Prevalence of hepatitis C virus infection among key populations in China: A systematic review

Abstract

Background and aim: Chronic hepatitis C is a major global health challenge. China has the world’s largest burden of hepatitis C and related liver disease, with several groups having an increased risk of acquiring hepatitis C virus (HCV) infection. We undertook a systematic review in Chinese and English literature to determine the seroprevalence of anti-HCV among men who have sex with men (MSM), sex workers, people who use drugs (PWUD) and migrant workers in China. Methods: We searched three Chinese databases (CNKI, Wanfang and Chongqing VIP Information) and four English databases (Pubmed, EMBASE, Global Health and CINAHL) for studies published between 2010 and 2015. Included were 89 studies for MSM, 112 for sex workers, 11 for migrant workers, 94 for people who inject drugs (PWID) and 67 for non-injectors. Random-effect models pooled estimates of anti-HCV seroprevalence in each population and a meta-regression model examined the relationship between anti-HCV seroprevalence and injecting drug use. Results: The overall pooled seroprevalence of anti-HCV among MSM was 0.67% (CI 95 0.51–0.86); for sex workers 0.65% (CI 95 0.53–0.77); for migrant workers 0.48 (CI 95 0.20–0.85); for IDUs 72.41% (CI 95 68.71–75.97); among non-injectors 25.07% (CI 95 21.51%–28.80%). Our meta-regression model predicted that the seroprevalence of anti-HCV among PWID increased by 8.6% for each 10% increase seroprevalence of reporting ever having injected drugs. Conclusions: Overall, seroprevalence of HCV infection is high among PWUD, especially those who inject. Lower HCV seroprevalence (<1%) was found among MSM, sex workers and migrant workers. Our estimates for IDU seroprevalence are higher than that from the national surveillance system, though estimates for other at-risk populations are similar. Keywords: Hepatitis, China, People who inject drugs, Hepatitis C virus, Men who have sex with men, Sex workers, Seroprevalence