Hepatitis B virus in Pakistan: A systematic review of prevalence, risk factors, awareness status and genotypes

In Pakistan, there are estimated 7-9 million carriers of hepatitis B virus (HBV) with a carrier rate of 3-5%. This article reviews the available literature about the prevalence, risk factors, awareness status and genotypes of the HBV in Pakistan by using key words; HBV prevalence, risk factors, awareness status and genotypes in Pakistani population in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. One hundred and six different studies published from 1998 to 2010 were included in this study. Weighted mean and standard deviation were determined for each population group. The percentage of hepatitis B virus infection in general population was 4.3318% +/- 1.644%, healthy blood donors (3.93% +/- 1.58%), military recruits (4.276% +/- 1.646%), healthcare persons (3.25% +/- 1.202%), pregnant women (5.872% +/- 4.984), prisoners (5.75% +/- 0.212%), surgical patients (7.397% +/- 2.012%), patients with cirrhosis (28.87% +/- 11.90%), patients with HCC (22% +/- 2.645%), patients with hepatitis (15.896% +/- 14.824%), patients with liver diseases (27.54% +/- 6.385%), multiple transfused patients (6.223% +/- 2.121%), opthalmic patients (3.89% +/- 1.004%) and users of injectable drugs (14.95% +/- 10.536%). Genotype D (63.71%) is the most prevalent genotype in Pakistani population. Mass vaccination and awareness programs should be initiated on urgent basis especially in populations with HBV infection rates of more than 5%.