Journal of Medicinal Plants Research Vol. 5(25), pp.

6102-6104, 9 November, 2011

Available online at http://www.academicjournals.org/JMPR
ISSN 1996-0875 ©2011 Academic Journals
DOI: 10.5897/JMPR11.307

Short Communication

Prevalence of Hepatitis C virus (HCV) in Gadap Town

Karachi, Pakistan
Asif Iqbal1, M. Akram1*, Hasan Ali2, Naveed Akhtar3, Saeed Ur Rashid Nazir4, Irshad Ahmad3,
Asim Awan1 and H. M. Asif3
1
Faculty of Eastern Medicine, Hamdard University Karachi, Pakistan.
2
Department of Biochemistry, Bahria Medical College, Karachi, Pakistan.
3
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Pakistan.
4
Faculty of Pharmacy, University of Sargodha, Pakistan.
Accepted 23 September, 2011

Hepatitis C has been increasing day by day due to unsafe and unsterilized use of injections and razor in
rural areas. The present study was conducted to determine the frequency of Hepatitis C and Hepatitis B
in Gadap Town Karachi, Pakistan. 600 hundred subjects were enrolled. 47% were females and 53% were
males. Mean ages of females was 25 years and mean age of male was 24 years. In Gadap Town, 5% was
anti HCV reactive. Risk factor for transmission of Hepatitis C virus (HCV) was unsterilized syringes and
razor use in this area.

Key words: Hepatitis C virus (HCV), injections, Pakistan.

INTRODUCTION

Hepatitis C virus (HCV) is a single- stranded RNA virus
arranged into structural and non- structural regions.
There are six subtype based on differences in the non-
structural region. Only types I, II and III are seen in
Europe and type IV occurs in the Far East. Immunogenic
peptides have been derived from these regions for use in
HCV assays and are becoming increasingly sensitive.
The concentration of viral antigens in the blood is very
low. Hepatitis C virus is increasing rapidly in developing
countries (Alter, 1997). Study on prevalence of HCV in
remote areas of Pakistan is not enough (Bari et al.,
2001). HCV is the most cause of cirrhosis and associated
symptoms like ascitis. Incidence rate of Hepatitis C
varies. It is difficult to calculate exact incidence rate of
Hepatitis C due latent nature of the disease prior to
clinical presentation. Prevalence rates across the world
have changed as well with more countries aware of
transfusion-related Hepatitis C and more and more
evidence supporting intravenous drug use as the leading
risk factor of spread of the virus. In present study,
prevalence of HCV has been evaluated and risk factor
*Corresponding author. E-mail: makram_0451@yahoo.com.
Tel: 92-021-6440083. Fax: 92-021-6440079.
has been identified (Agboatwalla et al., 1994). HCV
caused 90% of post-transfusion hepatitis before sero-
logical tests that allowed the screening of blood donors
(Sulaiman and Julitasari, 1995). Intravenous drug
abusers are at high risk of HCV infection (Hagan et al.,
2002). Incubation period averages 6 to 7 weeks. More
than 85% of cases lead to chronic hepatitis. Cirrhosis
develops in 20 to 30% within 5 to 30 years and about
15% develop hepatocellular carcinoma. Male patients
and people acquiring infection over 40 years have more
rapid development of fibrosis. Hepatitis C may be a
pathogenic factor in glomerulonephritis, autoimmune
thyroiditis, idiopathic pulmonary fibrosis and probably
lymphoma. The predominant role of blood transfusion
and injection drug use in the transmission of HCV has
consistently been reported worldwide (Wasley and Alter,
2000).
Epidemiology
HCV was identified in 1988 and was responsible for 70 to
90% of post–transfusion hepatitis in all countries where
blood was tested for HBV markers. Since the screening
of HCV in donor blood was introduced, this incidence has
fallen to 4%. In the UK, I: 1800 samples of donated blood

