Hepatitis C is a global health problem. The World Health Organisation has estimated that approximately 3.3 per cent of the world’s population (200 million people) have been infected with the hepatitis C virus. Hepatitis C is one of the commonest causes of chronic liver disease in Pakistan and is one of the leading indications for liver transplant. Several studies have looked at the prevalence of hepatitis C in chronic liver disease in Pakistan. The role of hepatitis c in the causation of liver cancer has been well documented.
According to WHO Pakistan is standing at 2nd position in prevalence of hepatitis C in the whole world after Egypt. "The Shadow Epidemic," it's been labeled because In Pakistan more than 10 million people are living with Hepatitis C virus (HCV) with high morbidity and mortality. According to Pakistan medical research Council approximately 7 per cent of total population of Pakistan is infected with Hepatitis C virus. The Silent Killer," health professionals call this virus that can slowly destroy the liver. Hepatitis C earned its label as the Silent Killer precisely because the virus leaves so few noticeable tracks of its presence. Lancet a reputable international medical journal termed Pakistan as a cirrhotic state in one of its articles. Hepatitis C is responsible for a significant proportion of liver disease in various regions of Pakistan. the high risk of chronicity of this blood-borne infection and association with cirrhosis and liver cancer underscores its public health importance. Hepatitis c like a ticking time bomb for health authorities. Hepatitis C, cirrhosis and its sequel Vomiting with blood in the vomit, Fluid retention causing swelling of the belly, legs, or whole body. Mental disturbances such as confusion, lethargy, extreme sleepiness, or hallucinations and liver cancer have become the commonest cause for admission, as well as the mortality in the tertiary care hospitals all over Pakistan. HCV prevalence is moderate in the general population but very high in injecting drug users and multi-transfused populations. majority of Pakistani nation is not introduced with Hepatitis C and its sequel. Inflammation of liver is called hepatitis and inflammation of liver due to hepatitis c virus is called hepatitis c. hepatitis c was first detected in 1989.In 1992, a test became available for checking blood for HCV.
Hepatitis C can present as acute(short term) or chronic(long term) in nature. 15 to 45% of those infected with HCV are able to clear the virus from their blood within about 6 months from the time of infection. However, 55 to 85% of people with acute(short term) hepatitis C do not get rid of the virus within 6 months and therefore have chronic (long-term) hepatitis C. About 70% of chronically infected persons will develop chronic liver disease.apporximatly a fifth of the patients with chronic hepatitis c progress to cirrhosis over a time spanning nearly a decade. Between 1 and 5 % of chronically infected patients may die from chronic liver disease. Hepatitis C is primarily transmitted by direct contact with blood or blood products. Unfortunately, HCV infection is not a notifiable disease in Pakistan and there is no national data collection system for evaluation of routine risk factors. Several published studies suggested that excessive use of unnecessary injections and reuse of unsterilised needles are the leading risk factors for HCV transmission in Pakistan. Health care workers usually practice unsafe injections or reuse of inadequately sterilized syringes and needles. The majority of health care workers are not medically qualified or scientifically trained and are unaware of standard sterilisation procedures or the importance of safe injection practice. Apart from this, the general population of Pakistan typically prefer to be treated by injection rather than oral medication. Thus, patient demand and financial incentives favour the use of injectable treatment in patient care. Routine reuse of syringes in Pakistan's back-street health centres has caused a surge in blood-borne infection such as hepatitis  C, which experts have dubbed “the AIDS of Pakistan”. In Pakistan, blood transfusion is still a major source of HCV transmission. Possible reasons for this include lack of resources, weak infra structure, ill-equipped resources, poorly trained staff, inadequate policy implementation, frequent power breakdown and ineffective screening of blood donors for anti-HCV antibody. Another significant risk factor of HCV transmission in Pakistan is daily face and armpit shaving at community barber shops. The delicate skin of the face and armpit are susceptible to micro trauma, leading to possible exposure to HCV through a contaminated traditional long-handled razor homosexuality and intravenous drug abuse are on the rise in Pakistan, although at present these make only a nominal contribution to HCV prevalence infection in this country. However, data are lacking regarding these possible routes of entry, and intravenous drug abuse is the leading risk factor for HCV transmission worldwide.
There are several other established risk factors contributing to the transmission of HCV infection, such as dental and surgical procedures, circumcision, tattooing, ear piercing and dialysis.