Introduction: The term "thalassemia" refers to a group of hereditary blood disorders characterised by anaemia. The two primary proteins that make up the oxygen-carrying HB (haemoglobin) component of red blood cells (RBCs) are beta and alpha chains. To create beta globin chains, two globin genes from each parent are required; if one or both of these genes are defective, beta thalassemia will result. The most common complication of beta thalassemia major that is iron over-loading in vital organ of the body like liver, spleen, heart and endocrine system due to regular blood transfusion, the second most common complication is transfusion transmission infection (TTI) hepatitis B, hepatitis C and HIV infection. Globally, the most common infection is hepatitis B and hepatitis C viruses’ infection. Material & Methods: Cross sectional correlational study was conducted at the Fatimid Foundation and Hamza in Peshawar, Pakistan. Research study had started from 1st March 2021 to 1st October 2021. In this study 184 beta thalassemia major patients had been included, 105 from Fatimid foundation and 79 from Hamza foundation. Results: Total of one hundred and eighty-four participants were included in the study. Among them 6= (3.3%) were positive for hepatitis B virus antigen, while hepatitis C virus was found in 43 (23.8%) patients. Furthermore, 4 (2.2%) were infected with both HBV and HCV virus infection. Conclusion: Cousin or other blood relation marriage was significant or risk factor for thalassemia disease. There was no significant relation found of hepatitis B or hepatitis C virus infection with thalassemia major patients. In order to minimize the risk of HBV and HCV infection, it is essential to utilize the most sensitive and specific Nucleic acid test for donor screening. Safe blood transfusion centres for thalassemia patients are needed which are well-equipped and all the facilities must be available in it.

7 Abstract: Hepatitis C is an infectious liver disease, the infection of HCV is often asymptomatic and the chronic infection comes to be hepatocellular carcinoma, cirrhosis and end-stage liver disease. Six main genotypes of HCV and several subtypes are recognized worldwide. HCV genotypes play important role in distribution of frequency, clinical management and development of vaccine. Current article shows distribution frequency of HCV genotypes present in various tehsils of district Mardan of Khyber Pakhtoonkhaw, Pakistan.Sum of 375 patients were positive for HCV RNA by PCR and were screened using genotyping assay. Data analysis showed that 241 out of 375 PCR positive patients were male and 134 were female. 190, 110 and 75 patients came from tehsils of Mardan, Takhat Bhai and Katlang respectively. Results showed that: Out of the total screened patients, genotype specific PCR fragments were seen in 322 (85.8%) patient. The distribution of typeable genotypes was as follows: 39 patients (10.4%) with genotype 1a, 11 (2.9%) patients with genotype 1b; 227 (60.5%) patients infected with genotype 3a; 24 (6.4%) patients genotype 3b; and 21(5.6%) patients were with mixed genotypic infection. 53 (14.1%) serum samples were found un-typeable by the molecular genotyping assay used. in Conclusion It was concluded from the current research work that different genotypes of HCV such as 1a, 1b, 3a and 3b present in different tehsils of Mardan district and genotype 3a is most common genotype among general population of district Mardan.

AIM: Hepatitis C viral infection is a major health issue in the globe especially in developing countries like in Pakistan with prevalence rate of about 6% of the total population. True epidemiological data in developing countries about this infection is almost inadequate. The main objective of this study was determined the existence of different HCV genotypes in study area, in gender and in different age groups. METHODS: It was a prospective, observational study carried for HCV genotyping from Jan, 2011 to March 2011 at Genome Center for Molecular Based Diagnostics and Research (GCMBDR) Lahore. A total of 375 HCV positive samples were received by GCMBDR Lahore from various areas of Karachi. These HCV Positive samples were used for genotyping by using nested and reverse transcriptase polymerase chain reaction. RESULTS: Molecular genotyping assay was carried out for 375 HCV positive serum samples. Out of 375 HCV positive serum samples 153(40.8%) were male and 222 (59.2 %) were female. Prevalence breakup of the circulating genotypes was: genotype 3a was detected in 220 (58.67%) patients followed by untypable 52 (13.87%), 1a 44 (11.73%), 2a 11 (2.93%), 3b 11 (2.93%), 1b 8 (2.13%) and 29 (7.73%) patients showed mixed infection of two different genotypes. CONCLUSION: It is concluded that most prevalent genotype was 3a in district Karachi. Most predominant prevalence was seen in age group of 20-40.

