Roos E Barth1, Quirine Huijgen, Jantjie Taljaard, Andy I M Hoepelman. 1. Department of Internal Medicine and Infectious Diseases, University Medical Centre Utrecht, F02.126, Postbus 85500, 3508 GA Utrecht, the Netherlands. r.e.barth@umcutrecht.nl
Abstract
OBJECTIVES: Hepatitis B virus (HBV), hepatitis C virus (HCV), and the human immunodeficiency virus (HIV) are endemic in Africa. However, hepatitis co-infection rates among HIV-infected individuals remain controversial. The aim of this review was to determine the prevalence of HBV and HCV in HIV-infected patients in sub-Saharan Africa and to analyze whether HIV is associated with a higher HBV/HCV prevalence in that region. DESIGN AND METHODS: We performed a systematic review and meta-analysis. Studies reporting HBV and HCV prevalence data amongst HIV-infected patients in sub-Saharan Africa were included. Weighted means and medians across studies were calculated. Studies including an HIV-negative control group were used for meta-analysis. Risk ratios (RRs) were calculated using a random effects model. RESULTS: Sixty studies were included. Among HIV-infected individuals, mean HBsAg and anti-HCV prevalence rates were 15% and 7%, respectively. RRs for a positive HBsAg and a positive anti-HCV were 1.40 (95% confidence interval (CI) 1.16-1.69) and 1.60 (95% CI 1.05-2.45) for HIV-infected, as compared to HIV-uninfected, patients. CONCLUSIONS: Many HIV-positive individuals in sub-Saharan Africa are HBV or HCV co-infected. HIV is associated with a higher prevalence of both HBV and HCV in this region. However, this association is less evident than that observed in Western countries and varies between studies.
OBJECTIVES:Hepatitis B virus (HBV), hepatitis C virus (HCV), and the human immunodeficiency virus (HIV) are endemic in Africa. However, hepatitis co-infection rates among HIV-infected individuals remain controversial. The aim of this review was to determine the prevalence of HBV and HCV in HIV-infectedpatients in sub-Saharan Africa and to analyze whether HIV is associated with a higher HBV/HCV prevalence in that region. DESIGN AND METHODS: We performed a systematic review and meta-analysis. Studies reporting HBV and HCV prevalence data amongst HIV-infectedpatients in sub-Saharan Africa were included. Weighted means and medians across studies were calculated. Studies including an HIV-negative control group were used for meta-analysis. Risk ratios (RRs) were calculated using a random effects model. RESULTS: Sixty studies were included. Among HIV-infected individuals, mean HBsAg and anti-HCV prevalence rates were 15% and 7%, respectively. RRs for a positive HBsAg and a positive anti-HCV were 1.40 (95% confidence interval (CI) 1.16-1.69) and 1.60 (95% CI 1.05-2.45) for HIV-infected, as compared to HIV-uninfected, patients. CONCLUSIONS: Many HIV-positive individuals in sub-Saharan Africa are HBV or HCV co-infected. HIV is associated with a higher prevalence of both HBV and HCV in this region. However, this association is less evident than that observed in Western countries and varies between studies.
Authors: Carmen Pittman; Sabrina Plitt; Ted Birse; Karen Doucette; Barbara Romanowski; Rya Cooper; Stan Houston; Stephen Shafran; Ameeta E Singh Journal: Can J Infect Dis Med Microbiol Date: 2014 Impact factor: 2.471
Authors: Charles S Chasela; Athena P Kourtis; Patrick Wall; Jan Drobeniuc; Caroline C King; Hong Thai; Eyasu H Teshale; Mina Hosseinipour; Sascha Ellington; Mary B Codd; Denise J Jamieson; Rod Knight; Patricia Fitzpatrick; Saleem Kamili; Irving Hoffman; Dumbani Kayira; Noel Mumba; Deborah D Kamwendo; Francis Martinson; William Powderly; Chong-Gee Teo; Charles van der Horst Journal: J Hepatol Date: 2013-11-06 Impact factor: 25.083