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Study On Sero Prevalance Of Hepatitis C For Predisposition Of Diabetes In Pregnant Women From Low Economic Status Famlies

By: Waseela ashraf (2015-VA-445) | Dr.Muhammad Hassan mushtaq.
Contributor(s): Mr.Ubaid ur rehman zia | Mr.Muhammad asad ali.
Material type: materialTypeLabelBookPublisher: 2017Description: 72p.Subject(s): Epidemiology and Public HealthDDC classification: 2865-T Dissertation note: This cross sectional study is design to rule out the effect of seroprevalence of HCV infection in causing diabetes in pregnant women and also in aim of identifying potential risk factors associated with HCV infection cause in pregnant women. A total of 550 pregnant women were participated in this study.We made two groups of pregnant women to rule out the association between seroprevalence of HCV and diabetes. One group consisted of 275 women who were anti- HCV negative and second group consisted of 275 women who were anti-HCV positive. A blood sample was drawnin a gel vial for testing of anti HCV and a fluoride oxalate vial was used to draw blood for random plasma glucose levels testing among pregnant women. ELISA was performed to confirm the seroprevalence of HCV infection and diabetes status was confirmed by testing blood glucose levels in pregnant women by hexokinase method. Data was gathered and analyzed on SPSS version 20.0 software. A Chi square test was used to know the relationship between diabetes and anti HCV. This test was also used to find outlink between anti HCV and other variables collected. Most of the women in both groups did not know about their diabetic status. HCV positive group was presented with strong family history of diabetes. From the data it was suggested that possible risk factors for causing HCV infection among pregnant women were surgical procedure, blood transfusion and history of syringe use. Ear/nose piercing, history of dental, dilatation and curettage procedure and accidents were statistically not significantly associated in causing HCV infection. It was also found that number of abortions were high in HCV infected group (p-value=0.046). No association was found between seroprevalence of HCV infection and diabetes among pregnant women (p value= 0.96). Therefore our hypothesis is rejected on the basis of this study results. The most frequent age group was 18-27years of women found for pregnancy. Therefore in this age group our study results found that HCV infection prevalence was high. This group was found to be very prone in catching viral infection. S/CO ratios were also found to be too high in this age group due to the fact thatin this age groupHCV infection prevalence was high. Also there is a strong association of blood pressure and HCV infection. Blood pressure found to be varying in HCV infected group. Recommendations for further Research According to several studies there was a strong true association between hepatitis C virus infection and diabetes. But our study results were not correlated. It may be due to the lack of confirmatory tests for both diseases which we did not perform.Following recommendations are offered for related research. 1. ELISA is commonly used as initial screening method for HCV antibody in serum. This method does not differentiate between acute, active or resolved infection. In this study we usedELISA for presence of antibody in serum but presence of antibody in serum is not a confirmation of active viremia in patient. The active viremia further can only be confirmed by PCR. It also tells us the true presence of virus in infected patient.So PCR is the confirmatory test of hepatitis C virus infection and it should be used for diagnosis and true presence of virus in body. 2. Random plasma glucose is a screening method for predicting gestational diabetes. Further confirmatory tests are required for diagnosis of gestational diabetes. Confirmatory test for diagnosis of gestational diabetes is oral glucose tolerance test (OGTT). 3. Age and body mass index are confounders in relating the association of diabetes and hepatitis C infection. High BMI and older age are risk factor in causing diabetes.
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This cross sectional study is design to rule out the effect of seroprevalence of HCV infection in causing diabetes in pregnant women and also in aim of identifying potential risk factors associated with HCV infection cause in pregnant women. A total of 550 pregnant women were participated in this study.We made two groups of pregnant women to rule out the association between seroprevalence of HCV and diabetes. One group consisted of 275 women who were anti- HCV negative and second group consisted of 275 women who were anti-HCV positive.
A blood sample was drawnin a gel vial for testing of anti HCV and a fluoride oxalate vial was used to draw blood for random plasma glucose levels testing among pregnant women.
ELISA was performed to confirm the seroprevalence of HCV infection and diabetes status was confirmed by testing blood glucose levels in pregnant women by hexokinase method. Data was gathered and analyzed on SPSS version 20.0 software. A Chi square test was used to know the relationship between diabetes and anti HCV. This test was also used to find outlink between anti HCV and other variables collected.
Most of the women in both groups did not know about their diabetic status. HCV positive group was presented with strong family history of diabetes. From the data it was suggested that possible risk factors for causing HCV infection among pregnant women were surgical procedure, blood transfusion and history of syringe use. Ear/nose piercing, history of dental, dilatation and curettage procedure and accidents were statistically not significantly associated in causing HCV infection. It was also found that number of abortions were high in HCV infected group (p-value=0.046).

No association was found between seroprevalence of HCV infection and diabetes among pregnant women (p value= 0.96). Therefore our hypothesis is rejected on the basis of this study results.
The most frequent age group was 18-27years of women found for pregnancy. Therefore in this age group our study results found that HCV infection prevalence was high. This group was found to be very prone in catching viral infection. S/CO ratios were also found to be too high in this age group due to the fact thatin this age groupHCV infection prevalence was high.
Also there is a strong association of blood pressure and HCV infection. Blood pressure found to be varying in HCV infected group.














Recommendations for further Research
According to several studies there was a strong true association between hepatitis C virus infection and diabetes. But our study results were not correlated. It may be due to the lack of confirmatory tests for both diseases which we did not perform.Following recommendations are offered for related research.
1. ELISA is commonly used as initial screening method for HCV antibody in serum. This method does not differentiate between acute, active or resolved infection. In this study we usedELISA for presence of antibody in serum but presence of antibody in serum is not a confirmation of active viremia in patient. The active viremia further can only be confirmed by PCR. It also tells us the true presence of virus in infected patient.So PCR is the confirmatory test of hepatitis C virus infection and it should be used for diagnosis and true presence of virus in body.
2. Random plasma glucose is a screening method for predicting gestational diabetes. Further confirmatory tests are required for diagnosis of gestational diabetes. Confirmatory test for diagnosis of gestational diabetes is oral glucose tolerance test (OGTT).
3. Age and body mass index are confounders in relating the association of diabetes and hepatitis C infection. High BMI and older age are risk factor in causing diabetes.

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