Prevalence of Hepatitis B and C in Pakistan from 2001 to 2022: A Systematic Review
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Abstract
Background: Hepatitis B and C represent a significant public health concern globally, with a substantial burden in developing countries, particularly Pakistan. The country's diverse demographic and socio-economic landscape presents challenges in the surveillance and management of these infectious diseases.
Objective: This systematic review aims to consolidate and analyse the prevalence data of Hepatitis B and C infections reported across Pakistan from 2001 to 2022 to understand the epidemiological trends and to inform public health interventions.
Methods: A thorough search of various research databases was conducted to identify studies that reported the prevalence of Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (anti-HCV) antibodies. Studies were selected based on inclusion criteria focused on the population of Pakistan between 2001 and 2022. Data extraction was systematic, although a comprehensive quality assessment of each study was not completed.
Results: The review included 54 studies with varying sample sizes and methodologies, including ELISA, ICT, PCR, and other serological assays. Prevalence rates for HBsAg and anti-HCV varied significantly, with HBsAg ranging from 0.9% to 44.4% and anti-HCV from 0.3% to 62.6%. These findings highlight a considerable regional variability and suggest an upward trend in HCV prevalence over the past two decades.
Conclusion: The elevated prevalence rates of Hepatitis B and C across Pakistan underscore the need for robust public health policies, standardized surveillance, and targeted interventions. Despite the systematic approach to data extraction, the review is limited by the absence of a comprehensive quality assessment, which is essential for future research to build upon.
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References
Zhang Ch, Cheng Y, Zhang S, Fan J, Gao Q. Changing epidemiology of hepatocellular carcinoma in Asia. Liver International. 2022;42(9):2029-41.
You MW, Kim KW, Shim JJ, Pyo J. Impact of liver‐stiffness measurement on hepatocellular carcinoma development in chronic hepatitis C patients treated with direct‐acting antivirals: a systematic review and time‐to‐event meta‐analysis. Journal of gastroenterology and hepatology. 2021;36(3):601-8.
Tariq R, Abbas A, Saeed F, Qureshi ZA. Frequency of hepatocellular carcinoma and associated sociodemographic factors in treated patients of chronic hepatitis C. Pakistan Armed Forces Medical Journal. 2021;71(Suppl-1):S52-6.
Tahata Y, Sakamori R, Yamada R, Kodama T, Hikita H, Hagiwara H, et al. Prediction model for hepatocellular carcinoma occurrence in patients with hepatitis C in the era of direct‐acting anti‐virals. Alimentary Pharmacology & Therapeutics. 2021;54(10):1340-9.
McGlynn KA, Petrick JL, El‐Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology. 2021;73:4-13.
Bhatti ABH. Hepatocellular carcinoma in Pakistan: an update. Liver Cancer in the Middle East. 2021:387-96.
Abro IB, Bhatti JM, Siddiqui AA. Hepatocellular Carcinoma in Hepatitis C-Associated Cirrhotic Patients Treated With Different Combinations of Direct-Acting Antiviral Agents Available in Pakistan: A Prospective Observational Study. 2021.
Yang M, Parikh ND, Liu H, Wu E, Rao H, Feng B, et al. Incidence and risk factors of hepatocellular carcinoma in patients with hepatitis C in China and the United States. Scientific Reports. 2020;10(1):20922.
Shiels MS, Engels EA, Yanik EL, McGlynn KA, Pfeiffer RM, O’Brien TR. Incidence of hepatocellular carcinoma among older Americans attributable to hepatitis C and hepatitis B: 2001 through 2013. Cancer. 2019;125(15):2621-30.
Haqqi A, Munir R, Khalid M, Khurram M, Zaid M, Ali M, et al. Prevalence of hepatitis C virus genotypes in Pakistan: current scenario and review of literature. Viral immunology. 2019;32(9):402-13.
Hussain S, Ali Z. Prevalence of hepatitis B virus in the Kurram Agency, Pakistan: A 5-year observational study in a war-affected region. Journal of Clinical Virology. 2016;82:17-9.
Khan M, Hussain U, Irshad A, Khan A. Prevalence of hepatitis B and C seropositivity in patients presenting for dental treatment. Pakistan Oral & Dental Journal. 2015;35(2).
Moosavy SH, Davoodian P, Nazarnezhad MA, Nejatizaheh A, Eftekhar E, Mahboobi H. Epidemiology, transmission, diagnosis, and outcome of Hepatitis C virus infection. Electronic physician. 2017;9(10):5646.