The objective of the present study was to find out the prevalence of different genotype of Hepatitis C virus (HCV) in different area of Pakistan include, Khyber Pakhtunkhwa province, Punjab province, Sindh province and Islamabad Capital Territory. The data were collected from the different Labs and Hospitals. The present study was carried out during January 2011 to December 2012. The overall result shows that the female are more infected as compare to male 190 (50.5%) and 186 (49.5%) respectively. The high number of cases was reported from the Khyber Pakhtunkhwa 201 (53.4%) where the lowest number of cases was reported in Sindh 32 (8.5%). The overall result shows that the 3a is the most common genotype while the genotype 1b is reported in lowest number. The age wise distribution shows that the high number of cases 135 (35.9%) was reported in age group 31-40 years while the low number of cases 6 (1.6%) was occurred in age group >60 years. The statistical analysis of the data shows that the P-value is less than 0.05 were considered as significant. From this study it was concluded that the genotype 3a is the most common genotype in different region of Pakistan.

The present study demonstrate the prevalence of active Hepatitis C viral infection and identification of its common genotypes circulating in district Mardan. A total of 582 patients were enrolled in this study in which 267 were male and 315 were female. Out of 582 samples, 329 were found HCV RNA positive through real-time PCR. The rates of active HCV infection were 59.9% in male while 53.6% in female. Age group above 60 were found with high rate of HCV infection, that is 80%. Out of 329 samples. Further a sum of 220 PCR based HCV RNA positive samples were screened for identification of HCV genotypes. Out of 220 positive samples Genotype 3a was found in 68.1%, 1a in 11.3%, 1b in 4.5%, Mixed-genotype in 4% and 3b in 2.7% while Untypable genotype in 9.5%. It was concluded from the present study that occurrence of active HCV infection rate were high in District Mardan and 3a was the most common genotype present in District Mardan.

Background: Hepatitis C virus (HCV) infection is the most significant source of chronic liver diseases in the globe. About 170 million individuals are infected by HCV worldwide. The reported prevalence of HCV in different areas of Khyber Pakhtunkhwa (KP) ranges from 4.1 to 36%.Objectives: The current study aimed to analyze the true prevalence of HCV infection in Khyber Pakhtunkhwa, Pakistan.Materials and Methods: Three hundred and ninety HCV enzyme- linked immunosorbent assay (ELISA) positive samples that belonged to the different regions of Khyber Pakhtunkhwa were sent to the Genome Centre for Molecular Based Diagnostics & Research (GCMBDR), Lahore, from January 2011 to March 2011, and were selected for the current study. Serological and biochemical data of these samples were provided by clinicians. Out of 390 samples, 40 were provided from Mardan, 65 from Dir (Lower), 185 from Swat and 100 from Malakand districts of Pakistan.Results: Out of 390 patients, 140 were found HCV RNA positive (by Polymerase Chain Reaction method) and 250 subjects were excluded from further analysis. Out of PCR positive subjects, 81 were male and 59 were female. All individuals were categorized in four age groups that is, 0 to 20, 21 to 40, 41 to 60 and above 60 years. HCV RNA was found in 16.67%, 37.5%, 35.51% and 36% of these groups, respectively. District wise HCV positivity rates were 36.2 % in Swat, 38.4% in Dir (L), 36% in Malakand and 30% in Mardan, respectively.Conclusions: It was found that among the studied areas, Dir district had the highest prevalence of HCV, the majorly of affected patients were among the age group of 21 to 40, male patients were found more susceptible to this infection (P = 0.0103 < 0.05), and the possible reason can be the high exposure of males to the HCV infection risk factors. Furthermore the current study was unable to find the important risk factors responsible for the frequent prevalence of HCV infection in Khyber Pakhtunkhwa

Hepatitis B is a major public health problem in Pakistan like other developing countries. HBV infection is a more contagious disease than HCV and HIV infection. The aim of the current study is to compare seroprevalence of HBV infection in outpatients who attended a district headquarter hospital of district Mardan, Pakistan. A total number of 270 patients were selected for this research work. Serum of patients were tested by HBsAg and ICT strip method and those found positive were sent to GCMBDR to confirmed for HBV DNA by Real Time PCR. Out of the total 270 screened patients, HBV DNA was confirmed in 94(34.81%) patients using Real Time PCR of which 56(59.6%) were male while 38(40.4%) were female outpatients. All the positive patients were divided into three categories on the bases of viral load categories such as low ( 10,000,000 IU/ml). On the bases of these categories 50 %( n=47) patients were found with low viral load, 33 %( n=31) with intermediate and 17 %( n=16) were found having high viral load. Female patients were slightly more susceptible to HBV infection compared to male patients. The highest HBV infection seroprevalence was found in patients of 21-40 age group. Majority of the sick subjects were however seen with low viral titers.

