Abstract The national burden of HCV has significantly mounted over the period of last few decades placing Pakistan at the worst placement of second largest burden of HCV globally. Herein for the first time from Pakistan, we examined clinical correlation of potential biomarkers with HCV. Nation-wide study was conducted on 13,348 suspected HCV patients during 2018-2022. During pre-COVID-19 era of 2018-2019, prevalence of HCV remained 30%. During 2018, among HCV positive patients, 91% of ALT, 63% of AST, 67% of GGT, 28% of Bili T, 62% of HB, 15% of HBA1C, 25% of CREAT, 15% of PT, 15% of aPTT and 64% of AFP were abnormal. During 2019, among HCV infected 74.47% of ALT, 63.54% of AST, 70.24% of GGT, 24.71% of Bili T, 8.77% of HB and 75% of AFP were raised. CT/CAT scan revealed 4.65% liver complications (mild 13.04%, moderate 30.43% and severe 56.52%). During 2020, HCV prevalence remained 25%. 65.17% of ALT, 64.20% of AST, 68.75% of GGT, 31.25% of Bili T, 20.97% of HB, 4.65% of CREAT and 73.68% of AFP levels were raised. CAT analysis revealed liver complications among 4.41% (14.81% mild, 40.74% moderate, and 44.44% sever). 85.71% of participants diabetes was out of control. During 2021, HCV prevalence remained 27.1%. ALT (73.86%), AST (50.6%), GGT (67.95%), Bili T (28.21%), HB (20%), CREAT (5.8%) and AFP (82.14%) levels were abnormal. During 2022, the levels of ALT (56.06%), AST (56.36%), GGT (56.6%), Bili T (19.23%), HB (43.48%), HBA1C (14.81), CREAT (18.92%), AFP (93.75%) were abnormal. CAT analysis revealed 7.46% liver complications (25% mild, 30.36% moderate, and 42.86% sever). During 2021-2022, 83.33% of subject’s diabetes was not controlled. globally Nationwide Nation wide 13348 13 348 13,34 20182022. 20182022 2018 2022. 2022 2018-2022 preCOVID19 preCOVID pre COVID 19 pre-COVID-1 20182019, 20182019 2019 2018-2019 30 30% 91 63 67 28 62 15 HBAC HBA C 25 PT 64 abnormal 7447 74 47 74.47 6354 54 63.54 7024 70 24 70.24 2471 71 24.71 877 8 77 8.77 75 raised CTCAT CT 465 4 65 4.65 mild 1304 04 13.04% 3043 43 30.43 56.52%. 5652 56.52% . 56 52 56.52%) 2020 6517 17 65.17 6420 20 64.20 6875 68 68.75 3125 31 31.25 2097 97 20.97 7368 73 73.68 441 41 4.41 14.81% 1481 14 81 (14.81 4074 40 40.74 4444 44 44.44 sever. sever sever) 8571 85 85.71 control 2021 271 27 1 27.1% 73.86%, 7386 73.86% , 86 (73.86%) 50.6%, 506 50.6% 50 6 (50.6%) 67.95%, 6795 67.95% 95 (67.95%) 28.21%, 2821 28.21% 21 (28.21%) 20%, 20% (20%) 5.8% 58 5 (5.8% 82.14% 8214 82 (82.14% 56.06%, 5606 56.06% 06 (56.06%) 56.36%, 5636 56.36% 36 (56.36%) 56.6%, 566 56.6% (56.6%) 19.23%, 1923 19.23% 23 (19.23%) 43.48%, 4348 43.48% 48 (43.48%) 14.81, 14.81 (14.81) 18.92%, 1892 18.92% 18 92 (18.92%) 93.75% 9375 93 (93.75% 746 7 46 7.46 (25 3036 30.36 4286 42 42.86 20212022, 20212022 2021-2022 8333 83 33 83.33 subjects subject s controlled 1334 34 13,3 2018202 201 202 2018-202 preCOVID1 pre-COVID- 2018201 2018-201 3 9 2 744 74.4 635 63.5 702 70.2 247 24.7 87 8.7 4.6 130 0 13.04 304 30.4 565 56.52 651 65.1 642 64.2 687 68.7 312 31.2 209 20.9 736 73.6 4.4 148 (14.8 407 40.7 444 44.4 857 85.7 27.1 738 73.86 (73.86% 50.6 (50.6% 679 67.95 (67.95% 282 28.21 (28.21% (20% 5.8 (5.8 82.14 821 (82.14 560 56.06 (56.06% 563 56.36 (56.36% 56.6 (56.6% 192 19.23 (19.23% 434 43.48 (43.48% 14.8 189 18.92 (18.92% 93.75 937 (93.75 7.4 (2 303 30.3 428 42.8 2021202 2021-202 833 83.3 133 13, 201820 2018-20 pre-COVID 74. 63. 70. 24. 8. 4. 13.0 30. 56.5 65. 64. 68. 31. 20. 73. (14. 40. 44. 85. 27. 73.8 (73.86 50. (50.6 67.9 (67.95 28.2 (28.21 (20 5. (5. 82.1 (82.1 56.0 (56.06 56.3 (56.36 56. (56.6 19.2 (19.23 43.4 (43.48 14. 18.9 (18.92 93.7 (93.7 7. ( 42. 202120 2021-20 83. 20182 2018-2 13. (14 (73.8 (50. 67. (67.9 28. (28.2 (5 82. (82. (56.0 (56.3 (56. 19. (19.2 43. (43.4 18. (18.9 93. (93. 20212 2021-2 2018- (1 (73. (50 (67. (28. (82 (56 (19. (43. (18. (93 2021- (73 (67 (28 (8 (19 (43 (18 (9 (7 (6 (4
