Hepatitis C virus prevalence and genotype distribution in Pakistan: Comprehensive review of recent data

Abstract

Hepatitis C virus (HCV) is endemic in Pakistan and its burden is expected to increase in coming decades owing mainly to widespread use of unsafe medical procedures. The prevalence of HCV in Pakistan has previously been reviewed. However, the literature search conducted here revealed that at least 86 relevant studies have been produced since the publication of these systematic reviews. A revised updated analysis was therefore needed in order to integrate the fresh data. A systematic review of data published between 2010 and 2015 showed that HCV seroprevalence among the general adult Pakistani population is 6.8%, while active HCV infection was found in approximately 6% of the population. Studies included in this review have also shown extremely high HCV prevalence in rural and underdeveloped peri-urban areas (up to 25%), highlighting the need for an increased focus on this previously neglected socioeconomic stratum of the population. While a 2.45% seroprevalence among blood donors demands immediate measures to curtail the risk of transfusion transmitted HCV, a very high prevalence in patients attending hospitals with various non-liver disease related complaints (up to 30%) suggests a rise in the incidence of nosocomial HCV spread. HCV genotype 3a continues to be the most prevalent subtype infecting people in Pakistan (61.3%). However, recent years have witnessed an increase in the frequency of subtype 2a in certain geographical sub-regions within Pakistan. In Khyber Pakhtunkhwa and Sindh provinces, 2a was the second most prevalent genotype (17.3% and 11.3% respectively). While the changing frequency distribution of various genotypes demands an increased emphasis on research for novel therapeutic regimens, evidence of high nosocomial transmission calls for immediate measures aimed at ensuring safe medical practices.

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“…Some researchers have noted that infection with HCV is higher in rural than urban areas [3,15]. Poverty has also been linked to the spread of common diseases [25].…”

“…Hepatitis C virus (HCV) is a single stranded positive sense RNA virus of the Flaviviridae family [1][2][3]. This virus has a high level of sequence heterogeneity, but based on sequence homology, 6 major genotypes and many distinct subtypes have been identified [3].…”

“…This virus has a high level of sequence heterogeneity, but based on sequence homology, 6 major genotypes and many distinct subtypes have been identified [3]. Interestingly, humans and Chimpanzees are the only species vulnerable to this viral infection [2].…”

Effectiveness of Sofosbuvir Regime in Hepatitis C Virus Infection in Hemodialysis Pakistani Patients: Single Centre Study

“…In Pakistan, approximately 10 million people are suffering from HCV, the 6% of 6 . For the HCV percent in HD patients, as per the published literature and small sample size (ranging from 28-190) studies (n=6) results showed that the 26.02% of the haemodialysis patients is HCV infected and the rate of Prevalence become high in the past as compared to recent studies 7 .…”

Latent tuberculosis infection screening in HCV patients: The necessity and guidelines for Pakistan

“…Pakistan is a resource constrains country with low per capita income and poor sanitary system. It ranked second in the world in term of HCV burden with more than 10 million infections [5,6]. Epidemiological data of HCV prevalence from last seven years (2010-2016) is reviewed and summarized in Figure 1.…”