Asif N, Khokhar N, Ilahi F. Sero-prevalence of HBV, HCV, and HIV infection among voluntary non remunerated & replacement donors in Northern Pakistan. Pakistan journal of medical sciences. 2004;20(1):24-8.
Avni T, Leibovici L, Paul M. PCR diagnosis of invasive candidiasis: systematic review and meta-analysis. Journal of clinical microbiology. 2011;49(2):665-70.
Sievert W, Altraif I, Razavi HA, Abdo A, Ahmed EA, AlOmair A, et al. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver international. 2011;31:61-80.
Shafi ST, Hassan MZ, Saleem M, Anjum R, Abdullah W, Shafi T. Frequency of Hepatitis C in hospitalized patients with chronic kidney disease. Pakistan journal of medical sciences. 2017;33(1):18.
Saeed M, Hussain S, Rasheed F, Ahmad M, Arif M, MT HR. Silent killers: Transfusion Transmissible Infections-TTI, among asymptomatic population of Pakistan. JPMA The Journal of the Pakistan Medical Association. 2017;67(3):369-74.
Mansha S, Imran M, Shah AMUH, Jamal M, Ahmed F, Atif M, et al. Hepatitis B and C virus infections among human immunodeficiency virus-infected people who inject drugs in Lahore, Pakistan. Viral immunology. 2017;30(5):366-70.
Akhtar N, Ilyas M, Muhammad K, Shams S, Saeed K, Asadullah A. Prevalence of Hepatitis C virus infections among the general population of Buner, Khyber Pakhtunkhwa, Pakistan. Biomedical Research and Therapy. 2016;3(12):1003-17.
Shafiq M, Nadeem M, Sattar Z, Khan SM, Faheem SM, Ahsan I, et al. Identification of risk factors for hepatitis B and C in Peshawar, Pakistan. HIV/AIDS-Research and Palliative Care. 2015:223-31.
Fayyaz M, Ghous SM, Ullah F, Abbas I, Ahmed N, Ahmed A. Frequency of hepatitis B and C in patients seeking treatment at the dental section of a tertiary care hospital. Journal of Ayub Medical College Abbottabad. 2015;27(2):395-7.
Ashraf F, Rasheed A, Ullah S, Shaukat M. HCV IN PUNJAB: ZONAL MOLECULAR DISTRIBUTION. The Professional Medical Journal. 2015;22(10):1268-72.
Asad M, Ahmed F, Zafar H, Farman S. Frequency and determinants of Hepatitis B and C virus in general population of Farash Town, Islamabad. Pakistan journal of medical sciences. 2015;31(6):1394.
Akhtar AM, Majeed S, Jamil M, Rehman A. Prevalence of hepatitis C infection: General patients attending various hospitals of Lahore, Pakistan: a cross sectional study. The Professional Medical Journal. 2015;22(11):1390-6.
Zaheer H, Saeed U, Waheed Y, Karimi S, Waheed U. Prevalence and trends of hepatitis B, hepatitis C and human immunodeficiency viruses among blood donors in Islamabad, Pakistan 2005-2013. J Blood Disorders Transf. 2014;5(217):2.
Maan MA, Fatma H, Muhammad J. Epidemiology of hepatitis C viral infection in Faisalabad, Pakistan: a retrospective study (2010-2012). African health sciences. 2014;14(4):810-4.
Ilyas M, Ahmad I. Chemiluminescent microparticle immunoassay based detection and prevalence of HCV infection in district Peshawar Pakistan. Virology journal. 2014;11:1-5.
Afridi SQ, Ali MM, Awan F, Zahid MN, Afridi IQ, Afridi SQ, et al. Molecular epidemiology and viral load of HCV in different regions of Punjab, Pakistan. Virology journal. 2014;11(1):1-5.
Abbasi IN, Fatmi Z, Kadir MM, Sathiakumar N. Prevalence of hepatitis B virus infection among barbers and their knowledge, attitude and practices in the district of Sukkur, Sindh. International journal of occupational medicine and environmental health. 2014;27:757-65.
Khan A, Tareen AM, Ikram A, Rahman H, Wadood A, Qasim M, et al. Prevalence of HCV among the young male blood donors of Quetta region of Balochistan, Pakistan. Virology journal. 2013;10:1-4.
IJAZ RR, Bhatti S. Risk of hepatitis C in factory workers and their relatives. Biomedica. 2013;29(1):42-3.
