Characterization of the hepatitis C virus epidemic in Pakistan

<h3>Background</h3><p dir="ltr">With one in every 20 Pakistanis already infected, Pakistan has the second largest number of hepatitis C virus (HCV) infections globally. The aim of this study was to present a quantitative and analytical characterization of the HCV epidemic...

وصف كامل

محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Sarwat Mahmud (4557208) (author)
مؤلفون آخرون: Zaina Al Kanaani (5018198) (author), Laith J. Abu-Raddad (9262524) (author)
منشور في: 2019
الموضوعات:
الوسوم: إضافة وسم
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author Sarwat Mahmud (4557208)
author2 Zaina Al Kanaani (5018198)
Laith J. Abu-Raddad (9262524)
author2_role author
author
author_facet Sarwat Mahmud (4557208)
Zaina Al Kanaani (5018198)
Laith J. Abu-Raddad (9262524)
author_role author
dc.creator.none.fl_str_mv Sarwat Mahmud (4557208)
Zaina Al Kanaani (5018198)
Laith J. Abu-Raddad (9262524)
dc.date.none.fl_str_mv 2019-09-14T03:00:00Z
dc.identifier.none.fl_str_mv 10.1186/s12879-019-4403-7
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Characterization_of_the_hepatitis_C_virus_epidemic_in_Pakistan/25904422
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Health sciences
Epidemiology
Public health
HCV
Hepatitis C
Pakistan
Province
Genotype
Prevalence
Epidemic
dc.title.none.fl_str_mv Characterization of the hepatitis C virus epidemic in Pakistan
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">With one in every 20 Pakistanis already infected, Pakistan has the second largest number of hepatitis C virus (HCV) infections globally. The aim of this study was to present a quantitative and analytical characterization of the HCV epidemic in Pakistan.</p><h3>Methods</h3><p dir="ltr">A standardized database of HCV antibody incidence and prevalence and HCV genotypes in all subpopulations was systematically assembled. Random-effects meta-analyses and random-effects meta-regressions were performed. Shannon Diversity Index was calculated to determine genotype diversity.</p><h3>Results</h3><p dir="ltr">The database included two incidence, 309 prevalence, and 48 genotype measures. Pooled mean HCV prevalence ranged between 7.0% (95% confidence interval (CI): 5.8–8.3%) in Sindh and 0.9% (95% CI: 0.1–2.4%) in Federally Administered Tribal Areas (F.A.T.A). Estimated number of chronically-infected persons ranged between 4.2 million in Punjab and 0.03 million in F.A.T.A. HCV prevalence was stable over time [adjusted odds ratio (AOR) of 1.0 (95% CI: 1.0–1.0)]. Population classification was the strongest predictor of HCV prevalence, explaining 51.8% of prevalence variation. Relative to the general population, HCV prevalence was higher in people who inject drugs [AOR of 23.8 (95% CI: 13.0–43.6)], populations with liver-related conditions [AOR of 22.3 (95% CI: 15.7–31.6)], and high-risk clinical populations [AOR of 7.8 (95% CI: 4.8–12.7)]. Low genotype diversity was observed (Shannon diversity index of 0.67 out of 1.95; 34.5%). There were only minor differences in genotype diversity by province, with genotype 3 being most common in all provinces.</p><h3>Conclusion</h3><p dir="ltr">Pakistan’s HCV epidemic shows homogeneity across the provinces, and over time. HCV prevalence is strikingly persistent at high level, with no evidence for a decline over the last three decades. Scale up of HCV treatment and prevention is urgently needed.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Infectious Diseases<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12879-019-4403-7" target="_blank">https://dx.doi.org/10.1186/s12879-019-4403-7</a></p>
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spelling Characterization of the hepatitis C virus epidemic in PakistanSarwat Mahmud (4557208)Zaina Al Kanaani (5018198)Laith J. Abu-Raddad (9262524)Health sciencesEpidemiologyPublic healthHCVHepatitis CPakistanProvinceGenotypePrevalenceEpidemic<h3>Background</h3><p dir="ltr">With one in every 20 Pakistanis already infected, Pakistan has the second largest number of hepatitis C virus (HCV) infections globally. The aim of this study was to present a quantitative and analytical characterization of the HCV epidemic in Pakistan.</p><h3>Methods</h3><p dir="ltr">A standardized database of HCV antibody incidence and prevalence and HCV genotypes in all subpopulations was systematically assembled. Random-effects meta-analyses and random-effects meta-regressions were performed. Shannon Diversity Index was calculated to determine genotype diversity.</p><h3>Results</h3><p dir="ltr">The database included two incidence, 309 prevalence, and 48 genotype measures. Pooled mean HCV prevalence ranged between 7.0% (95% confidence interval (CI): 5.8–8.3%) in Sindh and 0.9% (95% CI: 0.1–2.4%) in Federally Administered Tribal Areas (F.A.T.A). Estimated number of chronically-infected persons ranged between 4.2 million in Punjab and 0.03 million in F.A.T.A. HCV prevalence was stable over time [adjusted odds ratio (AOR) of 1.0 (95% CI: 1.0–1.0)]. Population classification was the strongest predictor of HCV prevalence, explaining 51.8% of prevalence variation. Relative to the general population, HCV prevalence was higher in people who inject drugs [AOR of 23.8 (95% CI: 13.0–43.6)], populations with liver-related conditions [AOR of 22.3 (95% CI: 15.7–31.6)], and high-risk clinical populations [AOR of 7.8 (95% CI: 4.8–12.7)]. Low genotype diversity was observed (Shannon diversity index of 0.67 out of 1.95; 34.5%). There were only minor differences in genotype diversity by province, with genotype 3 being most common in all provinces.</p><h3>Conclusion</h3><p dir="ltr">Pakistan’s HCV epidemic shows homogeneity across the provinces, and over time. HCV prevalence is strikingly persistent at high level, with no evidence for a decline over the last three decades. Scale up of HCV treatment and prevention is urgently needed.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Infectious Diseases<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12879-019-4403-7" target="_blank">https://dx.doi.org/10.1186/s12879-019-4403-7</a></p>2019-09-14T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12879-019-4403-7https://figshare.com/articles/journal_contribution/Characterization_of_the_hepatitis_C_virus_epidemic_in_Pakistan/25904422CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/259044222019-09-14T03:00:00Z
spellingShingle Characterization of the hepatitis C virus epidemic in Pakistan
Sarwat Mahmud (4557208)
Health sciences
Epidemiology
Public health
HCV
Hepatitis C
Pakistan
Province
Genotype
Prevalence
Epidemic
status_str publishedVersion
title Characterization of the hepatitis C virus epidemic in Pakistan
title_full Characterization of the hepatitis C virus epidemic in Pakistan
title_fullStr Characterization of the hepatitis C virus epidemic in Pakistan
title_full_unstemmed Characterization of the hepatitis C virus epidemic in Pakistan
title_short Characterization of the hepatitis C virus epidemic in Pakistan
title_sort Characterization of the hepatitis C virus epidemic in Pakistan
topic Health sciences
Epidemiology
Public health
HCV
Hepatitis C
Pakistan
Province
Genotype
Prevalence
Epidemic