Pakistan currently lacks a reliable and up-to-date nationwide estimate regarding the prevalence of the Hepatitis D virus (HDV). The World Health Organisation describes chronic Hepatitis D as the most severe form of chronic viral hepatitis.
Transmission of the virus occurs primarily through exposure to infected body fluids and blood, but it does not spread through water, food, or ordinary social contact. Medical conditions involving HDV include coinfection, where a person acquires both HBV and HDV simultaneously, and superinfection, which occurs when a person develops HDV after already having chronic HBV.
A WHO-supported survey in Sindh found that 32.8 per cent of participants who tested positive for HBsAg also tested positive for anti-HDV antibodies. Dr Yasar Yousafzai stated that HDV was certainly present in Khyber-Pakhtunkhwa, but the current provincial burden remains undetermined because no province-wide survey has been conducted.
Dr Yasar Yousafzai noted, "Older studies from K-P have generally found HDV in approximately 10 to 15 per cent of hepatitis-B-positive patients, while one molecular study found HBV-HDV coinfection in around 14 to 15 per cent of patients." The Public Health Reference Laboratory in Khyber-Pakhtunkhwa does not currently offer testing for Hepatitis D.
Dr Yasar Yousafzai explained, "The important issue is that we are not routinely monitoring HDV because testing is not widely available in government or local private-sector facilities." Dr Yasar Yousafzai added, "By the time obvious symptoms develop, significant liver damage may already have occurred."
Approximately 83 per cent of surveyed experts said HDV diagnostic tests are available but remain unaffordable for many patients. Only about half of the experts reported that they routinely order the specific PCR test for HDV among patients with Hepatitis B.
Dr Mushtaq Ahmad warned that superinfection can follow an especially aggressive course. Dr Tariq Mehmood stated, "Under our programme, our mandate is focused on hepatitis B and hepatitis C."
Punjab has established a network of hepatitis clinics through its provincial programme.
