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Meta-Analysis
. 2017 Aug 24;17(1):587.
doi: 10.1186/s12879-017-2695-z.

Prevalence of hepatitis B in people living with HIV/AIDS in Latin America and the Caribbean: a systematic review and meta-analysis

Fatima Mitiko Tengan  1   2 , Edson Abdala  3   4 , Marisa Nascimento  5 , Wanderley Marques Bernardo  6   7 , Antonio Alci Barone  3   4
Affiliations
Meta-Analysis

Prevalence of hepatitis B in people living with HIV/AIDS in Latin America and the Caribbean: a systematic review and meta-analysis

Fatima Mitiko Tengan et al. BMC Infect Dis. .

Abstract

Background: Hepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide. In immunocompromised patients, the chronicity rates of HBV infection are higher, but the rates of hepatitis Be antigen (HBeAg) and HBsAg loss and seroconversion to anti-HBe and anti-HBs are lower than those in immunocompetent subjects. This study aimed to evaluate articles on the prevalence of HBsAg in people living with human immunodeficiency virus (HIV) /AIDS (PLWHA) in Latin America and the Caribbean (LAC).

Methods: We searched the PubMed, Latin American and Caribbean Health Sciences, and Embase databases for studies up to November 2016 on infection with HIV and HBV in LAC without period or language restrictions. We did not include case reports, case series, review articles, comments, or studies with a sample size smaller than 100. We also evaluated the quality of the articles using a list of criteria totaling 21 items.

Results: Of the 28 selected articles (n = 18,457) published from 1999 to 2016, 18 studies (64.3%) were from Brazil, 3 (10.7%) were from Argentina, 2 (7.1%) were from Chile, 2 (7.1%) were from Cuba, 1 (3.6%) was from Colombia, 1 (3.6%) was from Venezuela, and 1 (3.6%) was from Jamaica. The mean score for the assessment of the study quality was 11.6 (range: 8-16). The estimated pooled prevalence of HBsAg among PLWHA in the selected studies was 7.0% (95% CI 7.0-7.0%). The pooled prevalence of HBsAg was 8.0% (95% CI 8.0-9.0%) in the studies published from 1999 to 2006 and 6.0% (95% CI 5.0-6.0%) in the studies published during the later timeframe.

Conclusions: The results of this review indicate the need to increase the investment in preventive measures against hepatitis B, particularly when the impact of adequate vaccination in this population is considered. Future studies with larger sample sizes are needed in LAC to determine the true prevalence of hepatitis B throughout the region and to clarify and address the risk factors associated with the acquisition of infection.

Keywords: HIV; Hepatitis B; Hepatitis B virus; Human immunodeficiency virus; Latin America; Prevalence; Review; Systematic review; The Caribbean.

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Conflict of interest statement

Ethics approval and consent to participate

No ethical approval was sought, because approval was deemed unnecessary for this systematic review.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of the identification, inclusion, and exclusion of the studies
Fig. 2
Fig. 2
Estimated pooled prevalence of HBsAg in the LAC region
Fig. 3
Fig. 3
Estimated pooled prevalence of HBsAg in the 12 studies published during the period from 1999 to 2006
Fig. 4
Fig. 4
Estimated pooled prevalence of HBsAg in the 16 studies published during the period from 1999 to 2006
See this image and copyright information in PMC

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