RISK FACTORS ASSOCIATED WITH HEPATITIS C VIRUS ACQUISITION IN A TERTIARY CARE SETTING

Background: Hepatitis C is prevalent worldwide. In Pakistan HCV infection has prevalence of about 4-6%. This study was conducted to identify the risk factors associated with positive hepatitis C status in a tertiary care setting. Material & Methods: This was hospital-based descriptive study, carried out in medical wards of Lady Reading Hospital, Peshawar, from June 2008 to November 2010. It included 542 anti-HCV positive patients of more than 12 years age and both sexes. Patients were selected by convenient sampling technique. Various indications for HCV testing and the risk factors for its acquisition were recorded on a pre-designed Performa. Results: Out of 542 patients, 228(42.07%) were males and 314(57.93%) females. Age ranged 14 to 90 years with mean 37.11+12.69. Re-use of syringes and therapeutic injections were reported in 433(79.88%), needle stick injuries 44(8.11%), blood transfusions 68(12.54%), dental procedures 243(44.83%), tattooing 10(1.84%), previous surgery 144(26.56%) and road traffic accidents in 16(2.95%) patients. Indications for anti-HCV testing included dilatation &/curettage in 37(11.78%), evacuation &/curettage in 41(13.05%), and antenatal checkup in 37(11.78%) female patients. Anti-HCV antibodies were detected pre-operatively in 63(11.62%), pre-endoscopy 2(0.36%), pre-vaccination against hepatitis B 14(2.58%), while donating blood in 18(3.32%), and as part of pre-employment or pre-insurance examination in 91(16.78%) patients. Conclusion: Hepatitis C is more common in patients with unnecessary use of injections, re-use of syringes, dental procedures and unscreened blood transfusions. In most of the patients, more than one risk factor can be found.