6 Abstract: Background: Liver cirrhosis is one among most common causes of death throughout the world. Pakistan is known as cirrhotic state with high number of cirrhosis anywhere in the world. Aims: The objectives of this study were to assess risk factors, clinical features and complications of liver cirrhosis. Method: This study was done at medical wards of Khyber Teaching Hospital and Lady Reading Hospital Peshawar. Data was collected from 74 patients with cirrhosis through structured questionnaire. Results revealed that in our results showed that Prevalence of liver cirrhosis is high in age group > 45 years(68.9%) and in male patients(79.7%), low in intermediate age group (29.7%) and infrequent in young age group (1.4%). Out of 74 cases 38 were attributed to HCV only, 12 to HBV and HCV co-infection, 7 to HBV only, 6 to HBV and Alcohol and HCV and Alcohol each, 3 to HBV, HCV and Alcohol acting conjointly and 1 to Fatty liver disease. For 1 patient the cause was unknown. More than 75% hepatitis (B and C) was associated with clinical mal-practices. Most frequent signs and symptoms in decreasing order were anorexia and weight loss (100%), jaundice (90.5 %), abdominal disturbances and spleenomegaly (75%), bleeding tendencies, decreasing mental function, itching and palmer erythema (<20%). Complications were ascites (97.3%), peripheral oedema(73%), recurrent infections (43.2), hepatic encephalopathy (28%), GIT bleeding (4.1%) and hepatocellular carcinoma (1.4%). Serum ALT and total Bilirubin were raised in 80 % and 90.7% patients respectively. Conclusion: Hepatitis C is the most frequent cause of liver cirrhosis mostly acquired through prick by contaminated syringes or blades or through blood transfusion.

IntroductionHepatitis C virus (HCV) is a principal cause of severe liver diseases worldwide and a possible source of significant morbidity and fatality in the long term. Information on the genotype is more significant because it has prognostic value in the response to antiviral therapy.ObjectivesThis study aimed to determine the frequency of various HCV genotypes circulating in the different districts of Punjab and to show the pattern distribution of HCV genotypes in different age groups and sexes.Materials and methodsA total of 542 HCV-positive patients were selected from various districts of the province and were subjected to an HCV genotype-specific assay. Among 542 positive patients, 300 (55.35%) were men and 242 (44.65%) were women. There were 245 (45.20%), 61 (11.25%), 56 (10.33%), 56 (10.33%), 53 (9.77%), 27 (5%), 20 (3.69%), 16 (3%), and eight (1.47%) HCV-positive patients from Lahore, Sargodha, Multan, Toba Tek Singh, Faisalabad, Rawalpindi, Mandi Bahauddin Gujranwala, and Sahiwal districts, respectively.ResultsOf a total of 542 serum samples analyzed, 476 (88%) were successfully genotyped whereas 66 (12%) samples were undetermined genotypes. Among the typable genotypes, 1a was found in 37 (7%), 1b in 18 (3%), 3a in 386 (71%), and genotype 3b in five (1%) patients. Thirty patients (6%) were identified to be infected with mixed HCV genotypes. Genotypes 3a (P=0.0001), 1a (P=0.001), and untypable genotypes (P=0.03) were circulating significantly in all the studied districts. All the genotypes were distributed evenly in male and female patients. The most affected age range of patients was 21-40 years as compared with teenage and older age groups.ConclusionThe study found a significantly high prevalence of HCV among the patients of Punjab. In addition, genotype 1a was found to be a significantly and rapidly increasing genotype in the study area. It appears that HCV-3a (the most prevalent genotype) may be replaced by genotype 1a. If this occurs, it will make the present scenario more complex in terms of response to therapy and economic burden on the health sector of Pakistan. HCV infection is more common in the age group of 21-40 years. All the genotypes were distributed at the same frequency in men and women. (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.