Hepatitis-C Virus Prevalence in District Shangla and Evaluation of Screening Tests for Anti-HCV

An estimated 11 million Pakistani individuals are infected with hepatitis and the disease is constantly increasing. Every 10th Pakistani is believed to be suffering from viral hepatitis. It is the first study documenting the epidemiology of HCV in District Shangla, Khyber Pakhtunkhwa (KPK). Blood samples from 900 individuals of various age groups were collected (August to November 2013) from patients at clinics, houses and pharmacies belonging to three Tehsils (Puran, Alpuri and Besham) of district Shangla. The Immuno-chromatographic (ICT) and enzyme linked Immunosorbant Assay (ELISA) techniques were applied for the presence of anti-HCV, while RT-PCR was used for active HCV infection. Our study reports an overall prevalence of HCV among 131 (14.55%), 103 (11.44%), and 94 (10.4%) by ICT, ELISA, and RT-PCR techniques in individuals belonging to 5 different age groups. The RT-PCR based results showed 53% HCV infection rate in samples from Tehsil Puran, 23% in Alpuri and 18% in Besham. The gender wise result (non-significant) showed 10% and 10.7% active HCV infection rates in males and females respectively. The RT-PCR based result observed maximum infection (14%) in individuals of 4150 years and minimum (2.7%) in individuals of 10-20 years. The ICT resulted in poor screening for HCV infections. The main route of HCV transmission in males is the sharing razors (33.33%), while in females, is the reuse of contaminated syringes (42%) at maternity homes respectively. These alarming results call for initiation of an emergency based awareness campaign about HCV among the public of district Shangla to prevent the impending epidemics of HCV. Additionally, for proper and actual results, the ELISA and RT-PCR techniques are suggested to be recommended instead of ICT for screening the blood against HCV. This work will provide the active HCV prevalence data for further research/studies, which can be helpful to health policy makers to plan strategies for the control of hepatitis C disease particularly in district Shangla and generally in Pakistan.