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Review
. 2023 Jul 17:2023:3551297.
doi: 10.1155/2023/3551297. eCollection 2023.

A Systematic Review and Meta-Analysis of the Prevalence of Triplex Infections (Combined Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus) among Pregnant Women in Nigeria

George Uchenna Eleje  1   2 , Olabisi Morebise Loto  3   4 , Hadiza Abdullahi Usman  5   6 , Chinyere Ukamaka Onubogu  7 , Preye Owen Fiebai  8   9 , Godwin Otuodichinma Akaba  10   11 , Ayyuba Rabiu  12   13 , Ikechukwu Innocent Mbachu  1   2 , Moriam Taiwo Chibuzor  14 , Rebecca Chinyelu Chukwuanukwu  15 , Ngozi Nneka Joe-Ikechebelu  16   17 , Emeka Philip Igbodike  18 , Richard Obinwanne Egeonu  2 , Ijeoma Chioma Oppah  9 , Uchenna Chukwunonso Ogwaluonye  19 , Chike Henry Nwankwo  20 , Stephen Okoroafor Kalu  21 , Chisom God'swill Chigbo  22 , Chukwuanugo Nkemakonam Ogbuagu  23 , Shirley Nneka Chukwurah  24 , Chinwe Elizabeth Uzochukwu  25 , Aishat Ahmed  11 , Chiamaka Henrietta Jibuaku  19 , Samuel Oluwagbenga Inuyomi  26 , Bukola Abimbola Adesoji  27 , Ubong Inyang Anyang  11 , Ekene Agatha Emeka  28 , Odion Emmanuel Igue  29 , Ogbonna Dennis Okoro  30 , Prince Ogbonnia Aja  15 , Chiamaka Perpetua Chidozie  15 , Hadiza Sani Ibrahim  13 , Fatima Ele Aliyu  13 , Harrison Chiro Ugwuoroko  2 , Aisha Ismaila Numan  6 , Solace Amechi Omoruyi  9 , Osita Samuel Umeononihu  1   2 , Chukwuemeka Chukwubuikem Okoro  2 , Ifeanyi Kingsley Nwaeju  2 , Arinze Anthony Onwuegbuna  31 , Lydia Ijeoma Eleje  32 , David Chibuike Ikwuka  33 , Eric Okechukwu Umeh  34 , Sussan Ifeyinwa Nweje  35 , Ifeoma Clara Ajuba  36 , Angela Ogechukwu Ugwu  37 , Uzoamaka Rufina Ebubedike  34 , Divinefavour Echezona Malachy  1 , Chigozie Geoffrey Okafor  2 , Nnaedozie Paul Obiegbu  2 , Emmanuel Onyebuchi Ugwu  38 , Ibrahim Adamu Yakasai  12   13 , Oliver Chukwujekwu Ezechi  39 , Joseph Ifeanyichukwu Ikechebelu  1   2
Affiliations
Review

A Systematic Review and Meta-Analysis of the Prevalence of Triplex Infections (Combined Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus) among Pregnant Women in Nigeria

George Uchenna Eleje et al. Obstet Gynecol Int. .

Abstract

Objective: We systematically identified the prevalence of triplex infections (combined human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)) in pregnancy.

Methods: To gather information on the frequency of triplex infections, we searched the databases of PubMed, CINAHL, and Google Scholar. Without regard to language, we utilized search terms that covered HIV, HBV, HCV, and pregnancy. Pregnant women with triplex infections of HIV, HBV, and HCV were included in studies that also examined the prevalence of triplex infections. Review Manager 5.4.1 was employed to conduct the meta-analysis. Critical appraisal and bias tool risk data were provided as percentages with 95% confidence intervals (95% CIs), and I2 was used as the statistical measure of heterogeneity. The checklist was created by Hoy and colleagues. The study protocol was registered on PROSPERO, under the registration number CRD42020202583.

Results: Eight studies involving 5314 women were included. We identified one ongoing study. Pooled prevalence of triplex infections was 0.03% (95% CI: 0.02-0.04%) according to meta-analysis. Subgroup analysis demonstrated a significantly high prevalence of 0.08% (95% CI: 0.06-0.10%; 3863 women) in HIV-positive population than 0.00% (95% CI:-0.00-0.00; 1451 women; P < 0.001) in general obstetric population. Moreover, there was a significant difference in the pooled prevalence between studies published between 2001 and 2010 and between 2011 and 2021 (0.14% (95% CI: 0.12 to 0.16 versus 0.03% (95% CI: 0.02 to 0.04%; P < 0.001))) and participants recruited in the period between 2001 and 2011 and between 2012 and 2021 (0.13% (95% CI: 0.05 to 0.21; p=0.002 versus 0.00% (95% CI: -0.00 to 0.00%; p=1.00))), respectively.

Conclusion: The combined prevalence of prenatal triplex infections was 0.03%, with rates notably higher among the group of pregnant women who were HIV-positive and during the recruitment period that took place before 2012. This prevalence still necessitates screening for these infections as necessary.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart. ∗Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers). ∗∗If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools.
Figure 2
Figure 2
Meta-analysis showing the overall prevalence of triplex infection in pregnancy in the included studies.
Figure 3
Figure 3
Meta-analysis showing the sensitivity analysis with prevalence of triplex infection in pregnancy with exclusion of study with high risk of bias.
Figure 4
Figure 4
Subgroup analysis according to type of obstetric population.
Figure 5
Figure 5
Subgroup analysis according to year of publication of the included studies.
Figure 6
Figure 6
Subgroup analysis according to year of recruitment of participants in the included studies.
See this image and copyright information in PMC

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