Seroprevalence of HIV, HBV, and HCV & Behavioral Factors among Truckers in Lahore, Pakistan: Implications for Targeted Public Health Intervention

Abstract

Background: Factors such as occupational mobility, long work hours, and less access to health services can affect transport workers' exposure to blood-borne infections and access to prevention services. The evidence based on serological screening, molecular detection, and behavioral traits in this occupational group is still sparse in Pakistan.

Objective: To assess the prevalence of HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) markers and their associations with sociodemographic, occupational, behavioural and health service related factors among the transport workers of Lahore, Pakistan.

Methods: A cross sectional study was conducted among 220 truck drivers and assistants at transport terminals Lahore, these were selected by convenience sampling. A structured questionnaire was used to obtain sociodemographic data and possible exposures history. HIV, hepatitis B surface antigen (HBs Ag), and anti-hepatitis C (anti-HCV) were tested in blood specimens, with polymerase chain reaction (PCR) performed on those that were screening-reactive. 95% Wilson confidence intervals were calculated for prevalence estimates. Associations with detectable viral nucleic acid were examined using crude odds ratios, Fisher's exact tests and Pearson chi-square tests.

Results: HIV RNA was found in nine (4.1%), HBV DNA in six (2.7%) and HCV RNA in 17 (7.7%) participants. Anti-HCV antibodies were detected in 23 participants (10.5%), including six without detectable HCV RNA. A total of 23 participants (10.5%) had at least one viral PCR positive, with 7 (3.2%) participants with multiple viral PCR positives. Factors associated with composite PCR detection included recent STI-related symptoms (OR: 7.25; p < 0.001), and being absent from work for more than 4 months (OR: 5.36; p < 0.001), and IDU (OR: 6.36; p < 0.001).

Conclusion: Transport workers were found to have detectable markers of HIV, HBV and HCV infection, overlapping viral detection occurred and a number of factors were associated with the detection of these viruses. The findings support targeted evaluation of confidential screening, HBV vaccination, infection-prevention education, and linkage-to-care services.