Epidemiology of hepatitis B virus and/or hepatitis C virus infections among people living with human immunodeficiency virus in Africa: A systematic review and meta-analysis

Abstract

Introduction Due to their common routes of transmission, human immunodeficiency virus (HIV) coinfection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) has become a major public health problem worldwide, particularly in Africa, where these viruses are endemic. Few systematic reviews report the epidemiological data of HBV and/or HCV coinfection with HIV in Africa, and none provided data on the case fatality rate (CFR) associated with this coinfection. This study was conducted to investigate the prevalence and case fatality rate of HBV and/or HCV infections among people living with human immunodeficiency virus (PLHIV) in Africa. Methods We conducted a systematic review of published articles in PubMed, Web of Science, African Journal Online, and African Index Medicus up to January 2022. Manual searches of references from retrieved articles and grey literature were also performed. The meta-analysis was performed using a random-effects model. Sources of heterogeneity were investigated using subgroup analysis, while funnel plots and Egger tests were performed to assess publication bias. Results Of the 4388 articles retrieved from the databases, 314 studies met all the inclusion criteria. The overall HBV case fatality rate estimate was 4.4% (95% CI; 0.7–10.3). The overall seroprevalences of HBV infection, HCV infection, and HBV/HCV coinfection in PLHIV were 10.5% [95% CI = 9.6–11.3], 5.4% [95% CI = 4.6–6.2], and 0.7% [95% CI = 0.3–1.0], respectively. The pooled seroprevalences of current HBsAg, current HBeAg, and acute HBV infection among PLHIV were 10.7% [95% CI = 9.8–11.6], 7.0% [95% CI = 4.7–9.7], and 3.6% [95% CI = 0.0–11.0], respectively. Based on HBV-DNA and HCV-RNA detection, the seroprevalences of HBV and HCV infection in PLHIV were 17.1% [95% CI = 11.5–23.7] and 2.5% [95% CI = 0.9–4.6], respectively. Subgroup analysis showed substantial heterogeneity. Conclusions In Africa, the prevalence of hepatotropic viruses, particularly HBV and HCV, is high in PLHIV, which increases the case fatality rate. African public health programs should emphasize the need to apply and comply with WHO guidelines on viral hepatitis screening and treatment in HIV-coinfected patients. Review registration PROSPERO, CRD42021237795.

A Systematic Review and Meta-Analysis of the Prevalence of Triplex Infections (Combined Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus) among Pregnant Women in Nigeria

“…However, the prevalence in the nonobstetric population was lower than in earlier systematic reviews and metaanalyses reported in Africa [30], Iran [31], China [32], and internationally [33,34]. For instance, Kenfack-Momo et al reported a pooled prevalence of 0.7% (95% CI � 0.3-1.0) for triplex infections among HIV-infected population in Africa in a systematic study in nonobstetric population [30]. In China, Yu et al observed a pooled triplex infection prevalence of 3.5% (95% CI 2.4-4.8%) in the nonobstetrics population, with variations detected in terms of age and geographic region [31].…”

“…However, the prevalence in the nonobstetric population was lower than in earlier systematic reviews and metaanalyses reported in Africa [30], Iran [31], China [32], and internationally [33,34]. For instance, Kenfack-Momo et al reported a pooled prevalence of 0.7% (95% CI � 0.3-1.0) for triplex infections among HIV-infected population in Africa in a systematic study in nonobstetric population [30].…”

HCV, HIV AND HBV rapid test diagnosis in non-clinical outreach settings can be as accurate as conventional laboratory tests

“…Performance, cost, and accessibility need to be considered. Other meta-analyses have shown that many people living with HIV (PLHIV) are HBV and/or HCV co-infected, and that the triple infection of HCV, HIV and HBV causes more clinically unfavourable consequences than mono- or dual infections 27 , 28 . Furthermore, these studies have shown that people who inject drugs (PWID) are severely and disproportionately affected by HCV, HIV and HBV, and that the prevalence of HIV/HCV coinfection is highest among PWID as compared with other high-risk groups and the general population 27 , 29 .…”

Metabolomics Approaches for the Diagnosis, Treatment, and Better Disease Management of Viral Infections

“…Among these, hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), and sometimes hepatitis E virus (HEV) infections may result in chronic disease. Several of the early metabolomics studies focused on chronic infections of HBV, HCV, human immunodeficiency virus (HIV), and human cytomegalovirus (HCMV) infections were performed using important methodologies that are summarized in this review [ 64 , 65 , 66 , 67 ].…”