Hepatitis C virus cascade of care among adults in Sindh province, Pakistan: Findings from 2019-2020 household sero-survey
Document Type
Article
Department
Medicine; Gastroenterology
Abstract
Pakistan has the largest national burden of hepatitis C virus (HCV) infections (9.8 million). High levels of testing and treatment are needed to achieve HCV elimination, but little data exists on this in Pakistan. A household sero-survey from Sindh province (2019-2020) collected self-reported data from adults on previous HCV testing and treatment, and undertook HCV-antibody (HCV-Ab) testing of participants (2988 children (< 18) and 3684 adults) and HCV-RNA testing of HCV-Ab positive individuals. We determined the self-reported HCV cascade-of-care among adults ever eligible for HCV treatment, defined as either having a past infection (HCV-Ab positive and HCV-RNA negative) with self-reported treatment history or current infection (HCV-RNA positive). We assessed factors associated with self-reporting ever being HCV-tested using multi-variable logistic regression. Overall, 10.8% (397/3684) of adults tested HCV Ab-positive in the sero-survey, of which 80.9% (321/397) had a HCV-RNA test result. Of adults defined as ever treatment eligible (n = 232), 40.9% (95/232) reported a previous HCV test and 91.2% (87/95) reported testing positive. Of these, HCV treatment was reported by 69.0% (60/87) and 46.7% (28/60) of treated individuals tested HCV-RNA-negative. Overall, 25.9% (60/232) of treatment-eligible adults reported being treated. The regression analysis suggested that males, older adults (>25 years), and adults with a secondary or higher education level were more likely to have ever been tested for HCV, as were individuals with a family history of hepatitis, received HBV vaccination or that had various risk factors linked to HCV transmission (e.g., blood transfusion, having tattoo/acupuncture, hospitalisation or therapeutic injection (s) history). The cascade-of-care for HCV needs improving to eliminate HCV in Pakistan, especially among younger adults, women and people with low education levels.
Publication (Name of Journal)
PLOS Global Public Health
DOI
10.1371/journal.pgph.0004706
Recommended Citation
Alamneh, T. S.,
Walker, J. G.,
Lim, A. G.,
Alam, E.,
Hamid, S.,
Foster, G. R.,
Choudhry, N.,
Ansari, M.,
Qureshi, H.,
Vickerman, P.
(2025). Hepatitis C virus cascade of care among adults in Sindh province, Pakistan: Findings from 2019-2020 household sero-survey. PLOS Global Public Health, 5(7), 1-12.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_med_gastroenterol/374