Background: As the prevalence of hepatitis B continues to rise in Pakistan, our study focused on educational institutions in the state of Azad Kashmir due to the complete absence of data on this scenario concerning college populations. We aimed to assess the prevalence of hepatitis B and identify associated risk factors among the population of postgraduate colleges in Muzaffarabad city, situated in Pakistan-administered Kashmir. Methods: In this cross-sectional study, rapid immuno-chromatographic tests and real-time quantitative PCR methods were used to identify hepatitis B infection, while serum ALT levels were tested to assess their diagnostic associations with the infection level. The evaluation of risk factors was conducted through interviews using a questionnaire, and the obtained data were subjected to statistical analysis. Results: The study revealed 1.3% of participants positive for HBsAg, 0.6% tested positive for HBV, and 0.1% tested positive for HBeAg. Male participants were found to be more likely to test positive for HBsAg (odds ratio of 4.026, p=0.0074), and participants aged 30 years and above exhibited a higher prevalence (p<0.0001) for hepatitis B. The average ALT level in the HBsAg positive participants was significantly higher (p<0.0001). A significant association between HBsAg positivity and various factors including married status (p=0.0005), doing jobs (p=0.0004), getting cuts at hair salons or parlours (p<0.0001), hospitalization history (p<0.0001), blood transfusion (p<0.0001), and residence in hostels (p=0.0015) was observed. Only 0.4% participants were vaccinated against hepatitis B virus. Conclusions: Our study revealed a significant prevalence of hepatitis B among postgraduate colleges in Muzaffarabad city, emphasizing the need for targeted awareness and prevention efforts. Identifying key risk factors such as blood transfusion, hospitalization, and residence in hostels underscores the importance of tailored initiatives. Considering the low vaccination rate, comprehensive actions, including routine screening, prioritized vaccination campaigns, and the implementation of multi-marker-based testing, are essential to mitigate the impact of hepatitis B.

Background: No prior studies have assessed hepatitis A, B, and C prevalence in Neelum Valley, Azad Kashmir, a major tourist hub along the Line of Control. This study evaluates the prevalence and risk factors associated with these infections in the region. Methods: A total of 374 participants (286 males, 88 females) from Neelum Valley were surveyed, and serum samples were tested for hepatitis markers using immuno-chromatographic tests and Real-Time PCR. Liver function markers (ALT, ALP, and Bilirubin) were also analyzed. Statistical analysis was conducted using GraphPad Prism V. 7.04. Results: The prevalence of recent hepatitis A infection (HAV IgM Positive) was 0.8%, while 4.8% had prior exposure (HAV IgG Positive). Hepatitis B (HBsAg positivity) was detected in 2.4%, with 1.3% showing active viral replication (HBV DNA Positive). Hepatitis C exposure (anti-HCV positivity) was 1.3%, with 0.5% showing active infection (HCV RNA Positive). All participants had normal liver function markers. Younger individuals (18–25 years) had higher infection rates, and males showed a greater prevalence than females for all infections. Significant risk factors (p < 0.0001) included contaminated food or water, jaundice history, hospitalization, blood transfusions, ear/nose piercing, tattooing, and treatment from local practitioners. Conclusions: The prevalence of hepatitis A, B, and C in Neelum Valley is lower than in some regional studies but remains a public health concern. The influx of tourists may facilitate disease transmission, highlighting the need for improved sanitation and healthcare measures.

An increased prevalence of diagnostically untypable HCV isolates has been reported for the past few years in Pakistan and the efficacy of DAA-based treatment regimens can be significantly affected by HCV genotypes and subtypes. The Current study aimed to evaluate the drug response of diagnostically untypable isolates to existing DAA based treatment regimens in Pakistan. Drug response was evaluated by an observational study including 192 patients infected with an untypable genotype with 101 patients receiving Sofosbuvir-Daclatasvir (SOF-DCV) and 91 receiving Sofosbuvir-Ribavirin (SOF-RBV) for 12 weeks and by monitoring Rapid virologic response (RVR) at 4 weeks of initiating therapy, end of treatment (EOT) response at 12 weeks and sustained virologic response at 12 weeks (SVR12) after EOT. Overall, SVR12 of untypable genotypes against the current treatment regimen was 83.3% (160/192). The untypable genotype responded significantly well to SOF-DCV as compared to SOF-RBV with an SVR12 rate of 91.0% and 74.7% respectively. The proportion of non-responders to SOF-DCV (6.9%) was significantly less as compared to non-responders to SOF-RBV (19.7%). Also, relapse rates were significantly high in the group treated with SOF-RBV (5.4%) as compared to SOF-DCV (1.9%) (p0.05) but did not vary with gender. A Pangenotypic SOF-DCV treatment regimen is found as an effective regimen for these circulating untypable genotypes.