Epidemiologic profile of hepatitis C virus infection and genotype distribution in Burkina Faso: a systematic review with meta-analysis

Abstract

Background: Detailed characteristics of Hepatitis C virus (HCV) infection in Burkina Faso are scarce. The main aim of this study was to assess HCV seroprevalence in various settings and populations at risk in Burkina Faso between 1990 and 2020. Secondary objectives included the prevalence of HCV Ribonucleic acid (RNA) and the distribution of HCV genotypes.

Methods: A systematic database search, supplemented by a manual search, was conducted in PubMed, Web of Science, Scopus, and African Index Medicus. Studies reporting HCV seroprevalence data in low and high-risk populations in Burkina Faso were included, and a random-effects meta-analysis was applied. Risk of bias was assessed using the Joanna Briggs institute checklist.

Results: Low-risk populations were examined in 31 studies involving a total of 168,151 subjects, of whom 8330 were positive for HCV antibodies. Six studies included a total of 1484 high-risk persons, and 96 had antibodies to HCV. The pooled seroprevalence in low-risk populations was 3.72% (95% CI: 3.20-4.28) and 4.75% (95% CI: 1.79-8.94) in high-risk groups. A non-significant decreasing trend was observed over the study period. Seven studies tested HCV RNA in a total of 4759 individuals at low risk for HCV infection, and 81 were positive. The meta-analysis of HCV RNA yielded a pooled prevalence of 1.65% (95% CI: 0.74-2.89%) in low-risk populations, which is assumed to be indicative of HCV prevalence in the general population of Burkina Faso and suggests that about 301,174 people are active HCV carriers in the country. Genotypes 2 and 1 were the most frequent, with 60.3% and 25.0%, respectively.

Conclusions: HCV seroprevalence is intermediate in Burkina Faso and indicates the need to implement effective control strategies. There is a paucity of data at the national level and for rural and high-risk populations. General population screening and linkage to care are recommended, with special attention to rural and high-risk populations.

Keywords: Burkina Faso; Genotype; Hepatitis C; Prevalence; Seroprevalence; Systematic review.

Fig. 1

Flowchart of records identification and study selection. A “report” refers to any document mentioning HCV seroprevalence data, and a “study” relates to the measurement of anti-HCV antibodies in a specific population or setting. Of the 31 reports that met the review criteria, four reported seroprevalence data on separate study subjects or settings (as shown in Table 1), and each seroprevalence data was extracted as an individual study. Therefore, 31 reports met the criteria for this review, and 37 prevalence data, referred to as “studies”, were extracted

Fig. 2

Meta-analysis of HCV seroprevalence in Burkina Faso by risk group. Pooled seroprevalence based on random-effects model. Low-risk group includes the general population, blood donors, pregnant women, and children. High-risk group is constituted of people living with Human Immunodeficiency Virus (HIV), sex workers, men having sex with men (MSM) and healthcare workers

Fig. 3

Meta-analysis of HCV RNA prevalence in Burkina Faso by risk group. Pooled prevalence based on random-effects model. Low-risk group includes the general population, blood donors, and pregnant women. Only one study evaluated HCV RNA in high-risk groups (people living with HIV)

Fig. 4

Distribution of HCV genotypes in Burkina Faso. Mixed infections consisted of genotypes 2/3 and 2/4

Fig. 5

Funnel plot of HCV seroprevalence meta-analysis. Double arcsine transformed proportion of individual studies is plotted against the sample size. The symmetrical distribution of studies in the funnel plot suggests an absence of publication bias