The documents discuss HIV/AIDS issues in Pakistan. The first describes an HIV/AIDS prevention and control program in Sindh province that has made progress but still has gaps. It recommends strategies for implementation at provincial and national levels. The second discusses a study that found high needlestick injury rates and HBV/HCV infection prevalence among operating room personnel, indicating a need for improved vaccination and safety measures. The third reports HBV and HCV infection in many hepatocellular carcinoma cases in Pakistan, suggesting viral causes. It recommends screening and prevention strategies. The last outlines urbanization, migration, exploitation, and drug use as factors enabling HIV's spread in Pakistan.

70. Volume 113, Issue 1, Pages 39-43 (January 1999)
Sub-national response in HIV/AIDS: a case study in AIDS prevention and control from
Sindh province, Pakistan
AA Hydera, OA Khan Mrb , SA Shahc, MA Memond, MR Khananid, S Alie
Accepted 28 July 1998.
Abstract
HIV/AIDS in Pakistan is slowly gaining recognition as a public health issue of great importance.
However, the responses to the disease have been marred by lack of coordination and
commitment. We examine, in this paper, the situation in the Sindh province of Pakistan, which is
recognized as having the sole fully functioning AIDS prevention and control programme in the
country. In discussing the results of the Sindh programme's activities we highlight progress made
as well as gaps in data and surveillance. We also recommend strategies for implementation at the
provincial and national levels. In addition this example of a sub-national government programme
provides a case study for similar programmes in the region.
Keywords: HIV, AIDS, Pakistan, South Asia, policy

71. Volume 38, Issue 2, Pages 133-137 (February 1998)
Frequency of parenteral exposure and seroprevalence of HBV, HCV, and HIV among
operation room personnel
S.A. Mujeeb, Y. Khatri, R. Khanani
Received 12 March 1997; accepted 21 May 1997.
Abstract
A study was designed to determine the frequency of needle-stick injuries, immunization status
for hepatitis B virus (HBV) and seroprevalence of HBV, hepatitis C virus (HCV), and human
immunodeficiency virus (HIV) infections among operation room personnel. Self-assessment
questionnaires were completed and blood tested for HBsAg, anti-HBc (total), anti-HCV and anti-
HIV. Of 114 operation room personnel studied, the majority (58·8%) reported more than four
needle-stick injuries per year, 36·8% one to three needle-stick injuries per year, while 4·4%
reported no needle-stick injury in the last five years. Thirty-six percent of personnel had received
a complete course of hepatitis C vaccination. There was serological evidence of hepatitis HBV
virus and/or HCV infections in 31% of the studied population. Four percent were reactive for
HCV infection, 7·5% for HBsAg infection and 25·43% for anti-HBc (total); none was HIV
positive. Eighty percent of the HCV positive and 55% of the anti-HBc (total) positive personnel
had more than four needle-stick injuries per year in the last five years, while 75% HBsAg-
reactive personnel had received one to three needle-stick injuries per year. This study indicates a
need for continued efforts to minimize the risk of blood-borne infection by enhancing the
compliance of operation room personnel with HBV vaccination and adherence to infection
control measures.
Keywords: Parenteral exposure, seroprevalence, HIV, HBV, HCV, infections, operation room
personnel

72. Trop Doct. 1997 Jan;27(1):45-6.
Prevalence of hepatitis B surface antigen and HCV antibodies in hepatocellular carcinoma
cases in Karachi, Pakistan.
Abdul Mujeeb S, Jamal Q, Khanani R, Iqbal N, Kaher S.
Blood Transfusion Services, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
Abstract
Hepatocellular carcinoma (HCC) is a common cancer the world over. In Pakistan it has an
incidence of 8/ 100,000 per annum. To assess the prevalence of Hepatitis B virus (HBV) and
Hepatitis C virus (HCV) infections in biopsy proven cases of HCC a serological study was
conducted at Screening Laboratory of Blood Transfusion Services, Jinnah Postgraduate Medical
Centre. Of 54 sera of HCC tested for HBV and HCV infections, 67% showed HBV infection,
and 33% HCV infection. Among them 24% were positive for both HBV and HCV infections. No
HBV and HCV infection was found in 24% cases of HCC. Our findings suggest viral association
for most of the HCC cases reported in the country. We suggest an immediate intervention
strategy to prevent the spread of HBV and HCV infections by mandatory screening of blood for
HBV and HCV infections, and the use of disposable/sterilized needles, instruments for all
invasive procedures. For the prevention of vertical transmission of HBV infections all pregnant
women should be screened and vaccinated and HBV vaccination should also be included in EPI
(expanded programme for immunization).
PMID: 9030022 [PubMed - indexed for MEDLINE]

73. J Pak Med Assoc. 2006 Jan;56(1 Suppl 1):S12-5.
Understanding the HIV/AIDS context in Pakistan.
Ali S, Khanani R, Tariq WU, Shah SA.
Pakistan AIDS Prevention Society, Services Hospital, Government of Sindh, Karachi.
Republished from:
Venereology. 1995 Aug;8(3):160-3.
Abstract
The social context of sexual relations is important in understanding the AIDS epidemic. So far,
HIV in Pakistan has spread by heterosexual contact and blood transfusions. The magnitude of the
problem is difficult to assess but health authorities estimate between 10,000 to 12,000 HIV
infected people. This paper outlines that rapid urbanization, together with single migrant
workers, deported HIV infected expatriates, exploitation of women and easy availability of
narcotic drugs, especially in the metropolis of Karachi, are some important factors that may be
responsible for the spread of HIV in Pakistan (Venereology 1995;8 [3]:160-3).
PMID: 16689475 [PubMed]