Frequency of Hepatitis B and C among Surgical Patients in a Teaching Hospital in Lahore: A Cross-Sectional Study
DOI:
https://doi.org/10.47489/szmc.v40i1.866Keywords:
Hepatitis B, Hepatitis C, Patients, Surgical Procedures, Operative, Cross-Sectional Studies, frequencyAbstract
Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are still predominant public health issues in Pakistan. This is a significant cause of liver disease and death. Patients who undergo surgical operations are at a higher risk, mainly because of blood exposure during the surgery and a lack of proper infection control in settings where resources are limited.
Objective: This research aimed to determine the frequency of HBV and HCV and their associations with socio-demographic and clinical factors such as residence, sex, marital status, and duration of hospital stay, among patients who underwent elective surgery at Pak Red Crescent Teaching Hospital, Lahore. Moreover, binary logistic regression was used to find out predictive factors for these infections.
Method: The study participants were 267 surgical patients admitted consecutively. Analysis was performed on 265 patients
with complete demographic data. It used a consecutive sampling approach. It extended from November 2024 to April 2025. The criteria for inclusion were age ?18 years, elective surgery scheduling, and complete preoperative records. In contrast, emergency cases, minors, incomplete files, and known hepatitis patients were excluded. Preoperative HBsAg and anti-HCV tests were conducted on all the patients. Hospital records were utilized to obtain the data. It was then analyzed using SPSS version 26.0. The study received approval from the Regional Ethics Committee (IRB No: 27/2025), and full patient anonymization was maintained.
Results: On average, participants' age was 40.7 years (SD ± 17.5); males accounted for 55.4%. The HBV rate was 0.7% (2 people; 95% CI: 0.1-2.5%). The HCV rate was 6.4% (17 people; 95% CI: 3.8-10.0%). These were devoid of co-infections. No tangible association was found between the infection and age, sex, residence, marital status, or hospital stay duration (p > 0.05).
Conclusion: Although the rate of HBV infection was very minimal. The rate of HCV infection among surgical patients was moderate. Continuation of routine preoperative screening and strict adherence to infection control measures are still of utmost importance to protect both patients and health workers.
References
Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B and C, 2019: a modelling study. Lancet Gastroenterol Hepatol. 2021;6(10):924-43. doi:10.1016/S2468-1253(21)00170-3
Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019;70(1):151-
Doi: 10.1016/j.jhep.2018.09.014
Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology. 2016;150(4):835-53. Doi: 10.1053 /j. gastro.2015.12.041
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. doi:10.3322/caac.21660
Balogh J, Victor D 3rd, Asham EH, Burroughs SG, Boktour M, Saharia A, et al. Hepatocellular carcinoma: a review. J Hepatocell Carcinoma. 2016; 3:41-53. doi:10.2147/JHC.S61146
Khan A, Afzal S, Yaqoob A, Fatima R, Haq MU, Junaid K, et al. Epidemiology of viral hepatitis B and C in Punjab, Pakistan: a multicenter cross-sectional study, 2017-18. F1000Res. 2019; 8:115. doi:10.12688/f1000research.20174.1
World Health Organization Regional Office for the Eastern Mediterranean. Hepatitis B and C elimination in Pakistan: Progress report 2023. Cairo: WHO EMRO; 2023. Available from: https://applications.emro.who.int/
