Prevalence of infection with hepatitis B and C virus and coinfection with HIV in medical inpatients in Malawi

Nyirenda, Mulinda; Beadsworth, Mike; Stephany, P.; Hart, C. A.; Hart, Ian; Munthali, C.; Beeching, Nicholas J.; Zijlstra, Eduard E.

doi:10.1016/j.jinf.2008.05.004

Cited by 107 publications

(107 citation statements)

References 30 publications

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“…published as a full-text paper in a peer-reviewed journal. 47 Sera from another study were collected and tested in Malawi 44 and had shown conflicting results. The same sera were retested in UK and results published as a full-text paper in a peer-reviewed journal.…”

Section: Literature Searchmentioning

confidence: 99%

“…47 Consequent to this we excluded 2 studies from further analysis. 44,47 Of the 27 studies, 24 were published as fulllength manuscripts in peer-reviewed journals, two studies were published as official reports of WHO & ICBS 11,12 and two studies were reported as conference abstracts. 29,33 There was unanimity between the authors about the selection of relevant articles.…”

Section: Literature Searchmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of Rapid Point-of-Care Diagnostic Tests for Hepatitis B Surface Antigen—A Systematic Review and Meta-analysis

Khuroo

Khuroo²,

Khuroo³

2014

Journal of Clinical and Experimental Hepatology

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Background: Rapid point-of-care tests provide plausible diagnostic strategy for hepatitis B surface antigen (HBsAg) in low resource areas. However, their utility depends upon their overall performance. Our objective was to meta-analyze the diagnostic accuracy of rapid point-of-care tests for HBsAg. Methods: Literature search was done with the help of a metasearch engine Mett a, a query interface for retrieving articles from five leading medical databases. Studies that employed rapid point-of-care tests for detection of HBsAg and compared the results with reference test were included. Two reviewers performed quality assessment of the studies and extracted data for estimating test accuracy. Twenty-seven studies were meta-analyzed and stratified by multiple parameters. Results: Twenty-seven studies had evaluated 49 test brands and generated 76 data points. Sensitivity of individual tests varied widely and were heterogeneous (range 43.5%-99.8%); while specificity estimates were more robust and close to 100% (range 90%-100%). Overall pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratio for all tests were 97.1% (95% CI, 96.1%-97.9%), 99.9% (CI, 99.8%-100%), 118.4 (CI, 84.7-165.5), 0.032 (CI, 0.023-0.045) and 4094.7 (CI, 2504.1-6600.8) respectively. This suggested high pooled accuracy for all studies. We found substantial heterogeneity between studies. Three factors (study location, reference standard and study score) appeared most strongly associated with test estimates and observed heterogeneity. The Determine test showed consistency in performance in studies done across developed and developing countries and the Determine and the BinaxNOW tests had significantly higher estimates than pooled estimates of remaining tests. Tests revealed analytical sensitivity of 4 IU/ml against manufacturer's claim of 0.5 IU/ml; reduced sensitivity with HBsAg mutants and poor performance in seroconversion panels. Conclusions: Tests with better analytical sensitivity need to be developed and their feasibility and outcomes in various clinical settings need to be addressed. ( J CLIN EXP HEPATOL 2014;4:226-240)

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Section: Literature Searchmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Accuracy of Rapid Point-of-Care Diagnostic Tests for Hepatitis B Surface Antigen—A Systematic Review and Meta-analysis

Khuroo

Khuroo²,

Khuroo³

2014

Journal of Clinical and Experimental Hepatology

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show abstract

“…In many parts of Africa, HIV/HBV coinfection is common, as seen in South Africa (5%) or Malawi (20%) [74,75]. Recent immigrants from Africa represent the largest group of newly diagnosed HIV-positive people in the UK [76] and therefore high coinfection rates are to be expected.…”

Section: Prevalencementioning

confidence: 99%

“…Since the introduction of combination ART and the dramatic improvement in the prognosis of people with HIV, liver disease attributable to chronic viral hepatitis has become an important cause of morbidity and mortality in coinfected patients as a result of cirrhosis and liver cancer [72,75,93].…”

Section: The Influence Of Hiv On Hbv Infectionmentioning

confidence: 99%

British HIV Association guidelines for the management of coinfection with HIV‐1 and hepatitis B or C virus 2010

et al. 2009

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“…In countries with intermediate and high HBV endemicity, the main routes of transmission of HBV are perinatal or in early childhood. In these countries, HIV/HBV co-infection rates are 10-20% [31].…”

Section: Hiv/hbv Co-infectionmentioning

confidence: 99%

HIV Co-Infection with Hepatotropic Viruses and Mycobacterial Tuberculosis

BU¹

2013

J AIDS Clin Res

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Prevalence of infection with hepatitis B and C virus and coinfection with HIV in medical inpatients in Malawi

Cited by 107 publications

References 30 publications

Accuracy of Rapid Point-of-Care Diagnostic Tests for Hepatitis B Surface Antigen—A Systematic Review and Meta-analysis

Accuracy of Rapid Point-of-Care Diagnostic Tests for Hepatitis B Surface Antigen—A Systematic Review and Meta-analysis

British HIV Association guidelines for the management of coinfection with HIV‐1 and hepatitis B or C virus 2010

HIV Co-Infection with Hepatotropic Viruses and Mycobacterial Tuberculosis

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