Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.

The burden of hepatitis C virus (HCV) infection in Pakistan is amongst the highest in the world. People living in slums are likely to be at high risk of infection. Here, we describe the results of a cross-sectional survey conducted in March 2022 that aimed to quantify the prevalence of HCV infection...

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Main Authors: Munazza Mansoor, William A de Glanville, Ridwa Alam, Khawar Aslam, Mubashir Ahmed, Petros Isaakidis, Aneeta Pasha
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0002076
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author Munazza Mansoor
William A de Glanville
Ridwa Alam
Khawar Aslam
Mubashir Ahmed
Petros Isaakidis
Aneeta Pasha
author_facet Munazza Mansoor
William A de Glanville
Ridwa Alam
Khawar Aslam
Mubashir Ahmed
Petros Isaakidis
Aneeta Pasha
author_sort Munazza Mansoor
collection DOAJ
description The burden of hepatitis C virus (HCV) infection in Pakistan is amongst the highest in the world. People living in slums are likely to be at high risk of infection. Here, we describe the results of a cross-sectional survey conducted in March 2022 that aimed to quantify the prevalence of HCV infection in Machar Colony, one of the largest and oldest slum settlements in Karachi. Risk factors for HCV seropositivity were identified using multi-level logistic regression. We recruited 1,303 individuals in a random selection of 441 households from Machar Colony. The survey-adjusted HCV-seroprevalence was 13.5% (95% Confidence Interval (CI) 11.1-15.8) and survey-adjusted viraemic prevalence was 4.1% (95% CI 3.1-5.4) with a viraemic ratio of 32% (95% CI 24.3-40.5). Of 162 seropositive people, 71 (44%) reported receiving previous treatment for chronic hepatitis C. The odds of HCV seropositivity were found to increase with each additional reported therapeutic injection in the past 12 months (OR = 1.07 (95% Credible Interval (CrI) 1.00-1.13)). We found weaker evidence for a positive association between HCV seropositivity and a reported history of receiving a blood transfusion (OR = 1.72 (95% CrI 0.90-3.21)). The seroprevalence was more than double the previously reported seroprevalence in Sindh Province. The overall proportion of seropositive people that were viraemic was lower than expected. This may reflect the long-term impacts of a non-governmental clinic providing free of cost and easily accessible hepatitis C diagnosis and treatment to the population since 2015. Reuse of needles and syringes is likely to be an important driver of HCV transmission in this setting. Future public health interventions should address the expected risks associated with iatrogenic HCV transmission in this community.
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spelling doaj.art-7b021471a2194d6190b983f720cfbba72023-09-28T05:55:06ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0139e000207610.1371/journal.pgph.0002076Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.Munazza MansoorWilliam A de GlanvilleRidwa AlamKhawar AslamMubashir AhmedPetros IsaakidisAneeta PashaThe burden of hepatitis C virus (HCV) infection in Pakistan is amongst the highest in the world. People living in slums are likely to be at high risk of infection. Here, we describe the results of a cross-sectional survey conducted in March 2022 that aimed to quantify the prevalence of HCV infection in Machar Colony, one of the largest and oldest slum settlements in Karachi. Risk factors for HCV seropositivity were identified using multi-level logistic regression. We recruited 1,303 individuals in a random selection of 441 households from Machar Colony. The survey-adjusted HCV-seroprevalence was 13.5% (95% Confidence Interval (CI) 11.1-15.8) and survey-adjusted viraemic prevalence was 4.1% (95% CI 3.1-5.4) with a viraemic ratio of 32% (95% CI 24.3-40.5). Of 162 seropositive people, 71 (44%) reported receiving previous treatment for chronic hepatitis C. The odds of HCV seropositivity were found to increase with each additional reported therapeutic injection in the past 12 months (OR = 1.07 (95% Credible Interval (CrI) 1.00-1.13)). We found weaker evidence for a positive association between HCV seropositivity and a reported history of receiving a blood transfusion (OR = 1.72 (95% CrI 0.90-3.21)). The seroprevalence was more than double the previously reported seroprevalence in Sindh Province. The overall proportion of seropositive people that were viraemic was lower than expected. This may reflect the long-term impacts of a non-governmental clinic providing free of cost and easily accessible hepatitis C diagnosis and treatment to the population since 2015. Reuse of needles and syringes is likely to be an important driver of HCV transmission in this setting. Future public health interventions should address the expected risks associated with iatrogenic HCV transmission in this community.https://doi.org/10.1371/journal.pgph.0002076
spellingShingle Munazza Mansoor
William A de Glanville
Ridwa Alam
Khawar Aslam
Mubashir Ahmed
Petros Isaakidis
Aneeta Pasha
Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.
PLOS Global Public Health
title Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.
title_full Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.
title_fullStr Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.
title_full_unstemmed Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.
title_short Prevalence and risk factors for hepatitis C virus infection in an informal settlement in Karachi, Pakistan.
title_sort prevalence and risk factors for hepatitis c virus infection in an informal settlement in karachi pakistan
url https://doi.org/10.1371/journal.pgph.0002076
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