Ann. Pak. Inst. Med. Sci. 2010; 6(1): 40-43

Objective: To find prevalence of Hepatitis B and C in pregnant women of Rawalpindi and Islamabad region.
Study Design: Retrospective Review
Place and Duration: Microbiology laboratory, Department of Pathology, PIMS, Islamabad, From January 2002 to July 2008
Materials and Methods: Blood samples were collected from healthy pregnant women who came for routine antenatal check up from Jan 2002 to July 2008. 75777 patients were screened for Hepatitis B&C; to avoid duplication; the women on the next visit were not included. From Jan 2002 to 2005 patient were screened by dry chromatography method Acon USA(one step), from 2006 till July 2008 patients were screened by third generation ELISA method by Best 2000 as facility available. Average age group of women was 25 to 40 Years.
Results: During the study period 255475 women attended the antenatal clinic and 75777 were tested for Hepatices B&C. The results of healthy pregnant ladies show that prevalence of both Hepatitis B and C has increased from 2002 to 2008. Prevalence of Hepatitis B increased from 1.4% to 3.4% and Hepatitis C from 6.3% to10.1%. The overall prevalence of HBsAg and HCV antibody in pregnant ladies was 1.9% and 7.4% respectively.
Conclusion: The seroprevalence of HBV and HCV in otherwise healthy pregnant women is alarmingly high. Third generation ELISA technique when employed for screening has a greater yield than dry chromatography technique.
Keyword: Hepatitis B & C prevalence, an antenatal period.

Introduction


Infections due to hepatitis Band C viruses are significant health problems around the globe. Hepatitis B virus is endemic and widespread in many parts of the world.¹ The Hepatitis B virus is a double stranded DNA Virus. More than 2 billion people have had contact with the virus and more than 350 million people are chronic carriers, in which 75% in Asia.² Ninety percent of HBV infection in healthy adults, the chronic carrier work as reservoirs, transmitting the virus to neonates. The increased frequency of chronic carriers of HBV infection amongst women of reproductive age, is considered the major factor in the high prevalence of HBV infection in some populations.^3-5

The primary vehicles for transmission are blood, blood products and body fluids. The categories at risk are those receiving blood transfusions, undergoing dialysis, drug abusers, homosexuals and cases of needle–stick accidents among health care worker.^3,6

The prevalence rate chronic hepatitis B virus infection is up to 20% in population of Asia-Pacific region. In Hong Kong, the overall prevalence and occurrence of chronic HBV infection in obstetric population is 10%, as compared to in Western Europe.³
Hepatitis C virus is a single strand RNA VIRUS having flavi-virus like properties. It was first identified in 1988.Risk factor for HCV infection.previous vaginal deliveries with episiotomy .surgeries blood transfusion, and D&C for abortion.⁶

The prevalence of Hepatices C virus is different in different part of the world highest incidence in the Eastern part of the globe compared with the western parts,⁷ Hepatitis C infection has an estimated seroprevalence of 1-2% in women of childbearing age and vertical transmission rate is 5-15%. About 5% infants born to women, who are positive for both HCV antibody and HCV RNA during pregnancy, acquire HCV infections.6 Prevalence of Hepatitis C in pregnancy has been studied in many countries of Europe and Africa considering WHO classification patients lie in intermediate zone with burden of hepatitis being 0.13% of total infectious disease in the country. Being a vulnerable group, pregnant women are likely to be more infected.¹

In Pakistan it is estimated that at least Nine million people harbor Hepatitis B virus and over fourteen million are chronically infected with Hepatitis C Virus.8,9 The exact prevalence rate of Hepatitis virus infection in Pakistan is unknown. A community based study in Hafizabad, showed prevalence of 4.3% of HBV and 6.5% of anti-HCV in the residents. In northern Pakistan, 3.3% of healthy blood donors were HBs Ag positive, 4% were anti-hepatitis C virus positive. The prevalence of HBsAg & Anti HCV in pregnant ladies attending antenatal clinic at Sheikh Zayed Medical Complex, Rahim Yar Khan were alarming high in the screening high 18.2%HCV 12.0%HBV positive.¹⁰

The prevalence varies from 0.5%-29%in general population around the world .in India it has been reported to be 5.1% were in Pakistan it varies from 0.5-25.7%.10 Main objective of our study was to assess the frequency of HBs Ag & HCV antibody in pregnant Ladies and to highlight the magnitude of the problem, so the safety measures can be devised to prevent the spread of these infections.