Bibi S, Dars S, Ashfaq S, Qazi RA, Akhund S. Seroprevalence and risk factors for hepatitis C virus (HCV) infection in pregnant women attending public sector tertiary care hospital in Hyderabad Sindh. Pakistan Journal of Medical Sciences. 2013;29(2):505.
Anwar MI, Rahman M, Hassan MU, Iqbal M. Prevalence of active hepatitis C virus infections among general public of Lahore, Pakistan. Virology journal. 2013;10(1):1-6.
Altaf A, Shah SA, Shaikh K, Constable FM, Khamassi S. Lessons learned from a community based intervention to improve injection safety in Pakistan. BMC research notes. 2013;6:1-6.
AKHTAR JAJ, QAMAR MU, SARWAR AHAWF, ANWAR J. Sero-prevalence of HBV and HCV in tuberculous patients at Sheikh Zayed hospital Rahim Yar khan, Pakistan. Biomedica. 2013;29(2):69-72.
YASMIN S. Prevalence of Hepatitis B virus infection among population of factory workers in Gujranwala (Punjab) Pakistan. Biologia (Pakistan). 2012;58:47-52.
Siddiqui TS, Lahrasab W, Sharif MA. Prevalence of hepatitis B and C in healthy adult males of paramilitary personnel in Punjab. Journal of Ayub Medical College Abbottabad. 2012;24(3-4):138-40.
Satti R, Farah M, Khan MI, Haq TS, Khan ZU, Zubair M, et al. Prevalence of hepatitis C virus in urban Ghettos of twin cities. Pakistan Journal of Zoology. 2012;44(4).
Safi AZ, Waheed Y, Sadat J, Salahuddin S, Saeed U, Ashraf M. Molecular study of HCV detection, genotypes and their routes of transmission in North West Frontier Province, Pakistan. Asian Pacific journal of tropical biomedicine. 2012;2(7):532-6.
Memon AR, Shafique K, Memon A, Draz AU, Rauf MUA, Afsar S. Hepatitis B and C prevalence among the high risk groups of Pakistani population. A cross sectional study. Archives of Public Health. 2012;70:1-6.
Ali A, Nisar M, Idrees M, Ahmad H, Hussain A, Rafique S, et al. Prevalence of HBV infection in suspected population of conflict-affected area of war against terrorism in North Waziristan FATA Pakistan. Infection, Genetics and Evolution. 2012;12(8):1865-9.
Ahmed F, Irving W, Anwar M, Myles P, Neal K. Prevalence and risk factors for hepatitis C virus infection in Kech District, Balochistan, Pakistan: most infections remain unexplained. A cross-sectional study. Epidemiology & Infection. 2012;140(4):716-23.
ur Rehman L, Ullah I, Ali I, Khan IA, Iqbal A, Khan S, et al. Active hepatitis C infection and HCV genotypes prevalent among the IDUs of Khyber Pakhtunkhwa. Virology Journal. 2011;8(1):327.
Rauf A, Nadeem MS, Ali A, Iqbal M, Mustafa M, Muzammal Latif M, et al. Prevalence of hepatitis B and C in internally displaced persons of war against terrorism in Swat, Pakistan. The European Journal of Public Health. 2011;21(5):638-42.
Khan F, Shams S, Qureshi ID, Israr M, Khan H, Sarwar MT, et al. Hepatitis B virus infection among different sex and age groups in Pakistani Punjab. Virology journal. 2011;8(1):1-5.
Khan F, Akbar H, Idrees M, Khan H, Shahzad K, Kayani MA. The prevalence of HBV infection in the cohort of IDPs of war against terrorism in Malakand Division of Northern Pakistan. BMC infectious diseases. 2011;11(1):1-6.
Ilyas M, Iftikhar M, Rasheed U. Prevalence of hepatitis B and hepatitis C in populations of college students in Gujranwala. Biol Pak. 2011;57(1&2):89-95.
Ali M, Idrees M, Ali L, Hussain A, Ur Rehman I, Saleem S, et al. Hepatitis B virus in Pakistan: a systematic review of prevalence, risk factors, awareness status and genotypes. Virology journal. 2011;8:1-9.
Ali I, Siddique L, Rehman LU, Khan NU, Iqbal A, Munir I, et al. Prevalence of HCV among the high risk groups in Khyber Pakhtunkhwa. Virology journal. 2011;8(1):1-4.
Sarwar J, Ahmad W, Saleem M, Jamshed F, Gul N, Idrees M. Frequency of hepatitis b in asymptomatic patients of District Headquarter Hospital Kotli, Azad Kashmir. Journal of Ayub Medical College Abbottabad. 2010;22(4):139-42.
