Frequency of HCV infection and its genotypes among patients attending a liver clinic and voluntary blood donors in a rural area of Pakistan

To determine the frequency of Hepatitis C virus [HCV] infection and its genotypic distribution in a rural area of Sindh, Pakistan. Retrospective study of patients attending the Free Liver Clinic [FLC], and investigated for detectable HCV antibodies [n=1638], and those screened for HCV infection prior to voluntary blood donation [n=804] at a teaching hospital, located in rural Sindh. All patients had HCV antibodies tested by ELISA. A total of 1022 patients, who tested 'reactive' to HCV antibodies, and who could financially afford to have HCV RNA tested by PCR, had their results analysed. A total of 200 patients also had their HCV genotyped and analysed. Patients at FLC had a higher chance of being reactive for HCV antibodies, compared to voluntary blood donors [20% VS 14% - p = 0.004]. HCV RNA was detectable in 904/1022 [88%] patients. Among typeable genotypes, 125/166 [75%] had a single genotype, and 7 patients [4%] were infected with genotype 1, either alone [n=4] or in combination with 3a. One out of every five people tested in our FLC, and 14% of "healthy" voluntary blood donors were seropositive for HCV antibodies. Genotype 1 is very rare in our region

Non-B, Non-C Hepatitis as a cause of advanced chronic liver disease requiring medical admission at a rural centre in Pakistan

To study the frequency and mortality of hepatitis B and C negative chronic liver disease [CLD] at a rural tertiary centre in Pakistan. Data was collected retrospectively from the case notes of all the 176 patients consecutively admitted with advanced CLD in our medical ward during one year period. Patients, who were seropositive for hepatitis B and / or C, were separated from those who were negative for them, and the data was analysed. Thirty five patients [20%] were negative for both viral markers. They were more likely to die during the admission than those who were seropositive [11% VS 25% - p = 0.029]. A significant proportion of patients with CLD are negative for viral markers. These patients are at higher risk of mortality, and need testing for other causes of CLD as some of them may benefit from curative treatments available