Abstract
BackgroundHepatitis B virus (HBV) infection is a serious health problem in Pakistan. In view of the serious socioeconomic consequences, identifying patient characteristics and the current treatment for the disease will enhance HBV regulation and its medical management.AimsTo describe the epidemiology, clinical characteristics, and current management status of patients infected by HBV.MethodsWe undertook an observational, cross-sectional, and epidemiological study at the Jinnah Postgraduate Medical Centre, Karachi, during the period from January 2014 to November 2017. Male and female patients of any age and with documentation for an HBV infection were eligible for inclusion in the study. An HBV infection was defined as a positive hepatitis B surface antigen test.ResultsA total of 500 patients were analyzed. The mean age at presentation was 29.86±13.68 years. The majority of the patients (25.6%) were ethnically Sindhi followed by Pathan (24.4%), indicating a high prevalence among the rural-based population of Pakistan. The mean duration of the disease was 3.51±4.46 years. The most common cause for the spread was positive family history (40.4%) followed by roadside barbers (30.0%). Most patients were Child-Pugh (CP) class A (84.6%) and the median Modified End-Stage Liver Disease (MELD) score was 7. Upper gastrointestinal bleeding was the most frequent hepatic complication (6.2%). Antiviral medications had been received by 18.6% of patients previously. Peg-interferon (6.0%) was the major antiviral medication prescribed to treatment-experienced patients.ConclusionsThis observational, real-life study has identified some gaps between clinical practice and guideline recommendations in Pakistan. To achieve better health outcomes, several improvements, such as disease monitoring and optimizing antiviral regimens, should be made to improve disease management.
Highlights
Hepatitis B virus (HBV), a blood-borne virus, is the leading cause of chronic liver disease (CLD) in the developing world and remains a major cause of the morbidity and mortality associated with CLD [1].Pakistan is in the intermediate endemicity region, with an estimated carrier rate of 3%-5% [2]
The majority of the patients (25.6%) were ethnically Sindhi followed by Pathan (24.4%), indicating a high prevalence among the rural-based population of Pakistan
Peg-interferon (6.0%) was the major antiviral medication prescribed to treatment-experienced patients
Summary
Hepatitis B virus (HBV), a blood-borne virus, is the leading cause of chronic liver disease (CLD) in the developing world and remains a major cause of the morbidity and mortality associated with CLD [1].Pakistan is in the intermediate endemicity region, with an estimated carrier rate of 3%-5% [2]. Hepatitis B virus (HBV), a blood-borne virus, is the leading cause of chronic liver disease (CLD) in the developing world and remains a major cause of the morbidity and mortality associated with CLD [1]. HBV remains a debilitating disease, especially for the province of Sindh [3], with some estimates putting the disease burden as high as 8 million patients in the province. This is especially significant in the setting of tertiary care, where chronic liver disease is presenting with an ever-increasing burden and HBV is one of the leading causes. In view of the serious socioeconomic consequences, identifying patient characteristics and the current treatment for the disease will enhance HBV regulation and its medical management
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