Abstract
To determine the prevalence and routes of transmission of hepatitis
C
virus (HCV) infection in
Hafizabad, Pakistan, we collected sera in 1993 from a geographically based
random sample of
residents, and in 1994 identified 15 HCV-infected individuals (cases) and
67 age and sex matched uninfected individuals (controls). Initially we
approached
504 households, and
collected serum from a randomly selected household member in 309 (64%).
Twenty persons (6·5%) had anti-HCV antibody; 31% percent had hepatitis
B core
antibodies, and 4·3% had
hepatitis B surface antigen. In the case-control study, persons who
received more therapeutic
injections (categorized as averaging 1, 2–4, 5–9 or >10
injections per year in the previous 10
years) were more likely to be infected with HCV (odds ratio 0,
1·5, 2·5 and 6·9 respectively,
P=0·008) compared to persons averaging 0 injections per
year. Efforts to limit therapeutic
injections to only those that are medically indicated and that use
sterile equipment are essential in order to prevent transmission of HCV.