10.6084/m9.figshare.6042080.v1 Zaina Al Kanaani Zaina Al Kanaani Sarwat Mahmud Sarwat Mahmud Silva P. Kouyoumjian Silva P. Kouyoumjian Laith J. Abu-Raddad Laith J. Abu-Raddad Supplementary Material from The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses The Royal Society 2018 Hepatitis C virus epidemiology prevalence incidence Middle East and North Africa 2018-03-27 17:14:17 Journal contribution https://rs.figshare.com/articles/journal_contribution/Supplementary_Material_from_The_epidemiology_of_hepatitis_C_virus_in_Pakistan_systematic_review_and_meta-analyses/6042080 To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations. We systematically reviewed all available records of HCV incidence and/or prevalence from 1989 to 2016, as informed by the Cochrane Collaboration Handbook. This systematic review was reported following the PRISMA guidelines. Populations were classified into six categories based on the risk of exposure to HCV infection. Meta-analyses were performed using DerSimonian and Laird random-effects models with inverse variance weighting. The search identified one HCV incidence study and 341 prevalence measures/strata. Meta-analyses estimated the pooled mean HCV prevalence at 6.2% among the general population, 34.5% among high-risk clinical populations, 12.8% among populations at intermediate risk, 16.9% among special clinical populations, 55.9% among populations with liver-related conditions and 53.6% among people who inject drugs. Most reported risk factors in analytical epidemiologic studies related to healthcare procedures. Pakistan is enduring an HCV epidemic of historical proportions—one in every 20 Pakistanis is infected. HCV plays a major role in liver disease burden in this country, and HCV prevalence is high in all-risk populations. Most transmission appears to be driven by healthcare procedures. HCV treatment and prevention must become a national priority.