PLoS ONE (Jan 2022)

Epidemiology of hepatitis B virus and/or hepatitis C virus infections among people living with human immunodeficiency virus in Africa: A systematic review and meta-analysis

  • Raoul Kenfack-Momo,
  • Sebastien Kenmoe,
  • Guy Roussel Takuissu,
  • Jean Thierry Ebogo-Belobo,
  • Cyprien Kengne-Ndé,
  • Donatien Serge Mbaga,
  • Serges Tchatchouang,
  • Martin Gael Oyono,
  • Josiane Kenfack-Zanguim,
  • Robertine Lontuo Fogang,
  • Chris Andre Mbongue Mikangue,
  • Elisabeth Zeuko’o Menkem,
  • Juliette Laure Ndzie Ondigui,
  • Ginette Irma Kame-Ngasse,
  • Jeannette Nina Magoudjou-Pekam,
  • Jean Bosco Taya-Fokou,
  • Arnol Bowo-Ngandji,
  • Seraphine Nkie Esemu,
  • Diane Kamdem Thiomo,
  • Paul Moundipa Fewou,
  • Lucy Ndip,
  • Richard Njouom

Journal volume & issue
Vol. 17, no. 5

Abstract

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Introduction Due to their common routes of transmission, human immunodeficiency virus (HIV) coinfection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) has become a major public health problem worldwide, particularly in Africa, where these viruses are endemic. Few systematic reviews report the epidemiological data of HBV and/or HCV coinfection with HIV in Africa, and none provided data on the case fatality rate (CFR) associated with this coinfection. This study was conducted to investigate the prevalence and case fatality rate of HBV and/or HCV infections among people living with human immunodeficiency virus (PLHIV) in Africa. Methods We conducted a systematic review of published articles in PubMed, Web of Science, African Journal Online, and African Index Medicus up to January 2022. Manual searches of references from retrieved articles and grey literature were also performed. The meta-analysis was performed using a random-effects model. Sources of heterogeneity were investigated using subgroup analysis, while funnel plots and Egger tests were performed to assess publication bias. Results Of the 4388 articles retrieved from the databases, 314 studies met all the inclusion criteria. The overall HBV case fatality rate estimate was 4.4% (95% CI; 0.7–10.3). The overall seroprevalences of HBV infection, HCV infection, and HBV/HCV coinfection in PLHIV were 10.5% [95% CI = 9.6–11.3], 5.4% [95% CI = 4.6–6.2], and 0.7% [95% CI = 0.3–1.0], respectively. The pooled seroprevalences of current HBsAg, current HBeAg, and acute HBV infection among PLHIV were 10.7% [95% CI = 9.8–11.6], 7.0% [95% CI = 4.7–9.7], and 3.6% [95% CI = 0.0–11.0], respectively. Based on HBV-DNA and HCV-RNA detection, the seroprevalences of HBV and HCV infection in PLHIV were 17.1% [95% CI = 11.5–23.7] and 2.5% [95% CI = 0.9–4.6], respectively. Subgroup analysis showed substantial heterogeneity. Conclusions In Africa, the prevalence of hepatotropic viruses, particularly HBV and HCV, is high in PLHIV, which increases the case fatality rate. African public health programs should emphasize the need to apply and comply with WHO guidelines on viral hepatitis screening and treatment in HIV-coinfected patients. Review registration PROSPERO, CRD42021237795.