Prevalence, trends, and distribution of hepatitis C virus among the general population in sub-Saharan Africa: A systematic review and meta-analysis

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2024-09-13 DOI:10.1111/liv.16102

Getahun Molla Kassa, Josephine G. Walker, Tesfa Sewunet Alamneh, Melaku Tileku Tamiru, Sandra Bivegete, Aynishet Adane, Wondwossen Amogne, John F. Dillon, Peter Vickerman, Emebet Dagne, Elias Ali Yesuf, Matthew Hickman, Clare E. French, Aaron G. Lim, the DESTINE NIHR Global Health Research Group

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Abstract

Background and Aims

Although the evidence is uncertain, existing estimates for hepatitis C virus (HCV) in sub-Saharan Africa (SSA) indicate a high burden. We estimated HCV seroprevalence and viraemic prevalence among the general population in SSA.

Methods

We searched Medline, Embase, Web of Science, APA PsycINFO, and World Health Organization Africa Index Medicus for community-based studies. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool, and heterogeneity using the index of heterogeneity (I²). Two approaches were deployed. First, we used random-effects meta-analysis to pool prevalence. Second, to derive representative estimates, we weighted each country's HCV seroprevalence using 2021 United Nations country population sizes.

Results

We synthesized 130 studies. Overall, SSA HCV seroprevalence from the random-effects model was 4.17% (95% confidence interval [CI]: 3.71–4.66, I² = 99.30%). There were no differences between males (4.31%) and females (4.03%). Seroprevalence was 2.25%, 3.31%, and 16.23% for ages ≤20, 21–64, and ≥65 years, respectively, and was higher in rural (6.63%) versus urban (2.93%). There was indication of decrement overtime from 5.74% to 4.35% to 3.03% in the years 1984–2000, 2001–2014, and 2015–2023, respectively. The weighted overall SSA HCV seroprevalence was estimated to be 2.30% (95% CI: 1.59–3.00) with regional variation: Africa-Southern (.79%), Africa-Central (1.47%), Africa-Eastern (2.71%), and Africa-Western (2.88%). HCV viremia among HCV seropositives was 54.77% (95% CI: 47.80–61.66).

Conclusions

HCV seroprevalence in SSA remains high. Populations aged ≥65 years, rural communities, Africa-Western, and some countries in Africa-Central and Africa-Eastern appear disproportionately affected. These results underline the need for governmental commitment to achieve the 2030 global HCV elimination targets.

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撒哈拉以南非洲普通人群中丙型肝炎病毒的流行率、趋势和分布：系统回顾和荟萃分析。

背景和目的尽管证据尚不确定，但现有的撒哈拉以南非洲（SSA）丙型肝炎病毒（HCV）估计值表明该地区的丙型肝炎病毒负担很重。我们估算了撒哈拉以南非洲地区普通人群中的丙型肝炎病毒血清阳性率和病毒流行率。方法我们检索了 Medline、Embase、Web of Science、APA PsycINFO 和世界卫生组织非洲医学索引中基于社区的研究。研究质量采用乔安娜-布里格斯研究所（Joanna Briggs Institute）的关键评估工具进行评估，异质性采用异质性指数（I2）进行评估。我们采用了两种方法。首先，我们使用随机效应荟萃分析法对流行率进行汇总。其次，为了得出具有代表性的估计值，我们使用 2021 年联合国国家人口规模对每个国家的 HCV 血清流行率进行了加权。总体而言，随机效应模型得出的 SSA HCV 血清流行率为 4.17%（95% 置信区间 [CI]：3.71-4.66，I2 = 99.30%）。男性（4.31%）和女性（4.03%）之间没有差异。年龄≤20 岁、21-64 岁和≥65 岁的血清阳性率分别为 2.25%、3.31% 和 16.23%，农村（6.63%）高于城市（2.93%）。有迹象表明，在1984-2000年、2001-2014年和2015-2023年，该比例分别从5.74%、4.35%和3.03%逐年下降。据估计，撒哈拉以南非洲地区的加权总体 HCV 血清流行率为 2.30%（95% CI：1.59-3.00），但存在地区差异：非洲南部（0.79%）、非洲中部（1.47%）、非洲东部（2.71%）和非洲西部（2.88%）。HCV血清阳性者的HCV病毒血症率为54.77%（95% CI：47.80-61.66）。年龄≥65 岁的人群、农村社区、非洲-西部以及非洲-中部和非洲-东部的一些国家受到的影响尤为严重。这些结果凸显了政府为实现 2030 年全球消除丙型肝炎病毒目标所做承诺的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.