Risk Factors for Hepatitis C Virus Among the General Population in Sub-Saharan Africa—An Analysis of Systematic Review Data

Abstract

Understanding risk factors for hepatitis C virus (HCV) is critical for targeting screening and prevention. We systematically reviewed risk factors associated with HCV seroprevalence among the general population in sub-Saharan Africa (SSA). Comprehensive systematic review of HCV seroprevalence of community-based observational studies reporting HCV risk factors in SSA. Study quality was assessed using Joanna Briggs Institute tool. Random effect meta-analyses were used to estimate odds ratios (OR) with 95% confidence intervals (CI). We identified 92 studies. Higher odds of HCV seroprevalence were observed among age 21–64 (OR = 1.77, 95% CI 1.17–2.68) and 65+ groups (OR = 11.75, 95% CI 5.51–25.05) compared to those aged ≤ 20 years; not being formally educated (OR = 1.78, 95% CI 1.35–2.35) compared to secondary/above and being married (OR = 1.91, 95% CI 1.45–2.51) or divorced (OR = 3.20, 95% CI 1.91–5.36) compared to never married. Family history of HCV (OR = 1.52, 95% CI 1.17–1.96), being a person living with HIV (OR = 2.64, 95% CI 1.61–4.33) or being HBsAg positive (OR = 1.66, 95% CI 1.10–2.50) were all positively associated with increased HCV seroprevalence, as was having a history of blood transfusion (OR = 1.81, 95% CI 1.33–2.45), hospitalisation (OR = 1.55, 95% CI 1.22–1.96), medical operation (OR = 1.28, 95% CI 1.01–1.62), scarification (OR = 1.29, 95% CI 1.01–1.64) and injection drug use (OR = 7.04, 95% CI 1.16–42.68). Pilot HCV screening programmes targeting older adults and people exposed to healthcare-associated factors could potentially lead to the efficient detection of HCV cases and reduce future HCV exposures among the general population in SSA countries.