Global, regional, and national prevalence of hepatitis B infection in the general and key populations living with HIV: a systematic review and meta-analysis protocol

Abstract

Abstract Background Hepatitis B causes death mainly due to liver disease worldwide. Human immunodeficiency virus increases the pathological effect of hepatitis viruses and potentiates re-activation of latent hepatitis infections as a result of reduced immunity. Because of the same modes of transmission shared by the two infections, HBV represents an important cause of co-morbidity and mortality among people living with HIV; hence, the aim of this review is to determine the prevalence of HBV among people living with HIV. Methods This systematic review and meta-analysis will include cross-sectional, case-control, and cohort studies of patients positive for HBV and HIV irrespective of their countries. All pertinent articles published on hepatitis B in people living with HIV from January 1, 1990, to July 31, 2017, without any language restriction will be searched in PubMed/MEDLINE, Global Index Medicus Web of Science, and Excerpta Medica Database. Two review authors will independently assess the relevance of all titles and abstracts identified from the electronic searches. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate of the prevalence of HBV across studies. We will assess statistical heterogeneity and pool clinically homogeneous studies. On the other hand, we will evaluate statistical heterogeneity by the chi-squared test on Cochrane’s Q statistic. Symmetry of funnel plots and Egger’s test will be used to detect the presence of publication and selective reporting bias. In the case of publication bias, we will report estimates after adjustment on publication bias using the trim-and-fill method. We will assess inter-rater agreement between investigators for study inclusion, data extraction, and methodological quality assessment using Kappa Cohen’s coefficient. This protocol will comply with the guidelines for meta-analyses and systematic reviews of Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Discussion To our knowledge, this is the first systematic review and meta-analysis protocol to report the prevalence of HBV in people living with HIV. We believe its outcomes will be of utility in providing insights on the characteristics of HBV epidemic in people living with HIV, and draw more attention of public health services to this association. Systematic review registration PROSPERO CRD42017073124

Keywords

• Hepatitis B
• HIV
• AIDS
• Key population