KARACHI: Pakistan bears the heaviest burden of hepatitis C in the world, with a nationwide prevalence exceeding five per cent (10 million cases). These cases are primarily concentrated in Punjab, followed by Sindh, Khyber Pakhtunkhwa (KP), and Balochistan. The country is also home to approximately five million individuals carrying the hepatitis B virus (HBV).

This information was shared by experts at a seminar organised by Ziauddin Hospital in connection with World Hepatitis Day.

Highlighting concerns over the prevalence of blood-borne hepatitis, Dr Khurram Baqai, assistant professor of gastroenterology at Ziauddin University (ZU), said an estimated 4.5m premature deaths could be averted in low and middle-income countries by 2030 through the implementation of vaccination, diagnostic tests, medicines, and awareness campaigns.

“In Pakistan, approximately five million individuals carry the hepatitis B virus, with a carrier rate of 2.5 per cent. Notably, certain districts in upper Sindh, southern Punjab, and Balochistan have significantly higher prevalence rates than the national average.”

Speaking about the factors responsible for the spread of hepatitis, Prof Zaigham Abbas, head of the department of hepatology and gastroenterology at ZU, said hepatitis B and C were transmitted by infected blood and body fluids. This could be through the transfusion of infected blood, using syringes or surgical equipment previously used by a hepatitis-positive patient, a lack of sterilisation facilities, or quackery.

“In Pakistan, an average person receives 10 injections per year, of which 90 per cent are avoidable and remain non-essential. Let us unite in safeguarding our future generations, preventing mother-to-child transmission, and promoting responsible sexual practises to combat hepatitis B.” said Prof Abbas.

According to him, hepatitis B patients may experience a more aggressive form of the disease if they get infected with the hepatitis D virus. Lack of awareness about the complications has resulted in the disease being labelled a ‘silent killer’ and ‘black jaundice’.

Prof Abbas Zafar, dean faculty of health sciences at ZU, said that better treatment was possible only with early diagnosis.

“Everyone should get tested for the disease. We are fortunate to have an effective hepatitis B vaccine as well as treatment facilities,” he said, adding that misconceptions about the disease and a lack of awareness were the reasons behind the rapid spread of hepatitis in Pakistan.

He informed the audience that ZU had signed a memorandum of understanding (MoU) with the provincial government to fight hepatitis.

Emphasising the need for preventive strategies, Dr Fatima Jehangir, chair of the department of family medicine at ZU, said good hand hygiene, consumption of properly cooked food, and clean water could help prevent hepatitis A and E.

“Vaccines for hepatitis A and E are available in Pakistan. Hepatitis B vaccination is crucial for infants, healthcare workers, high-risk individuals, diabetics, and those with chronic liver or kidney disease. Safe sexual practises and the use of sterile needles and equipment are essential to minimising transmission risk.”

Dr Zulfiqar Dharejo, additional director at the hepatitis control programme in Sindh and also the chief guest, spoke about the government’s commitment towards prevention and treatment of hepatitis and said the government was actively engaged in providing free vaccines and treatment.

Published in Dawn, July 22th, 2023