are positive for HCV antibodies; the prevalence may well
be higher than this figure (Sultana et al., 2000). HCV is
much more common in southern Europe and Japan than
in the UK, and in Egyptian blood donors the prevalence is
as high as 19%. It is transmitted by blood and blood
products and it is postulated that 76% of hemophiliacs
(Desenclos, 2000; Brandao and Costa, 2002). The most
recent WHO estimate of the prevalence of HCV infection
is 2%, representing 123 million people (Perz et al., 2004).
Clinical features
Symptoms are few in the acute phase with a mild flu-like
illness and a rise in serum transferases. Less than 20%
of patients develop jaundice and this is mild and self-
limiting. Most patients will not be diagnosed until they
present, extra hepatic manifestations are seen, including
arthritis, agranulocytosis and aplastic anemia, as well as
diffuse neurological problems. Rarely, fulminant hepatic
failure occurs. At least 50% of patients go on to develop
chronic liver disease. Histologically, a chronic hepatitis
leading to a cirrhotic picture is seen. Cirrhosis develops in
about 10 to 20% within 5 to 30 years and of these
patients about 15% will develop hepatocellular carcinoma
(Khattak et al., 2002)
Diagnosis
Diagnosis of hepatitis C is based on an enzyme
immunoassay that detects antibodies to HCV. Anti-HCV
is not protective, and in patients with acute or chronic
hepatitis its presence in serum generally signifies that
HCV is the cause (Hayashi et al., 1994). Limitations of
the enzyme immunoassay include moderate sensitivity
(false-negatives) for the diagnosis of acute hepatitis C
early in the course and low specificity (false-positives) in
some persons with elevated γ-globulin levels. In these
situations, a diagnosis of hepatitis C may be confirmed by
using an assay for HCV RNA. Occasional persons are
found to have anti-HCV in serum, confirmed by a
recombinant immunoblot assay (RIBA), without HCV
RNA in serum, suggesting recovery from HCV infection in
the past. Testing donated blood for HCV has helped
reduce the risk of transfusion–associated hepatitis C from
10% in 1990 to about 1 case per 2 million units today
(Haider et al., 1994).
Prevention and treatment
Major prevention problems persist in the developing
countries. Many of them cannot afford the anti-HCV blood
test kits, where the use of contaminated equipment for
injection and other medical and dental procedures is
widespread. Efforts are therefore, necessary to persuade
the manufacturers of tests to lower the costs for
Iqbal et al. 6103
developing countries. Health education programmes are
also needed to inform the general public and health care
workers, about the risk of transmitting infection with the
use of unsterile equipments. Surveillance on a global
scale needs to be strengthened in order to improve
medical knowledge of transmission of the virus
(Chowdhury et al., 2003).
Interferon is the only drug that has been found effective
in the treatment of HCV infection. However treatment is
very expensive-thousands of dollars for the drug alone-
and must be administered by injection several times a
week for several months. Moreover, some patients,
experience serious side effects. Also, about half of the
patients go into remission but 50% relapse when the
treatment is stopped: only 25% is long term remission.
Given its cost, only a minority of patients can afford it. Or
are likely to be offered it. Studies involving less costly,
orally administered drugs are continuing. But results so
far have been disappointing. For a number of technical
reasons, the development of a vaccine to prevent HCV
infection is unlikely for many years (Luby et al., 1997).
MATERIALS AND METHODS
Study area
This study was carried out in Gadap Town Karachi, Pakistan.
Objective
This study was carried out to determine the frequency of HCV and
identify risk factors for transmission of these infections in Gadap
Town Karachi, Pakistan.
Procedure
Screening and evaluation of risk factors for HCV Antibody (Anti-
HCV) was done in Gadap Town Karachi Pakistan. In this study,
subject above age of 10 years and all previously unscreened adults
who were counseled and a written informed consent was obtained.
All drug addicts by history were excluded. A structured information
sheet regarding risk factors was filled and screening done by
immunochromatography (ICT) kits. Blood samples were collected
from individuals who volunteered to participate in the study after a
counselling session. Demographic information about each
participant was obtained by oral interview. Such information
included sex and age.
Sample collection
Blood samples were collected by venepuncture. The arm of the
individual was tied with a tourniquet and the position of the veins
disinfected using cotton wool soaked in methylated spirit. Using a
disposable sterile needle and 5 ml syringe for each participant,
blood samples were collected from them. Each sample resultant
supernatant (Plasma) was carefully decanted into a new labelled
tube and stored at -29°C until ready for use.
Statistical analysis
The prevalence of HCV was determined from the proportion of
6104 J. Med. Plants Res.
seropositive individuals in the total population under consideration
and expressed as a percentage. P values of < 0.05 were
considered to be statistically significant.
RESULTS
Hepatitis C is quite prevalent in both developing and
developed countries. Therefore, the global mortality and
morbidity related to chronic Hepatitis C poses a serious
threat to public health around the globe. In present study,
600 hundred subjects were enrolled. 47% were females
and 53% were males. Mean ages of females was 25
years and mean age of male was 24 years. In Gadap
town 5% was anti HCV reactive. Risk factor for trans-
mission of HCV was unsterized syringes and razor use in
this area.
Conclusion
Hepatitis C viruses constitute a major public health
problem because of the morbidity and mortality
associated with the acute and chronic consequences of
the infection. HCV cases have been increasing rapidly in
rural areas. Most common cause for transmission of this
infection may be unsterilized injection and razor use in
rural areas. This can be controlled by awareness
programs about HCV transmission in rural areas. The
prevention of HCV infection can be achieved by blood
screening for HCV before donation, avoiding sharing
needles or any injecting equipment and following safe
sexual practices.
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