Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

ABSTRACT

To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre [tertiary care public sector hospital], other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex 4th Generation ELISA kits. A total of 2965 cases were referred in a year. Overall seroprevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1%in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally [20.3%] seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the departments had less than 1% positivity of co-infection. Both genders were equally infected with HCV, but males were predominantly more infected with HBV, with a male to female ratio of 21 [p>0.001]. High frequency of HBV and HCV infection is due to a biased population of hospitalized cases. High referral from medical and gynaecology department indicates high awareness about these diseases in the health care providers and similar awareness needs to be created in other departments of public and private sector hospitals. Serious efforts need to be done to inculcate awareness regarding HBV and HCV in all departments of public and private hospitals