Global seroprevalence of hepatitis E among people living with HIV: a systematic review and meta-analysis.

Abstract

Hepatitis E virus (HEV) infection can progress to chronic hepatitis in immunosuppressed individuals. The seroprevalence of hepatitis E among people living with HIV remains controversial. In this systematic review and meta-analysis, the pooled global seroprevalence of hepatitis E among people living with HIV is estimated. This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and was registered in PROSPERO. Searches were conducted in the PubMed, Embase, and Web of Science databases. The seroprevalence of hepatitis E (anti-HEV IgG) among people living with HIV was estimated by meta-analysis using the random-effects model. Subgroup meta-analyses were performed for each continent. A total of 88 studies from 5 continents were included; most were conducted in European countries (48.9%). The pooled seroprevalence of HEV infection was 16.0% (95% CI, 13.0-18.0; I2 = 97.7%). Subgroup analyses revealed seroprevalence rates of 12.0% in Europe, 24.0% in Asia, 19.0% in Africa, and 11.0% in the Americas, and a notably high prevalence was observed in low-income countries (37.0%). Sensitivity analyses restricted to studies with sample sizes of more than 200 participants and risk of bias score ≥ 7 indicated seroprevalence estimates of 18.0% and 15.0%, respectively. In conclusion, this meta-analysis demonstrates a pooled global seroprevalence of HEV infection of 16.0% among people living with HIV, ranging from 11.0% to 24.0% across the continents.