Qazi HA, Saleem K, Mujtaba I, Hashmi A, Soomro JA. Prevalence and factors associated with HCV (hepatitis C virus) seropositivity in Islamabad, Pakistan. Acta Medica Iranica. 2010:394-8.
Majid A, Khan MS, Ullah S. Rising prevalence of hepatitis B and C and risk factors at district headquarter teaching hospital Bannu, Khyber Pakhtunkhwa. J Coll Physicians Surg Pak. 2010;20(7):492-3.
Kazi AM, Shah SA, Jenkins CA, Shepherd BE, Vermund SH. Risk factors and prevalence of tuberculosis, human immunodeficiency virus, syphilis, hepatitis B virus, and hepatitis C virus among prisoners in Pakistan. International Journal of Infectious Diseases. 2010;14:e60-e6.
Jamil MS, Ali H, Shaheen R, Basit A. Prevalence, knowledge and awareness of hepatitis C among residents of three Union Councils in Mansehra. Journal of Ayub Medical College Abbottabad. 2010;22(3):192-6.
Hyder O, Ijaz M, Arshad MA, Zahira T. Age-specific frequency of screen-detected hepatitis C virus seropositivity in men from the Punjab province of Pakistan. Journal of medical screening. 2010;17(4):214-6.
Hashmi A, Saleem K, Soomro JA. Prevalence and factors associated with hepatitis C virus seropositivity in female individuals in islamabad, pakistan. International journal of preventive medicine. 2010;1(4):252.
Gorar ZA, Zulfikar I. Seropositivity of hepatitis C in prison inmates of Pakistan—a cross sectional study in prisons of Sindh. JPMA The Journal of the Pakistan Medical Association. 2010;60(6):476-9.
Gul N, Sarwar J, Idris M, Farid J, Rizvi F, Suleman M, et al. Seroprevalence of hepatitis C in pregnant females of Hazara division. Journal of Ayub Medical College Abbottabad. 2009;21(4):83-6.
Mujeeb SA, Pearce MS. Temporal trends in hepatitis B and C infection in family blood donors from interior Sindh, Pakistan. BMC Infectious Diseases. 2008;8:1-6.
Idrees M, Lal A, Naseem M, Khalid M. High prevalence of hepatitis C virus infection in the largest province of Pakistan. Journal of digestive diseases. 2008;9(2):95-103.
Butt T, Amin M. Seroprevalence of hepatitis B and C infections among young adult males in Pakistan. EMHJ-Eastern Mediterranean Health Journal, 14 (4), 791-797, 2008. 2008.
Sultan F, Mehmood T, Mahmood MT. Infectious pathogens in volunteer and replacement blood donors in Pakistan: a ten-year experience. International Journal of Infectious Diseases. 2007;11(5):407-12.
Quddus A, Luby SP, Jamal Z, Jafar T. Prevalence of hepatitis B among Afghan refugees living in Balochistan, Pakistan. International Journal of Infectious Diseases. 2006;10(3):242-7.
Jafri W, Jafri N, Yakoob J, Islam M, Tirmizi SFA, Jafar T, et al. Hepatitis B and C: prevalence and risk factors associated with seropositivity among children in Karachi, Pakistan. BMC infectious diseases. 2006;6(1):1-10.
Abdul Mujeeb S, Nanan D, Sabir S, Altaf A, Kadir M. Hepatitis B and C infection in first-time blood donors in Karachi-a possible subgroup for sentinel surveillance. EMHJ-Eastern Mediterranean Health Journal, 12 (6), 735-741, 2006. 2006.
Khokhar N, Gill ML, Malik GJ. General seroprevalence of hepatitis C and hepatitis B virus infections in population. Journal of the College of Physicians and Surgeons--pakistan: JCPSP. 2004;14(9):534-6.
Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. The Lancet. 2015;386(10003):1546-55.
Zampino R, Boemio A, Sagnelli C, Alessio L, Adinolfi LE, Sagnelli E, et al. Hepatitis B virus burden in developing countries. World journal of gastroenterology. 2015;21(42):11941.
Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. Journal of hepatology. 2014;61(1):S45-S57.
Zuberi BF, Zuberi FF, Hasan SR, Kumar R, Memon SA, Afsar S. Frequency of acute Hepatitis C after needle stick injury and its treatment outcome. Consultant. 2009;6:02.9.