THE RELATIONSHIP BETWEEN THERAPEUTIC INJECTIONS AND HIGH PREVALENCE OF HEPATITIS-C INFECTION IN HAFIZABAD, PAKISTAN

To determine the prevalence and routes of transmission of hepatitis C virus (HCV) infection in Hafizabad, Pakistan, we collected sera in 199 3 from a geographically based random sample of residents, and in 1994 identified 15 HCV-infected individuals (cases) and 67 age and sex matc hed uninfected individuals (controls). Initially we approached 504 hou seholds, and collected serum from a randomly selected household member in 309 (64%). Twenty persons (6.5%) had anti-HCV antibody; 31% percen t had hepatitis B core antibodies, and 4.3% had hepatitis B surface an tigen. In the case-control study, persons who received more therapeuti c 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 wit h HCV (odds ratio 0, 1.5, 2.5 and 6.9 respectively, P = 0.008) compare d to persons averaging 0 injections per year. Efforts to limit therape utic injections to only those that are medically indicated and that us e sterile equipment are essential in order to prevent transmission of HCV.