Abstract
IntroductionAlthough hepatitis C virus (HCV) screening is recommended for all HIV-infected patients initiating antiretroviral therapy, data on epidemiologic characteristics of HCV infection in resource-limited settings are scarce.MethodsWe searched PubMed and EMBASE for studies assessing the prevalence of HCV infection among HIV-infected individuals in Africa and extracted data on laboratory methods used. Prevalence estimates from individual studies were combined for each country using random-effects meta-analysis. The importance of study design, population and setting as well as type of test (anti-HCV antibody tests and polymerase chain reactions) was examined with meta-regression.ResultsThree randomized controlled trials, 28 cohort studies and 121 cross-sectional analyses with 108,180 HIV-infected individuals from 35 countries were included. The majority of data came from outpatient populations (55%), followed by blood donors (15%) and pregnant women (14%). Based on estimates from 159 study populations, anti-HCV positivity prevalence ranged between 3.3% (95% confidence interval (CI) 1.8–4.7) in Southern Africa and 42.3% (95% CI 4.1–80.5) in North Africa. Study design, type of setting and age distribution did not influence this prevalence significantly. The prevalence of replicating HCV infection, estimated from data of 29 cohorts, was 2.0% (95% CI 1.5–2.6). Ten studies from nine countries reported the HCV genotype of 74 samples, 53% were genotype 1, 24% genotype 2, 14% genotype 4 and 9% genotypes 3, 5 or 6.ConclusionsThe prevalence of anti-HCV antibodies is high in HIV-infected patients in Africa, but replicating HCV infection is rare and varies widely across countries.
Highlights
Hepatitis C virus (HCV) screening is recommended for all HIV-infected patients initiating antiretroviral therapy, data on epidemiologic characteristics of hepatitis C virus (HCV) infection in resource-limited settings are scarce
The overall anti-HCV antibody prevalence obtained in our meta-analysis was higher than the estimates from the general population, which ranged from 2.0% in East Africa to 2.8% in West Africa according to a recent meta-analysis [15]
Only two studies focused on men who have sex with men (MSM) and five on persons who inject drugs (PWID), whereas injection drug use (IDU) was only reported in eight studies, including three from North Africa, two from Tanzania, one from Kenya, one from Senegal and one from Nigeria
Summary
Hepatitis C virus (HCV) screening is recommended for all HIV-infected patients initiating antiretroviral therapy, data on epidemiologic characteristics of HCV infection in resource-limited settings are scarce. Conclusions: The prevalence of anti-HCV antibodies is high in HIV-infected patients in Africa, but replicating HCV infection is rare and varies widely across countries. The World Health Organization (WHO) recommends that all HIV-infected individuals be screened for HCV infection, ideally at presentation or before the initiation of ART [5]. These guidelines are based on a wealth of data from high-income countries, showing that HIV-infected patients, especially persons who inject drugs (PWID) and men who have sex with men (MSM), are at increased risk of HCV infection [6,7]. Similar discrepancies between HCV serology and PCR results were found in pregnant women in Southern Africa and outpatients in West Africa [10,11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
