HEPATITIS B INFECTION

Presented by
Dr.Rakhshinda Ambreen
MSPH batch II
AIPH,JSMU
CONTENT
• Background
• Pakistan’s scenario
• Risk factors
• Prevalence in Pakistan
• Prevention and control
 BACKGROUND
• Hepatitis B is a viral infection that attacks the liver and can cause
both acute and chronic disease.
• The virus is transmitted through contact with the blood or other
body fluids of an infected person.
• 240 million people are chronically infected with hepatitis B
every year globally.
• More than 686 000 people die every year due to complications of
hepatitis B, including cirrhosis and liver cancer 1.
• Hepatitis B is an important occupational hazard for health
workers.
 PAKISTAN’S SCENARIO

• Chronic HBV prevalence:

2.5% (4 million)*

Highest rate of therapeutic

injections in the world: up to 13
injections/person/year

*Qureshi H, et al. (2010). ***CDC. (Oct 2011).2

HEPATITIS B PREVALENCE IN PAKISTAN

1.1M 2.4M
RISK FACTORS FOR ACUTE HEPATITIS, PAKISTAN,
2010-2011
• Distribution of risk factors 6 weeks prior to infection

Source: CDC. (Oct 2011). 3

RISK FACTORS
HIGH RISK GROUPS
•Surgeons
•Dental surgeons
•Nurses
•Lab technicians
•Blood bank workers
•Homosexuals
•Sex workers
•IV drug abusers
•Infants of HBV carrier
mothers
 PREVENTION AND CONTROL
Blocking the channel of transmission:
Sterilization, avoid sharing of toothbrush/syringes/razors, screening
of blood, safe sex practice

Protection of susceptible individuals:

Active immunization and passive immunization

Prevention of mother to child transmission:

Protection and immunization
 HEPATITIS B IMMUNIZATION SCHEDULE
Regular dosage Rapid schedule chronic Post prophylaxis Special dosage
hemodialysis schedule
patients

Adults: 3 doses For high risk 4 doses each of 40 HBIG dose 0.05 to Active and passive
each individuals: mcg at interval of 0.07 ml/kg immunization
1 ml at 0,1,6 surgeons, dentists, 0,1,2,6 followed by bodyweight. 2 (HBs Ag +HB Ig)
months IM lab tech. 0,1,2 with booster dose once doses are given New born of
Below 10 years- boosters at 12 in 5 years with an interval of carrier mothers
neonates: 0.5ml months followed 4 weeks. It are given vaccine
EPI 6 wks,10 wks., by a booster after protects for about with in 12 hours of
14 wks. every 8 years 3 months. This birth but not later
Booster dose after should be given than 48 hours
5 years with in 24 hours of
exposure.
 GOVERNMENT’S EFFORTS
Hepatitis control program Pakistan started in 2005
Objectives :
• control of transmission
• Mortality
• infected waste
• free immunization
• capacity building and training of healthcare professionals
ACHIEVEMENTS
• Infection control training in 25 high risk districts (WHO &
PMRC)
• Medicine have been distributed among 38 sentinel sites.
• Computers purchased and distributed to develop data bank.
• Health promotion activities.
ACHIEVEMENTS

• 38 Sentinel sites for diagnosis , screening and treatment has

been established
• A network of PCR Labs has been established to facilitate PCR
testing.
THANK YOU!
Any questions??
REFERENCES
1. K.Suriya, water born disease, viral hepatitis; Community
medicine with recent advances;2nd edition.pg. 369-373
2. Qureshi H, et al. (2010). East Mediterr Health J;16 Suppl:S15-
S23. **Homie Razavi, APASL STC, Karachi, October 2014.
***CDC. (Oct 2011). Establishment of a Viral Hepatitis
Surveillance System – Pakistan, 2009-2011. MMWR, 60(40),
1385-1390.
3. Source: CDC. (Oct 2011). Establishment of a Viral Hepatitis
Surveillance System – Pakistan, 2009-2011. MMWR, 60(40),
1385-90.