Mother-to-Child Transmission of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Among Pregnant Women with Dual or Triplex Infections of HIV, HBV and HCV in Nigeria: A Systematic Review

Abstract

Background: There is no previous systemic review on mother-to-child transmission (MTCT) rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among pregnant women with dual or triplex infections of HIV, HBV and HCV. The aim of this study was to systematically review the literature and identify MTCT rates and factors associated with MTCT of HIV, HBV and HCV among pregnant women and their infant pairs with dual or triplex infections of HIV, HBV and HCV in Nigeria. Methods: A systematic review was done using PRISMA guidelines. Searches were conducted on 19th February 2021 in PubMed, Google Scholar and CINAHL to identify studies published from 1st February 2001 until 31st January 2021 using keywords including ‘MTCT,’ ‘co-infection,’ ‘dual infection,’ ‘triplex infection,’ ‘HIV,’ ‘HBV,’ and ‘HCV’. Studies that reported MTCT rate of at least any of HIV, HBV and HCV and/or its associated factors with them among pregnant women and their infant pairs with dual and triplex infections of HIV, HBV and HCV in Nigeria irrespective of publication status or language were eligible. If there was no eligible study, studies on mono-infection (HIV or HBV or HCV) population were eligible for narrative synthesis only. Studies were excluded if they were abstracts only or published prior to February 2001. The data from these studies were extracted independently by two authors with disagreements resolved by a third author and consensus reached. The protocol was prospectively registered in the PROSPERO database, ID: CRD42020202070. Findings: The search identified 891 reports. After screening titles and abstracts, 25 full-text articles were assessed for eligibility and none of the studies was included for quantitative synthesis in the systematic review. We identified one relevant large national ongoing study. We have included a comprehensive narrative account of 18 studies where we identified a MTCT rate analysis of HIV (median MTCT rate at birth: 2.18%; range: 0.0% to 9.6%; 5,863 participants; 15 studies) and HBV (median MTCT rate at birth: 51.6%; range: 42.86% to 72.0%; 433 participants; three studies) among mother-infant pairs with mono-infection of HIV and HBV respectively, as this forms the only evidence base in this area. Interpretation: Currently, we found no reliable evidence to inform decisions on the rate of MTCT transmission of HIV, HBV and HCV among mother-infant pairs with dual or triplex infection of HIV, HBV and HCV in Nigeria since the only present study is ongoing. This important topic has been addressed in few studies involving an entirely mono-infection population for HIV or HBV but not HCV. Future research needs to focus on the MTCT rates among mother-infant pairs with dual or triplex infections of HIV, HBV and HCV. Funding: TETFund National Research Fund 2019 (Grant number TETFund/DR&D/CE/NRF/STI/33). Declaration of Interest: We declare no competing interests.