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Meta-Analysis
. 2022 Nov 9;22(1):826.
doi: 10.1186/s12879-022-07838-w.

Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis

Ousman Mohammed  1 , Ermiyas Alemayehu  2 , Habtye Bisetegn  2 , Mihret Tilahun  2 , Alemu Gedefie  2 , Endris Ebrahim  2 , Mesfin Fiseha  2 , Mogesie Necho  3 , Temesgen Fiseha  2
Affiliations
Meta-Analysis

Prevalence of hepatotoxicity among HIV-infected patients in Ethiopia: a systematic review and meta-analysis

Ousman Mohammed et al. BMC Infect Dis. .

Abstract

Background: Globally, the human immunodeficiency virus has been recognized as a major public health concern. The direct toxicity of antiretroviral medicines or their active metabolites causes liver cell destruction by different mechanisms, inducing immune-mediated inflammation, oxidative stress, and other mechanisms. On the other hand, the virus itself also produces hepatotoxicity. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of hepatotoxicity among HIV-infected patients in Ethiopia.

Methods: PubMed, Science Direct, Cochrane Library, Web of Science, and ResearchGate databases were used to find relevant articles. As well, various professional associations were searched to retrieve grey literature. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of recruited studies. The data were extracted using Microsoft Excel, and the meta-analysis was carried out using STATA 14 software. I2 and Cochran's Q test were employed to assess the presence of heterogeneity between studies. A random effect model was used. The funnel plot and Egger's statistics were used to assess publication bias. Moreover, subgroup analysis and sensitivity analysis were also done.

Results: The pooled prevalence of hepatotoxicity among HIV patients in Ethiopia was 25.45% (95% CI = 20.06-30.84%). There was high heterogeneity, with an I2 value of 93.7%. Subgroup analysis by HAART status showed a higher pooled prevalence of hepatotoxicity among HIV patients taking HAART (23.63%) than among HAART naive patients (7.29%). In subgroup analysis, the pooled prevalence of hepatotoxicity among HIV/Tb co-infected and HIV mono-infected patients was 26.3% and 17.94%, respectively.

Conclusion: The current systematic review and meta-analysis showed a high prevalence of hepatotoxicity among HIV-infected patients. Therefore, regular monitoring of hepatotoxicity among HIV-infected patients is required in order to avoid liver damage and other complications. Systematic review registration PROSPERO (2022:CRD42022334704).

Keywords: Antiretroviral therapy; Ethiopia; HIV/AIDS; Hepatotoxicity; Liver enzyme elevation.

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Conflict of interest statement

The authors declare that they have no potential competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of studies’ search and retrieval process
Fig. 2
Fig. 2
Forest plot showing the pooled prevalence of hepatotoxicity among HIV infected patients
Fig. 3
Fig. 3
Forest plot showing the pooled prevalence of hepatotoxicity among ART taking and naïve HIV/AIDS patients
Fig. 4
Fig. 4
Forest plot showing the pooled prevalence of hepatotoxicity grading among treatment taking and naïve HIV/AIDS patients
Fig. 5
Fig. 5
Forest plot showing the pooled prevalence of hepatotoxicity among HIV/AIDS patients by study design
Fig. 6
Fig. 6
Forest plot showing the pooled prevalence of hepatotoxicity among HIV/AIDS patients by year of publication
Fig. 7
Fig. 7
Forest plot showing the pooled prevalence of hepatotoxicity among HIV/AIDS patients by HIV/Tb Co-infection status
Fig. 8
Fig. 8
Bias assessment plot of reported prevalence rates of hepatotoxicity among HIV-infected individuals across studies published in Ethiopia between 2008 and May, 2022
See this image and copyright information in PMC

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