REGIONAL DIFFERENCES IN HEPATITIS B AND C PREVALENCE IN PAKISTAN: TRENDS, CHALLENGES AND FUTURE DIRECTIONS – A REVIEW

Abstract

Hepatitis B (HBV and Hepatitis C (HCV are important public health issues in Pakistan, with unique regional patterns and issues that influence their prevalence and control. Though HBV is vaccine-preventable, it still infects some groups because of incomplete immunization coverage, particularly the timely delivery of the birth dose, and has high regional heterogeneity. HCV, on the other hand, is not yet vaccinated against and has a much greater prevalence in the country, especially in rural and underserved areas, and renders Pakistan one of the countries with the highest HCV burden in the world. Socioeconomic factors like poverty, low literacy, and poor access to healthcare increase susceptibility to the two diseases, while unsafe injection practices, unregulated blood transfusions, and traditional barbering are cultural practices that increase the transmission of the viruses. Despite government programs having increased HBV vaccination coverage and opened up HCV treatment access, equitable access and regulation of healthcare practice continue to be a challenge. Economic constraints hinder the universal application of prevention and treatment measures, and cost-effective and region-specific interventions become a mandatory priority. Recent trends show progress in HBV control among children and increased availability of HCV treatments, but persistent unsafe practices and inadequate awareness continue to impede disease elimination. Future directions should focus on universal HBV vaccination at birth, expanded HCV screening and treatment, and targeted public health education, alongside robust policy enforcement and healthcare system strengthening. Addressing regional disparities and integrating socioeconomic and cultural considerations will be critical for effective hepatitis control and eventual elimination in Pakistan.