H Mahmood, Q Saeed, F Averhoff, N Ahmed, H Qureshi
This study examined hepatitis B and C prevalence among transgender individuals and men who have sex with men in Pakistan, finding measurable infection rates alongside gaps in access to care. Using a community-based “one-stop shop” model, the program successfully improved testing, treatment initiation, and cure rates, demonstrating an effective approach to reaching underserved populations.
H Qureshi, H Mahmood, SE Alam, A Aabroo, ZI Channa, A Shaheen, ZJ Fatima, N Glass, N Khetsuriani, MA Kazi RA Tohme
This study addresses the high burden of hepatitis B in Pakistan by evaluating a pilot program implementing birth dose vaccination within 24 hours of delivery in two tertiary hospitals. Using a 24/7 facility-based model, nearly all newborns (2,000/2,008) received the vaccine within one hour of birth, with no reported adverse effects or additional costs. These findings demonstrate that timely birth dose vaccination is a feasible, cost-effective, and scalable strategy to reduce early-life hepatitis B transmission.
H Qureshi, H Mahmood, SK Pasha, SE Alam, Z Dharejo
This study assessed the burden of hepatitis B, C, D, and HIV in Sindh province, Pakistan, through a large, population-based seroprevalence survey. Using a stratified two-stage sampling design, over 6,600 individuals across 29 districts were tested, revealing notable prevalence of HCV (6.1%) and HDV (32.8%), with changes observed compared to prior surveys. Findings underscore the need for integrated, large-scale testing and treatment strategies to control hepatitis and HIV and inform public health policy in Pakistan.
H Mahmood, H Qureshi, R Tirmizi, S Farooq
This follow-up study evaluated hepatitis C reinfection rates and linkage to care among transgender individuals and men who have sex with men in Pakistan, populations with limited longitudinal data. Re-engaging 123 participants from a prior cohort, the study used a community-based “one-stop shop” model for screening, confirmatory testing, and treatment, identifying 13.8% anti-HCV positivity with all cases initiating and completing treatment. Findings highlight the effectiveness of integrated, community-led approaches in sustaining linkage to care and addressing reinfection among key populations.
H Mahmood, H Qureshi, R Tirmizi, S Farooq
This study addresses the high burden of hepatitis C in Pakistan by evaluating a micro-elimination pilot program in Khairpur district focused on community-based screening, diagnosis, and referral for hepatitis B and C. Using outreach by community health workers and an EMR-supported care cascade, over 31,000 individuals were screened, with high rates of confirmatory testing and treatment initiation and completion among those diagnosed. Findings demonstrate the feasibility of integrated, data-driven approaches to hepatitis elimination in resource-limited settings and provide a model for scale-up at the provincial and national levels.
H Qureshi, H Mahmood, N Ahmed, Z Dharejo, A Qudus, S Kumar, U Shams, F Zaman, S Farooq, S Shah, SE Alam
This study evaluated the performance of the Elecsys HCV Duo Assay for hepatitis C screening in Pakistan, where high disease burden and gaps in efficient testing persist. Using over 3,600 samples from both key populations and the general population, results showed high sensitivity (96%) for anti-HCV detection, while HCV core antigen demonstrated lower sensitivity but high specificity compared to RNA testing. Findings suggest the Duo assay is a useful screening tool within a diagnostic workflow, though confirmatory PCR remains important for accurate case identification.
G Greene, S Whiteside, L Nyagah, L Momanyi, R Moturi, A Mayi, J Wagude, J Nyaliech, S Sikawata, M Inimah, C Mwangi
Using facility surveys and retrospective data from nine sites, findings showed improved CD4 testing coverage among new clients and strong uptake of recommended treatment for cryptococcal meningitis, though gaps remained in patients returning to care, commodity availability, and linkage systems. These results highlight key implementation challenges and provide actionable insights to inform national scale-up of AHD services.
G Greene, T Do, Sarah Whiteside, N Ahmed, M Munir, R Mansouri
This initiative addresses critical gaps in inpatient care for advanced HIV disease, particularly cryptococcal meningitis, across Kenya, Uganda, South Africa, and Eswatini. Through a public-private partnership, Centers of Excellence were established to strengthen clinical capacity, improve monitoring systems, and expand access to diagnostics, treatment, and essential commodities. Early findings highlight persistent challenges in provider training and supply availability, while demonstrating that coordinated, system-level investments can improve inpatient care and support sustainable scale-up of AHD services.
