Prevalence of and risk factors for Plasmodium spp. co-infection with hepatitis B virus: a systematic review and meta-analysis

Abstract

Background Plasmodium spp. and hepatitis B virus (HBV) are among the most common infectious diseases in underdeveloped countries. This study aimed to determine the prevalence of Plasmodium spp. and HBV co-infection in people living in endemic areas of both diseases and to assess the risk factors related to this co-infection. Methods The PubMed, Web of Science, and Scopus databases were searched. Observational cross-sectional studies and retrospective studies assessing the prevalence of Plasmodium species and HBV co-infection were examined. The methodological quality of the included studies was assessed with the Newcastle-Ottawa Scale (NOS), a tool for assessing the quality of nonrandomized studies in meta-analyses, and heterogeneity among the included studies was assessed with Cochran's Q test and the I2 (inconsistency) statistic. The pooled prevalence of the co-infection and its 95% confidence interval (CI) were estimated using the random-effects model, depending on the amount of heterogeneity there was among the included studies. The pooled odds ratio (OR) represented the difference in qualitative variables, whereas the pooled mean difference (MD) represented the difference in quantitative variables. Meta-analyses of the potential risk factors for Plasmodium spp. and HBV co-infection, including patient age and gender, were identified and represented as pooled odds ratios (OR) and 95% CIs. Publication bias among the included studies was assessed by visual inspection of a funnel plot to search for asymmetry. Results Twenty-two studies were included in the present systematic review and meta-analysis. Overall, the pooled prevalence estimate of Plasmodium spp. and HBV co-infection was 6% (95% CI 4–7%, Cochran's Q statistic < 0.001, I2: 95.8%), with prevalences of 10% in Gambia (95% CI: 8–12%, weight: 4.95%), 8% in Italy (95% CI 5–12%, weight: 3.8%), 7% in Nigeria (95% CI 4–10%, weight: 53.5%), and 4% in Brazil (95% CI 2–5%, weight: 19.9%). The pooled prevalence estimate of Plasmodium spp. and HBV co-infection was higher in studies published before 2015 (7%, 95% CI 4–9%, Cochran's Q statistic < 0.001, I2: 96%) than in those published since 2015 (3%, 95% CI 1–5%, Cochran's Q statistic < 0.001, I2: 81.3%). No difference in age and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and the Plasmodium monoinfection group (p: 0.48, OR: 1.33, 95% CI 0.60–2.96). No difference in gender and risk of Plasmodium spp. and HBV co-infection group was found between the Plasmodium spp. and HBV co-infection and HBV co-infection group and the Plasmodium monoinfection group (p: 0.09, OR: 2.79, 95% CI 0.86–9.10). No differences in mean aspartate aminotransferase (AST), mean alanine aminotransferase (ALT), or mean total bilirubin levels were found (p > 0.05) between the Plasmodium spp. and HBV co-infection group and the Plasmodium monoinfection group. Conclusions The present study revealed the prevalence of Plasmodium spp. and HBV co-infection, which will help in understanding co-infection and designing treatment strategies. Future studies assessing the interaction between Plasmodium spp. and HBV are recommended.

Hepatitis B and Asymptomatic Malaria Infection among Pregnant Women in a Semiurban Community of North-Central Nigeria

“…The P. falciparum /HBV coinfection rate of 0.5% in the current study is lower than the prevalence rates of 4.3%, 6%, and 0.7% earlier reported in parts of Nigeria [ 12 ], Gambia [ 8 ], and Ghana [ 20 ], respectively. None of the subjects with a history of vaccination show any evidence of HBV infection, suggesting that immunity provided through HBV vaccination in the studied population could have contributed to the low HBV monoinfection rate and by implication lower comorbid state.…”

“…Malaria and HBV coinfection may pose a serious public health problem among pregnant women in developing countries where both infectious diseases are endemic [ 8 ]. Despite having different transmission routes, the overlapping endemicity or geographical coincidence of both infections predispose people who reside in the endemic territory to coinfection [ 8 ].…”

“…Malaria and HBV coinfection may pose a serious public health problem among pregnant women in developing countries where both infectious diseases are endemic [ 8 ]. Despite having different transmission routes, the overlapping endemicity or geographical coincidence of both infections predispose people who reside in the endemic territory to coinfection [ 8 ]. A study by Scotto and Fazio [ 9 ] posited that since HBV is highly contagious from one infected individual to another, especially in the tropics, chances of viral transmission through the same route of transmission of Plasmodium vis-à-vis blood-to-blood contact, sharing needles, and blood transfusions are high.…”

Prevalence of malaria and scrub typhus co-infection in febrile patients: a systematic review and meta-analysis

“…The pooled prevalence of malaria and scrub typhus co-infection among febrile patients was estimated using the DerSimonian–Laird method for the random-effects model, based on the inverse variance approach for measuring weight as described previously [ 22 , 23 ]. The number of co-infected patients and participants tested for both pathogens was used in the meta-analysis.…”

Excreted Trypanosoma brucei proteins inhibit Plasmodium hepatic infection

“…There are several reports of co-infections between Plasmodium and bacteria [ 19 , 20 ], viruses [ 21 , 22 ] and even other parasites [ 23 – 25 ]. Given that human infections by Plasmodium and T .…”