Resumo A carga nacional de HCV aumentou significativamente ao longo das últimas décadas, colocando o Paquistão na pior colocação da segunda maior carga de HCV globalmente. Pela primeira vez no Paquistão, examinamos a correlação clínica de potenciais biomarcadores com HCV. Um estudo nacional foi realizado com 13.348 pacientes suspeitos de HCV de 2018 a 2022. Durante a era pré-COVID-19 de 2018 a 2019, a prevalência do HCV permaneceu em 30%. Durante 2018, entre pacientes positivos para HCV, 91% de ALT, 63% de AST, 67% de GGT, 28% de Bili T, 62% de HB, 15% de HBA1C, 25% de CREAT, 15% de PT, 15% de aPTT e 64% de AFP eram anormais. Durante 2019, entre os infectados pelo HCV, 74,47% de ALT, 63,54% de AST, 70,24% de GGT, 24,71% de Bili T, 8,77% de HB e 75% de AFP foram elevados. A TC/TAC revelou 4,65% de complicações hepáticas (leve 13,04%, moderada 30,43% e grave 56,52%). Durante 2020, a prevalência do HCV permaneceu em 25%. 65,17% de ALT, 64,20% de AST, 68,75% de GGT, 31,25% de Bili T, 20,97% de HB, 4,65% de CREAT e 73,68% de AFP estavam elevados. A análise de TAC revelou complicações hepáticas em 4,41% (14,81% leves, 40,74% moderadas e 44,44% graves). 85,71% dos participantes o diabetes estava fora de controle. Durante 2021, a prevalência de HCV permaneceu em 27,1%. Os níveis de ALT (73,86%), AST (50,6%), GGT (67,95%), Bili T (28,21%), HB (20%), CREAT (5,8%) e AFP (82,14%) estavam anormais. Durante 2022, os níveis de ALT (56,06%), AST (56,36%), GGT (56,6%), Bili T (19,23%), HB (43,48%), HBA1C (14,81), CREAT (18,92%), AFP (93,75%) eram anormais. A análise de TAC revelou 7,46% de complicações hepáticas (25% leves, 30,36% moderadas e 42,86% severas). Durante 2021 e 2022, 83,33% do diabetes do sujeito não foi controlado. décadas globalmente 13348 13 348 13.34 201 2022 préCOVID19 préCOVID pré COVID 19 pré-COVID-1 2019 30 30% 91 63 67 28 62 15 HBAC HBA C 25 PT 64 anormais 7447 74 47 74,47 6354 54 63,54 7024 70 24 70,24 2471 71 24,71 877 8 77 8,77 75 elevados TCTAC TC 465 4 65 4,65 leve 1304 04 13,04% 3043 43 30,43 56,52%. 5652 56,52% . 56 52 56,52%) 2020 6517 17 65,17 6420 20 64,20 6875 68 68,75 3125 31 31,25 2097 97 20,97 7368 73 73,68 441 41 4,41 14,81% 1481 14 81 (14,81 leves 4074 40 40,74 4444 44 44,44 graves. graves graves) 8571 85 85,71 controle 271 27 1 27,1% 73,86%, 7386 73,86% , 86 (73,86%) 50,6%, 506 50,6% 50 6 (50,6%) 67,95%, 6795 67,95% 95 (67,95%) 28,21%, 2821 28,21% 21 (28,21%) 20%, 20% (20%) 5,8% 58 5 (5,8% 82,14% 8214 82 (82,14% 56,06%, 5606 56,06% 06 (56,06%) 56,36%, 5636 56,36% 36 (56,36%) 56,6%, 566 56,6% (56,6%) 19,23%, 1923 19,23% 23 (19,23%) 43,48%, 4348 43,48% 48 (43,48%) 14,81, 14,81 (14,81) 18,92%, 1892 18,92% 18 92 (18,92%) 93,75% 9375 93 (93,75% 746 7 46 7,46 (25 3036 30,36 4286 42 42,86 severas. severas severas) 202 8333 83 33 83,33 controlado 1334 34 13.3 préCOVID1 pré-COVID- 3 9 2 744 74,4 635 63,5 702 70,2 247 24,7 87 8,7 4,6 130 0 13,04 304 30,4 565 56,52 651 65,1 642 64,2 687 68,7 312 31,2 209 20,9 736 73,6 4,4 148 (14,8 407 40,7 444 44,4 857 85,7 27,1 738 73,86 (73,86% 50,6 (50,6% 679 67,95 (67,95% 282 28,21 (28,21% (20% 5,8 (5,8 82,14 821 (82,14 560 56,06 (56,06% 563 56,36 (56,36% 56,6 (56,6% 192 19,23 (19,23% 434 43,48 (43,48% 14,8 189 18,92 (18,92% 93,75 937 (93,75 7,4 (2 303 30,3 428 42,8 833 83,3 133 13. pré-COVID 74, 63, 70, 24, 8, 4, 13,0 30, 56,5 65, 64, 68, 31, 20, 73, (14, 40, 44, 85, 27, 73,8 (73,86 50, (50,6 67,9 (67,95 28,2 (28,21 (20 5, (5, 82,1 (82,1 56,0 (56,06 56,3 (56,36 56, (56,6 19,2 (19,23 43,4 (43,48 14, 18,9 (18,92 93,7 (93,7 7, ( 42, 83, 13, (14 (73,8 (50, 67, (67,9 28, (28,2 (5 82, (82, (56,0 (56,3 (56, 19, (19,2 43, (43,4 18, (18,9 93, (93, (1 (73, (50 (67, (28, (82 (56 (19, (43, (18, (93 (73 (67 (28 (8 (19 (43 (18 (9 (7 (6 (4