Hepatitis C affects an estimated 10 million people in Pakistan. Hepatitis C is one of the most common chronic infections in Pakistan and a major burden on the healthcare system – 2nd largest burden of HCV in the world. HCV prevalence was observed in nearly 5% of the general population which is in parallel with the WHO estimates of HCV in Pakistan with much higher figures for certain population pockets. PMRC (Pakistan Medical and Research Council) data suggest highest prevalence in Punjab (6.7%) followed by Sindh (5.0%), Baluchistan (1.5%) and KPK (1.1%). This translates into an estimated 10 million infected people, of which large population could have serious liver disease and many might be at greater risk of developing liver cancer. Genotype 3 is the most prevalent among all genotypes that accounts for around 80-85% cases of all Hepatitis C infections in Pakistan.
Hepatitis C spreads through blood and body secretions. Majority of cases with hepatitis C virus get infected without any history of jaundice or liver disease. The major complaints are lethargy and weakness in majority of patients. The acute infection clears in 20-30% cases while in the rest it persists as chronic hepatitis C. It is a very slowly progressing disease and in about 25% cases over 10 years it progresses to chronic liver disease and over another decade in 25% it goes to advanced disease. In Pakistan there is a need to work on prevention of virus transmission that occurs most commonly from re-using syringes, contaminated instruments and unhygienic hospital environment. Transfusion of blood and other bodily fluids without proper screening should also need to focus.
Since the advent of first oral therapy, Sovaldi (Sofosbuvir), Interferon alpha with ribavirin were the drugs of choice in Pakistan. Sovaldi (Sofosbuvir) was first brought in on named-patient basis in Pakistan in August 2014 under an access program partnership with Gilead Sciences, Inc.