Mehmood S, Raza H, Abid F, Saeed N, Rehman HM, Javed S, et al. National prevalence rate of hepatitis B and C in Pakistan and its risk factors. J Public Health. 2020;28(6):751-64. Doi: 10.1053 /j. gastro.2010.12.032
Khan S, Attaullah S. Share of HBV and HCV infections in the general population of Pakistan and their risk factors. Hepat Mon. 2021;21(8): e9985.doi: 10.1016/j.ijid.2008.06.019
Shahzad MN, Iqbal M, Javed F, Khan MA. Frequency of needle stick injuries among healthcare workers in a tertiary care hospital. J Pak Med Assoc. 2016;66(11):1436-40. PMID: 27812078 https://pubmed.ncbi.nlm.nih.gov/20392374/
Rafique I, Saaiq M. Needle stick injuries amongst healthcare workers in Pakistan. J Pak Med Assoc. 2013;63(12):1553-6. PMID:
https://www.researchgate.net/publication/262725865_Needle_stick_injuries_among_health_care
World Health Organization. Global hepatitis report 2024. Geneva: WHO; 2024. Available from: https://www.who.int/publications/i/item/9789240092709
Ilyas M, Alam S, Rehman A. Frequency of hepatitis B and C in patients undergoing surgical procedures. Pak Armed Forces Med J. 2011;61(3):317-20. Available from: https://www.pafmj.org/PAFMJ/article/download/1975/1715
Jadoon Q, Jadoon M, Niazi S. Seroprevalence of hepatitis B and C viruses among surgical patients in a tertiary care hospital, Pakistan. Pak J Surg. 2020;36(2):89-93.https://pakheartjournal.com/index.php/pk/article/view/49/46
Waheed Y, Shafi T, Safi S. Hepatitis elimination by 2030: progress and challenges in Pakistan. World J Gastroenterol. 2017;23(21):4422-30. https://doi.org/10.3748/wjg.v23.i21.4422
Ali M, Saeed S, Khan T. Prevalence of hepatitis B and C among preoperative surgical patients in a tertiary care hospital of Lahore. Pak J Med Health Sci. 2021;15(11):3034-8. Available from: https://pjmhsonline.com/2021/nov/3034.pdf
Rehman MU, et al. Prevalence and risk factors of HBV and HCV in Pakistan: systematic review. Int J Hepatol. 2018;2018:9607869. https://doi.org/10.1155/2018/9607869
Peduzzi P, Concato J, Kemper E, et al. Simulation study of events per variable in logistic regression. J Clin Epidemiol. 1996;49(12):1373-9. https://doi.org/10.1016/0895-4356(96)00236-3
Asrani SK, Devarbhavi H, Eaton J, Kamath PS. Burden of liver diseases in the world. J Hepatol. 2019;70(1):151-
Doi: 10.1016/j.jhep.2018.09.014
Umar M, Khaar H, Khokhar N. Hepatitis C in Pakistan: a review of the epidemiology and control measures. East Mediterr Health J. 2010;16(6):60-70.https://pmc.ncbi.nlm.nih.gov/articles/PMC3269085/
Waheed Y, Shafi T, Safi S. Hepatitis elimination by 2030: progress and challenges in Pakistan. World J Gastroenterol. 2017;23(21):4422-30. https://doi.org/10.3748/wjg.v23.i21.4422
Rafique I, Saeed S, Rehman A. Prevalence of hepatitis B and C in surgical patients of Ayub Teaching Hospital, Abbottabad. J Ayub Med Coll Abbottabad. 2010;22(2):157-9. Available from: https://ayubmed.edu.pk/JAMC/PAST/22-2/Rafique.pdf
Khan S, Attaullah S. Share of HBV and HCV infections in the general population of Pakistan and their risk factors. Hepat Mon. 2021;21(8): e9985.doi: 10.1016/j.ijid.2008.06.019
Khan AA, Khan MS, Khan SA. Dentistry as a possible route of hepatitis C transmission in Pakistan. J Coll Physicians Surg Pak. 2003;13(6):324-7. PMID: 12873110https://pubmed.ncbi.nlm.nih.gov/12873110/
Mehmood S, Raza H, Abid F, Saeed N, Rehman HM, Javed S, et al. National prevalence rate of hepatitis B and C in Pakistan and its risk factors. J Public Health. 2020;28(6):751-64. Doi: 10.1053 /j. gastro.2010.12.032
World Health Organization. Global hepatitis report 2024. Geneva: WHO; 2024. Available from: https://www.who.int/publications/i/item/9789240092709

This work is licensed under a