Original Article PREVALENT RISK FACTORS OF HCV TRANSMISSION IN HEALTH CARE WORKERS (HCWS) IN PAKISTAN ASAD ZIA 1 , IKRAM ULLAH 1 , SHAHID ALI 2 , MUHAMMAD ZIA 3 , SHILU MATHEW 4 , KANEEZ FATIMA 5 , ABIDA RAZA 6* , ISHTIAQ QADRI 7* 1 Department of Biotechnology, Quaid-I-Azam University Islamabad, Pakistan, 2 The Biotech Medical Labs and Research Center Islamabad, Pakistan, 3 Department of Biotechnology, Faculty of Biological Sciences, Quaid i Azam University Islamabad Pakistan, 4 Center of Excellence in Genomic Medicine Research, King Abdul Aziz University, Jeddah, Saudi Arabia, 5 IQInstitute of Infection and Immunity, Lahore, Punjab, Pakistan, 6 Nuclear Institute of Radiotherapy and Oncology, Islamabad, Pakistan, 7 King Fahd Medical Research Center, King Abdul Aziz University, Jeddah, Saudi Arabia Email: ishtiaq80262@yahoo.com Received: 02 Jun 2015 Revised and Accepted: 08 Aug 2015 ABSTRACT Objective: To study and analyze the prevalent risk factors of Hepatitis C Virus (HCV) transmission in Health Care Workers (HCWs) in Pakistan Methods: A literature survey (2005-2012) was conducted from the available literatures to identify the most prominent risk factors and prevalence rate of HCV affected workers in Pakistan. Health care workers include doctors, nurses, paramedical staffs, dispensers, laboratory technicians and pharmacists. The most common risk factors associated with the high incidence rate of HCV in HCWs are lack of well-trained paramedical staff and their non-scientific behavior, improper disposal of hospital waste, lack of sterilization facilities, poor infrastructure, direct exposure to blood and its products and finally needle stick injury. Results: The mean prevalence of HCV in HCWs is 4.46%±2, with the highest prevalence (6%) in Islamabad and Rawalpindi area. Conclusion: We recommend for the HCWs to become aware of the possible risks of HCV spread and minimize the complications of hospital care. The government should have to initiate awareness program on HCV infection among health care professionals. Keywords: HCV, Health care workers, Risk factors. INTRODUCTION Hepatitis is a major public health concern around the globe and mainly affects least developed countries including Pakistan. In Pakistan, almost 40% of the total burden of diseases is caused by infectious or transmittable diseases including tuberculosis, diarrhea, immunisable childhood diseases, malaria, HBV, HCV as well as acute respiratory infections [1-3]. According to the medium term development framework (2010) of Pakistan, the increasing threat of injecting drug users pose a major problem when one considers the hidden cases of HIV/AIDS and HCV among the addicted people. HCWs are also among the risk of acquiring transmissible diseases especially HCV. Hepatitis C is a blood borne infection which causes a high human morbidity and mortality both in the general population and health care workers [4, 5]. Occupational exposure to healthcare workers is considered any contact with a material that carries the risk of acquiring an infection, which occurs during the working activities, either in direct contact with patients or with body fluids or tissues [6]. The greatest risk for transmission of HCV, HBV or HIV occurs after a percutaneous injury, such as needle stick injury and cuts with sharp objects [7, 8]. According to Leachy (2011) and WHO (2013), approximately 9% of the global population are infected with HCV, HBV and or HDV worldwide. HBV and HCV globally account for 60% of cirrhosis and 80% of hepatocellular carcinoma (HCC) as well as cause one million deaths each year. Least developed countries share a substantial set of hurdles to continue the epidemic, including insufficient screening, poor medical infrastructures, shortage of healthcare workers, inadequate access to care and treatment [9]. According to Hussain et al. (2010), approximately 10 million Pakistani people, from among the 6% of the overall population, are suffering from HCV. About 16,000 HCV infections have occurred worldwide in the year 2000 due to occupational exposure among HCWs [10, 11] of the 35 million people of the worldwide working population, 12% represents the health care workforce. An individual that provides health care services in a systematic way to individuals, families or communities is called HCW [12]. Health care providers not only work in hospitals but also in academic and research institutions. The size, skills and commitment of the health care workforce greatly affect health services. Fewer safety precautions and a higher prevalence of infections increase the risk of HCV in the HCWs communities. In Pakistan various health programs are initiated to control the risk of morbidity and mortality. These programs includes; Family Planning and Primary Health Care, HIV/AIDS Control Program, National Programme for Prevention and Control of Blindness, National TB Control Program, Cancer Treatment, Dengue Epidemic and Control Programme, National Maternal and Child Health Program, Malaria Control Program and Drug Abuse [13]. However, there are no such programs have been initiated for the prevention of HCV in Pakistan. Some research studies show that the prevalence of HCV varies between four provinces of Pakistan, and it is reported at6.7% in Punjab 5% in Sindh, 1.5% in Baluchistan and 1.1% in Khyber Pakhtunkhwa [14]. Hepatitis patients are not registered formally, however hospital based data suggest that every fourth patient in the medical ward has liver related diseases. From the literature, we found that various risk factors are involved in the transmission of HCV in the general population. This literature based on novel study was conducted specifically to identify the rationale the most prevalent risk factors of HCV in the HCW, working in the health care system. MATERIALS AND METHODS A literature survey was conducted to identify the most prominent risk factors and prevalence rate from the available literature in Pakistan HCW. Literature was searched in PubMed, Google Scholar and Pak Medina by using the keywords; prevalence of HCV in Pakistan, HCV and HCW in Pakistan, HCV in Pakistan HCW, HCV for Nurses of Pakistan, risk factors of HCV in HCWs. The primary data on the prevalence of HCV in health care worker were identified and reviewed. International Journal of Pharmacy and Pharmaceutical Sciences ISSN- 0975-1491 Vol 7, Issue 10, 2015 Innovare Academic Sciences