Prevalence and Associated Risk Factors Analysis of Hepatitis B & C Infections in the Low Socioeconomic Communities; A Cross-Sectional Study from Pakistan

Abstract Background: Pakistan is bearing the second highest global burden of hepatitis C and B virus, infecting 3-4 % of its overall 22 million population. These infections remain unchecked in most of the cases and such incidences become a continuous source of infection to the healthy population. Maximum efforts for screening, prevalence and surveillance of these viral infections is needed to stem the devastating impact on the underprivileged communities living in the outskirt of major cities. Methods: This study was designed to determine the prevalence of hepatitis B & C and the corresponding risk factors among the low socioeconomic communities of Islamabad. Participants (aged 10-70 years) were recruited from six localities inhabited with people living in underprivileged conditions. Relationship between hepatitis B/C incidence, demographics and risk factors was measured using Pearson's Chi-square test, univariate and multivariate regression analysis. A total of 1004 individuals were enrolled in this study.Results: Out of 1004 individuals, almost 4% were found positive for hepatitis C and 1% for hepatitis B after screening with PCR. Pearson’s Chi-square test showed a strong relationship of hepatitis B/C infection with marital status (p= 0.000), hepatitis B vaccination status (p= 0.000), blood or blood product recipient (p= 0.000), having a tattoo, family income (p= 0.026) and participant age (p= 0.000). Multivariable analysis showed hepatitis B vaccination odds ratio (OR) =5.309 (95% confidence interval [CI] 2.812-10.025), population exposed to therapeutic injections four-times/past 6 months OR=4.328 (95% CI 1.319-13.617) dental visit four-time/past six months OR=11.9 (95% CI 3.350-40.098) people having exposure to HCV patients ≥6 times/past six months OR=3.095 (95% CI 1.577-6.074) and age of the participants OR=1.049 (95% CI 1.026-1.072) were independently associated with hepatitis C infection. Conclusions: These findings show that the risk of hepatitis B/C is multifactorial. However, on multivariate analysis, no association was found between hepatitis C incidence and blood donation, blood recipient, nose/ear piercing, barber visit, tattooing, drug abuse, marital status, family income and education status.