206 Hepatitis C in Pakistan Most of the data have come from hospital-based studies, because there is a dearth of community- based ones (3-5). Although the National Survey of Hepatitis has concluded, its results have not yet been officially published, except for a few presentations made by researchers at official meetings. This review summarizes the available data on the epidemiology of hepatitis C since the first report of its recognition in 1992. HCV-Related Pakistani Data All available Pakistani data published or unpublished till the writing of this article were collected by a literature search through electronic databases like Pubmed, Pakmedinet, Yahoo and Google etc. Unpublished data from any source, if accessible, were also reviewed. Data from 132 published studies and 3 unpublished data sets were gathered and grouped in six categories, based on the type of population studied i.e. 1) general population, 2) blood donors, 3) patients with liver diseases, 4) patients with diseases other than hepatic diseases, 5) pregnant women and 6) children. Most of the data (78.5%) pertained to the years 2001-2008. Year by year distribution of this data is given in Table 1. Table 1. Distribution of studies and unpublished data sets by year of publication/data gathering/presentation. Year 2005 – 2008 2001 – 2004 1996 - 2000 1995 and earlier. Total Number 47 59 20 9 135 Percent 34.8 43.7 14.8 6.7 100.0 General Population Twenty-five studies (6-30) pertained to the serofrequency of hepatitis C in the general population. Details are given inTable 2.The majority of these studies (92%) were conducted during the period 2000-2008. Two studies were conducted in the nineties (6, 7). The data of 178,322 persons were included in this group. Unfortunately, there was no study from any major city of Balochistan, or from the NWFP provinces. The frequency of HCV infection ranged from 0.4% in Karachi (6) to 33.7% in Jarwar (Sindh) (28). The mean frequency was 4.7% (95% confidence interval [CI]: 4.6 - 4.8). Hepatitis Monthly, Summer 2010; 10(3): 205-214 Table 2. Sero-Prevalence of HCV in General Population Author Agboatwala et al. Luby Aslam Aslam Ali et al. Khan Khokhar Muhammad Farooq et al. Hashim et al. Ahmad Fayyaz et al. Tariq & Janjua Jafri et al. Sherif & Tariq Zaman Ahmad et al. Altaf et al. Mirza et al. Malik et al. Hakim et al. Butt & Amin Khan et al. Idrees et al. Abbas et al. Alam et al. Year 1994 1997 2001 2001 2002 2004 2004 2005 2005 2005 2006 2006 2006 2006 2006 2006 2007 2007 2007 2008 2007 2008 2008 2008 2008 2008 Total Place Karachi Hafizabad Lahore Gujranwala Rawalpindi Mardan Islamabad Buner Khuzdar Attock Swat Bahawalpur Rawalpindi Karachi Rawalpindi Bahawalpur Faisalabad Hyderabad Bahawalpur Pannu Aqil Karachi DI Khan Azad Kashmir Lahore Jarwar (Sindh) Mianwali Number 258 313 488 1,922 5,370 700 47,538 16,400 665 4,552 41,613 2,086 15,550 3,533 2,558 6,815 300 2,835 1821 5,237 4,000 5,707 245 6,817 873 697 178,322 Anti HCV (%) Reference 0.4 (6) 6.5 (7) 16.0 (8) 23.8 (8) 3.3 (9) 9.0 (10) 5.3 (11) 4.6 (12) 3.3 (13) 4.0 (14) 2.2 (15) 6.3 (16) 3.7 (17) 1.6 (18) 2.8 (19) 4.4 (30) 16.0 (20) 5.2 (21) 2.5 (22) 4.8 (23) 5.2 (24) 1.7 (25) 3.3 (26) 14.6 (27) 33.7 (28) 1.9 (29) 4.7(95%CI:4.6-4.8)6.3) Blood Donors Blood donor data constituted the largest data set. There were 27 studies and 3 unpublished data sets in this group. The total population covered in this group was 982,481 over the period 1996-2008 (Table 3). The studies covered all provinces of Pakistan. The serofrequency of HCV ranged from 0.3% in Multan (31) to 12.5% in Islamabad (32). The mean frequency was 3.0% (95% CI: 3.0- 3.1). Only five studies (29, 32-35) showed a frequency of > 5%. Patients with Liver Diseases Forty-one studies (36-68) dealing with the frequency of hepatitis C among patients with liver diseases were found, covering 7,765 patients over a period of 27 years from 1992 to 2008 (Table 4, and 5). Liver diseases included cirrhosis, chronic liver disease, chronic active hepatitis and hepatocellular carcinoma. Fourteen studies (37-50) pertained to cirrhosis patients. The number of individuals included in these studies was 1,902. HCV serofrequency in these individuals ranged from 10.5-79.6%, with