Abstract
BackgroundHepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide. In immunocompromised patients, the chronicity rates of HBV infection are higher, but the rates of hepatitis Be antigen (HBeAg) and HBsAg loss and seroconversion to anti-HBe and anti-HBs are lower than those in immunocompetent subjects. This study aimed to evaluate articles on the prevalence of HBsAg in people living with human immunodeficiency virus (HIV) /AIDS (PLWHA) in Latin America and the Caribbean (LAC).MethodsWe searched the PubMed, Latin American and Caribbean Health Sciences, and Embase databases for studies up to November 2016 on infection with HIV and HBV in LAC without period or language restrictions. We did not include case reports, case series, review articles, comments, or studies with a sample size smaller than 100. We also evaluated the quality of the articles using a list of criteria totaling 21 items.ResultsOf the 28 selected articles (n = 18,457) published from 1999 to 2016, 18 studies (64.3%) were from Brazil, 3 (10.7%) were from Argentina, 2 (7.1%) were from Chile, 2 (7.1%) were from Cuba, 1 (3.6%) was from Colombia, 1 (3.6%) was from Venezuela, and 1 (3.6%) was from Jamaica. The mean score for the assessment of the study quality was 11.6 (range: 8–16). The estimated pooled prevalence of HBsAg among PLWHA in the selected studies was 7.0% (95% CI 7.0–7.0%). The pooled prevalence of HBsAg was 8.0% (95% CI 8.0–9.0%) in the studies published from 1999 to 2006 and 6.0% (95% CI 5.0–6.0%) in the studies published during the later timeframe.ConclusionsThe results of this review indicate the need to increase the investment in preventive measures against hepatitis B, particularly when the impact of adequate vaccination in this population is considered. Future studies with larger sample sizes are needed in LAC to determine the true prevalence of hepatitis B throughout the region and to clarify and address the risk factors associated with the acquisition of infection.
Highlights
Hepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide, and approximately 350 million people are chronically infected
This study aimed to evaluate the studies on the prevalence of hepatitis B surface antigen (HBsAg) in Latin America and the Caribbean (LAC) countries or territories
We conducted a systematic review of published articles on the prevalence of HBV infection in PLWHA in LAC countries or territories
Summary
Hepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide. Hepatitis B virus (HBV) infection is a major cause of chronic liver disease worldwide, and approximately 350 million people are chronically infected. In the absence of antiviral therapy, 15% to 40% of patients positive for the hepatitis B surface antigen (HBsAg) develop progressive liver disease, cirrhosis, hepatocellular carcinoma, and terminal liver failure [1]. The chronicity rates of HBV infection are higher, but the rates of hepatitis Be antigen (HBeAg) and HBsAg loss and seroconversion to anti-HBe and anti-HBs are lower than those in immunocompetent subjects [3,4,5]. Coinfection is associated with a higher incidence of hepatocellular carcinoma [7, 8]
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