortality, but the relative risk of mortality with HCV infection is too small to affect significantly our projections . We did not explicitly factor mother to child transmission in the model, but the contribution of this mode of exposure is limited relative to the overall infection burden in Pakistan …”

Section: Discussionmentioning

confidence: 99%

“…While HCV epidemics appear to be contracting across countries globally, it has been suggested that Pakistan's epidemic may be bucking this trend with a growing epidemic . Different lines of evidence further suggest a high ongoing HCV incidence, driven possibly by various healthcare‐related procedures, such as reuse of injections, inadequate blood screening and deficient infection control, among others …”

Section: Introductionmentioning

confidence: 99%

Characterizing the temporal evolution of the hepatitis C virus epidemic in Pakistan

Ayoub

Kanaani

Abu‐Raddad

2018

Journal of Viral Hepatitis

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Summary Pakistan has the second largest number of HCV infections in the world. We assessed past, present and future levels and trends of the HCV epidemic in Pakistan. An age‐structured mathematical model was developed and analysed to describe transmission dynamics over 1980‐2050. The model was fitted to a nationally representative survey and a comprehensive database of systematically gathered HCV Ab prevalence data. HCV Ab and chronic infection prevalences peaked at 5.3% and 3.9% in 2000 but were projected to decline to 4.3% and 3.2% by 2017, 3.4% and 2.6% by 2030 and 2.6% and 1.9% by 2050, respectively. The number of chronically infected individuals was estimated at 6 663 906 in 2017 and was projected to peak at 6 665 900 in 2018 and decline to 6 372 100 in 2030 and 5 131 500 in 2050. Annual number of new infections peaked at 346 740 in 1992 but was projected to decline to 198 320 in 2017, 151 090 in 2030 and 98 120 in 2050. Incidence rate per 100 000 person‐year peaked at 343 in 1988 but was projected to decline to 99 in 2017, 62 in 2030 and 36 in 2050. Prevalence and incidence varied by age, and the majority of new infections occurred in the 20‐39 age group. Prevalence and incidence of HCV in Pakistan have been slowly declining for two decades—Pakistan is enduring a large epidemic that will persist for decades if not controlled. Nearly, 10% of global infections are in Pakistan, with about 200 000 additional infections every year. Rapid and mass scale‐up of prevention and treatment programmes are critically needed.

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Estimate of vertical transmission of Hepatitis C virus in Pakistan in 2007 and 2012 birth cohorts

Abstract: SummaryDespite a combination of high Hepatitis C virus (HCV) prevalence, a large adult population and high fertility, no published estimates of the scale and contribution of vertical

Cited by 15 publications

References 24 publications

The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses

The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses

The epidemiology of hepatitis C virus in Iran: Systematic review and meta-analyses

Characterizing the temporal evolution of the hepatitis C virus epidemic in Pakistan

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