May 15, 2013
Unnecessary injections, unsafe injection practices, and non-sterile syringes and needles are major factors contributing to the spread of hepatitis C virus (HCV) in Pakistan, according to Dr. Quaid Saeed, World Health Organization (WHO) national program officer on HIV and hepatitis. Other factors that contribute to the spread of the virus include poverty and illiteracy, roadside dentists' use of unsterilized equipment, and "contaminated blood transfusions," according to Saeed. Pakistan has had a Safe Blood Transfusion Act since 2002, but Saeed stated that only Punjab province has implemented the legislation fully. He estimated that Pakistan does not screen 40 percent of blood transfusions for HCV and HIV. Pakistan's laws do not regulate syringe use.
Although current data estimated that 23 percent of Pakistanis are hepatitis B carriers and 45 percent of Pakistanis carry HCV, Saeed believed the numbers would be higher if officials surveyed the whole population. Although some people infected with HCV recover, up to 80 percent may become chronic carriers, according to Saeed. In contrast, approximately 80 percent of hepatitis B-infected patients recover from the virus. WHO defines national hepatitis prevalence between 28 percent as an "intermediate" risk. Saeed noted that Pakistan has the highest prevalence of chronic liver disease in the world.
Dr. Aftab Mohsin, a leading Pakistani liver and gastroenterology physician, confirmed that dentists, medical practitioners, and "quacks" are responsible for syringe reuse and misuse. In addition, Dr. Arshad Altaf, Pakistani volunteer for WHO's Safety Injection Global Network, estimated that 90 percent of injections in Pakistan are unnecessary.
Mohsin stated that HCV treatment in Pakistan is "far worse" than syringe practice. Although HCV genotype 3 is the most prevalent form of HCV among Pakistani patients, most receive conventional interferon treatment instead of the preferred treatment of pegylated interferon.