• Javed Akhtar Rathore
  • Masood Alam Shah
  • Adnan Mehraj


Background: Hepatitis C Virus (HCV) is major health hazard. About 350 million people havebeen suffering from HCV infection in the world. HCV progresses into chronic liver disease in 50–80% of cases and may end up in cirrhosis. This study was carried out to explore the transmissionof risk factors for HCV. Methods: This prospective study included 210 consecutive HCV patientsof either sex, ranging from 20–69 years of age, referred to Sheikh Khalifa Bin Zyad Hospital/Combined Military Hospital, Muzaffarabad, Azad Kashmir. In patients having HCV positive byELISA, the PCR qualitative tests of HCV RNA were performed. A questionnaire was filled forevery patient regarding possible risk factors. Results: Most common risk factors among HCVpatients were surgical procedures (p<0.001), followed by injections (p<0.05), dental surgeries(p<0.010), ear and nose piercing (p<0.001), and shaving (p<0.001). Univariate analysis identifiedtattooing (p=0.033) also as an important risk factor. Conclusion: Multiple risk factors have beenidentified in nearly all HCV infected patients. The identification of multiple risk factors ofhepatitis C acquisition may have important implications in the approach to HCV surveillance,prevention, and management.Keywords: Hepatitis C virus, Polymerase chain reaction, PCR, Risk Factors


Global surveillance and control of hepatitis C. Report of a WHO

Consultation organized in collaboration with the Viral Hepatitis

Prevention Board, Antwerp, Belgium. J Viral Hepat 1999;6:35–47.

Pawlotsky JM. Pathophysiology of hepatitis C virus infarction

and related liver disease. Trend Microbial 2004:12:96–102.

Merkinaite S, Lazarus JV, Gore C. Addressing HCV infection in

Europe: reported, estimated and undiagnosed cases. Cent Eur J

Public Health 2008;16:106–10.

Jafri, W, Subhan A. Hepatitis C in Pakistan: magnitude,

genotype, disease characteristics and therapeutic response. Trop

Gastroenterol 2008;29:194–201.

Velati C, Romano L, Fomiatti L, Baruffi L, Zanetti AR. Impact

of nucleic acid testing for hepatitis B virus, hepatitis C virus, and

human immunodeficiency virus on the safety of blood supply in

Italy: a 6-year survey. Transfusion 2008;48:2205–13.

Bari A, Akhtar S, Rahbar MH, Luby SP. Risk factors for

hepatitis C virus infection in male adults in RawalpindiIslamabad, Pakistan. Trop Med Int Health 2001;6:732–8.

Idrees M, Riazuddin S. Frequency distribution of hepatitis C

virus genotypes in different geographical regions of Pakistan and

their possible routes of transmission. BMC Infect Dis 2008;8:69.

Qureshi H, Arif A, Riaz K, Alam SE, Ahmed W, Mujeeb SA.

Determination of risk factors for hepatitis B and C in male

patients suffering from chronic hepatitis. BMC Res Notes


Raja NS, Janjua KA. Epidemiology of hepatitis C virus infection

in Pakistan. J Microbiol Immunol Infect 2008;41:4–8.

Khan YP, Bhutta SZ, Munim S, Bhutta ZA. Maternal health and

survival in Pakistan: issues and options. J Obstet Gynaecol Can


Janjua NZ, Hutin YJ, Akhtar S, Ahmad K. Population beliefs

about the efficacy of injections in Pakistan’s Sindh province.

Public Health 2006;120:824–33.

Luby S, Khanani R, Zia M, Vellani Z, Ali M, Qureshi AH, et al.

Evaluation of blood bank practices in Karachi, Pakistan, and the

government’s response. J Pak Med Assoc 2006;56:825–30.

Ahmad W, Qureshi H, Arif A, Alam SE. Changing trend of viral

hepatitis: A twenty one year report from Pakistan Medical

Research Council Research Centre, Jinnah Postgraduate Medical

Centre, Karachi. J Pak Med Assoc 2010;60:86–9.

Siddiqui FA, Ehrinpreis MN, Janisse J, Dhar R, May E,

Mutchnick MG. Demographics of a large cohort of urban chronic

hepatitis C patients. Hepatol Int 2008;2:376–81.

Altaf A, Janjua NZ, Hutin Y. The cost of unsafe injections in

Pakistan and challenges for prevention program. J Coll

Physicians Surg Pak 2006;16:622–4.

Alter MJ. Epidemiology of hepatitis C in the West. Semin Liver

Dis 1995:15:514.

Wasley A, Alter MJ. Epidemiology of hepatitis C geographic

differences and temporary trends. Semin Liver Dis 2000;20:116.

al-Faleh FZ, Ramia S, Arif M, Ayoola EA, al-Rashed RS, alJeffry M, et al. Profile of hepatitis C virus and the possible modes

of transmission of the virus in the Gizan area of Saudi Arabia: a

community-based study. Ann Trop Med Parasitol 1995;89:431–7.

Khattak MF, Salamat N, Bhatti FA, Qureshi TZ. Seroprevalence

of hepatitis B, C, and HIV in blood donors in northern Pakistan. J

Pak Med Assoc 2002;52:398–402.

Robert L, Carithers JR. Hepatitis C and renal failure. Am J Med


Samuel MC, Doherty PM, Bulterys M, Jenison SA. Association

between heroin use, needle sharing and tattoos received in prison

with hepatitis B and C positivity among street-recruited injecting

drug users in New Mexico, USA. Epidemiol Infect


Alter HJ, Seeff LB. Recovery, persistence, and sequelae in

hepatitis C virus infection: a perspective on long-term outcome.

Seminars in Liver Disease 2000;20:17–35.

J Ayub Med Coll Abbottabad 2012;24(3-4)


Hahn JA, Page-shafer K, Lum PJ, Ochoa K, Moss AR. Hepatitis

C virus infection and needle exchange use among young injection

drug users in San Francisco. Hepatology. 2001;34:180–6.

Miro JM, Laguno M, Moreno A, Rimola A. Management of end

stage liver disease (ESLD): what is the current role of orthotopic

liver transplantation (OLT)? J Hepatol 2006;44:S140–5.

Alter MJ, Kruszon-Moran D, Nainan OV, McQuillan GM, Gao

F, Moyer LA, et al. Prevalence of hepatitis C virus infection in

the United States, 1988 through 1994. N Engl J Med


World Health Organization. Hepatitis C –global prevalence

(update) Wkly Epidemiol Rec 1999;74:425–7.

Touzet S, Kraemer L, Colin C, Pradat P, Lanoir D, Bailly F, et al.

Epidemiology of hepatitis C virus infection in seven European

Union countries: a critical analysis of the literature. HENCORE

Group. (Hepatitis C European Network for Co-operative

Research. Eur J Gastrol Hepatol 2000;12:667–78.

Sagnelli E, Stroffolini T, Mele A, Almasio P, Coppola N,

Ferrigno L, et al. The importance of HCV on the burden of

chronic liver disease in Italy: a multicenter prevalence study of

,997 cases. J Med Virol 2005;75:522–7.

Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The

contributions of hepatitis B virus and hepatitis C virus infections

to cirrhosis and primary liver cancer worldwide. J Hepatol


Stroffolini T. Etiological factor of hepatocellular carcinoma in

Italy. Minerva Gastroenterologica Dietologica 2005;51:1–5.



Most read articles by the same author(s)