{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:32:17Z","timestamp":1790890337393,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pakistan harbours a large burden of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. We utilised repeat sero\u2010surveys to assess progress achieved towards hepatitis elimination in Pakistan. Multilevel logistic regression evaluated the change in HBV infection (HBV surface antigen (HBsAg)\u2010positive) prevalence and HCV exposure (HCV antibody (HCV\u2010Ab)\u2010positive) prevalence between two sero\u2010surveys from 2007 and 2019 for Sindh province and associated risk factors. Adjusted odds ratios (aORs) were estimated and population\u2010attributable fractions (PAF) for modifiable risk factors for HCV exposure. The 2007 and 2019 surveys included 8855 and 6672 individuals. HBsAg prevalence decreased from 2.6% (95% confidence intervals (95% CI): 2.2\u20132.9) in 2007 to 1.1% (95% CI: 0.8\u20131.3) in 2019, while HCV\u2010Ab prevalence increased from 5.1% (95% CI: 4.6%\u20135.5%) to 6.2% (95% CI: 5.6%\u20136.8%). The age and gender\u2010adjusted HBsAg prevalence decreased by 80% (aOR\u2009=\u20090.2, 95% CI: 0.1\u20130.4) among children and 60% (aOR\u2009=\u20090.4, 95% CI: 0.3\u20130.6) among adults over 2007\u20132019, while HCV\u2010Ab prevalence decreased by 60% (aOR\u2009=\u20090.4, 95%CI:0.2\u20130.7) in children and increased by 40% (aOR\u2009=\u20091.4, 95% CI: 1.2\u20131.7) in adults. HCV\u2010Ab prevalence was lower in adults with secondary (aOR\u2009=\u20090.6, 95% CI: 0.5\u20130.8) and higher (aOR\u2009=\u20090.5, 95%CI:0.3\u20130.8) education compared to illiterates and higher among adults reporting blood transfusion (aOR\u2009=\u20091.7, 95% CI: 1.2\u20132.4), family history of hepatitis (aOR\u2009=\u20092.5, 95% CI: 1.9\u20133.3), past year medical injection (aOR\u2009=\u20092.1, 95% CI: 1.6\u20132.7), being tattooed (aOR\u2009=\u20091.4, 95% CI: 1.0\u20131.9) and shaved by traditional barber (aOR\u2009=\u20091.2, 95% CI: 1.0\u20131.5). Modifiable risk factors accounted for 45% of HCV exposure, with medical injection(s) accounting for 38% (95%CI,25.7\u201348.4%). Overall HCV has increased over 2007\u20132019 in Sindh province, while HBV prevalence has decreased. Medical injections should be an important focus of prevention activities.<\/jats:p>","DOI":"10.1111\/jvh.13986","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T12:26:08Z","timestamp":1721996768000},"page":"645-656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Changes in the prevalence of hepatitis B and C viral infections in Sindh province, Pakistan: Findings from two sero\u2010surveys in 2007 and 2019"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4830-931X","authenticated-orcid":false,"given":"Tesfa Sewunet","family":"Alamneh","sequence":"first","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"Department of Epidemiology and Biostatistics Institute of Public Health, College of Medicine and Health Sciences, University of Gondar  Gondar Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine G.","family":"Walker","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron G.","family":"Lim","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ejaz","family":"Alam","sequence":"additional","affiliation":[{"name":"Pakistan Health Research Council Research Centre  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Hamid","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham R.","family":"Foster","sequence":"additional","affiliation":[{"name":"Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naheed","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Azim","family":"Ansari","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huma","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Doctor Plaza  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8291-5890","authenticated-orcid":false,"given":"Peter","family":"Vickerman","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12123"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0010.5280"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118637272"},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization.Interim Guidance for Country Validation of Viral Hepatitis Elimination.2021."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2015.01.004"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30270-X"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.26719\/2010.16.Supp.15"},{"key":"e_1_2_10_9_1","volume-title":"Global Health Sector Strategy on Viral Hepatitis 2016\u20132021. 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