Dataset Information

The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: a systematic review and meta-analysis.

ABSTRACT:

Background

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common among individuals with human immune deficiency virus (HIV) infection worldwide. In this study, we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV, HBV and HIV coinfections among HIV-positive prisoners.

Methods

We searched PubMed via MEDLINE, Embase, the Cochrane Library, SCOPUS, and Web of science (ISI) to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV. We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies. We used random-effect models and meta-regression for the meta-analysis of the results of the included studies.

Results

The number of the included studies were 50 for HCV-HIV, and 23 for HBV-HIV co-infections. The pooled prevalence rates of the coinfections were 12% [95% confidence interval (CI) 9.0-16.0] for HBV-HIV and 62% (95% CI 53.0-71.0) for HCV-HIV. Among HIV-positive prisoners who reported drug injection, the prevalence of HBV increased to 15% (95% CI 5.0-23.0), and the HCV prevalence increased to 78% (95% CI 51.0-100). The prevalence of HBV-HIV coinfection among prisoners ranged from 3% in the East Mediterranean region to 27% in the American region. Also, the prevalence of HCV-HIV coinfections among prisoners ranged from 6% in Europe to 98% in the East Mediterranean regions.

Conclusions

Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners, particularly among those with a history of drug injection, varies significantly across the globe. The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades, rising a call for better screening and treatment programs targeting this high-risk population. To prevent the above coinfections among prisoners, aimed public health services (e.g. harm reduction via access to clean needles), human rights, equity, and ethics are to be seriously delivered or practiced in prisons. Protocol registration number: CRD42018115707 (in the PROSPERO international).

SUBMITTER: Ahmadi Gharaei H

PROVIDER: S-EPMC8252262 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundHepatitis 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.MethodsThis 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).DiscussionTo 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 registrationPROSPERO CRD42017073124.

Project description:Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV.

Project description:BackgroundPrison populations tend to be marginalized and disadvantaged of the rights and freedoms that other people in the community benefit from. Their separation from families, a narrow room and lack of privacy in the prison, violence between prisoners, and the uncertainty about the future result in psychological distress, for example, depression. The review has synthesized previous studies conducted on the topic and summarized to formulate recommendations for future prison health care services.MethodsWe systematically searched the databases: PubMed, Psych Info, and SCOPUS, as well as manual Google Scholar searches, were conducted to retrieve published literature globally. We have included observational studies, written in English language. Estimates were pooled using a random-effects model. The study protocol was registered in PROSPERO with protocol number CRD42020156108. Subgroup and sensitivity analysis was conducted, and heterogeneity across the studies was evaluated using Q and the I 2-test. Publication bias was assessed by inspection of the funnel plot and Egger's regression test.ResultA total of 1313 studies were initially identified through the electronic database; among these, a total of 73 full-text articles were retrieved for further appraisal. Further, 32 full-text articles were included in the final systematic review and meta-analysis. In this meta-analysis, the pooled prevalence of depression among prisoners was 36.9% (95% CI; 27.3-47.6). The pooled prevalence of depression among prisoners in the developing and developed countries was 39.2% and 33.1%, respectively. Moreover, the prevalence of depression was 19.1% and 54% for the studies that used diagnostic and screen tools to diagnose or screen depression, respectively. A leave-one-out analysis revealed that the pooled prevalence of depression among prisoners was not dependent on a single study removal or addition. Thus, the pooled prevalence of depression ranges between 35.3 and 38.0%.ConclusionThe prevalence of depression among prisoners was high. Therefore, regular and continuous screening of depressive symptoms for prisoners along with its appropriate management is highly recommended.

Project description:BackgroundThe burden of chronic obstructive pulmonary disease (COPD) across many world regions is high. We aim to estimate COPD prevalence and number of disease cases for the years 1990 and 2010 across world regions based on the best available evidence in publicly accessible scientific databases.MethodsWe conducted a systematic search of Medline, EMBASE and Global Health for original, population-based studies providing spirometry-based prevalence rates of COPD across the world from January 1990 to December 2014. Random effects meta-analysis was conducted on extracted crude prevalence rates of COPD, with overall summaries of the meta-estimates (and confidence intervals) reported separately for World Health Organization (WHO) regions, the World Bank's income categories and settings (urban and rural). We developed a meta-regression epidemiological model that we used to estimate the prevalence of COPD in people aged 30 years or more.FindingsOur search returned 37 472 publications. A total of 123 studies based on a spirometry-defined prevalence were retained for the review. From the meta-regression epidemiological model, we estimated about 227.3 million COPD cases in the year 1990 among people aged 30 years or more, corresponding to a global prevalence of 10.7% (95% confidence interval (CI) 7.3%-14.0%) in this age group. The number of COPD cases increased to 384 million in 2010, with a global prevalence of 11.7% (8.4%-15.0%). This increase of 68.9% was mainly driven by global demographic changes. Across WHO regions, the highest prevalence was estimated in the Americas (13.3% in 1990 and 15.2% in 2010), and the lowest in South East Asia (7.9% in 1990 and 9.7% in 2010). The percentage increase in COPD cases between 1990 and 2010 was the highest in the Eastern Mediterranean region (118.7%), followed by the African region (102.1%), while the European region recorded the lowest increase (22.5%). In 1990, we estimated about 120.9 million COPD cases among urban dwellers (prevalence of 13.2%) and 106.3 million cases among rural dwellers (prevalence of 8.8%). In 2010, there were more than 230 million COPD cases among urban dwellers (prevalence of 13.6%) and 153.7 million among rural dwellers (prevalence of 9.7%). The overall prevalence in men aged 30 years or more was 14.3% (95% CI 13.3%-15.3%) compared to 7.6% (95% CI 7.0%-8.2%) in women.ConclusionsOur findings suggest a high and growing prevalence of COPD, both globally and regionally. There is a paucity of studies in Africa, South East Asia and the Eastern Mediterranean region. There is a need for governments, policy makers and international organizations to consider strengthening collaborations to address COPD globally.