Desikan Prabha, Khan Zeba
Department of Microbiology, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India.
Indian J Med Microbiol. 2017 Jul-Sep;35(3):332-339. doi: 10.4103/ijmm.IJMM_17_257.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) have several important similarities including worldwide distribution, hepato-tropism, similar modes of transmission and the ability to induce chronic infection that may lead to liver cirrhosis and hepatocellular carcinoma. Since both viruses are individually known to cause the pathologies mentioned above, co-infection with both HBV and HCV would be expected to be linked with higher morbidity as well as mortality and impact healthcare resource utilisation. Precise estimate of the prevalence of HBV/HCV co-infection would be needed to formulate policy decisions and plan communal health interventions. This systematic review and meta-analysis, therefore, aims to understand the prevalence of HBV and HCV co-infection in India based on the available literature. Following PRISMA guidelines, primary studies reporting the prevalence of HBV/HCV co-infection in India were retrieved through searches conducted in PubMed, Google SCHOLAR, Medline, Cochrane Library, WHO reports, Indian and International journals online. All online searches were conducted between December 2016 and February 2017. Meta-analysis was carried out using StatsDirect statistical software. Thirty studies published between 2000 and 2016 conducted across six regions of India were included in this review. The pooled HBV/HCV co-infection prevalence rate across the thirty studies was 1.89% (95% confidence intervals [CI] = 1.2%-2.4%). A high heterogeneity was observed between prevalence estimates. The HBV/HCV co-infection prevalence in different subgroups varied from 0.02% (95% CI = 0.0019%-0.090%) to 3.2% (95% CI = 1.3%-5.9%). The pooled prevalence of HBV/HCV co-infection in India was found to be 1.89%. This systematic review and meta-analysis revealed high prevalence of HBV/HCV co-infection in chronic liver patients, followed by HIV-positive patients, and then followed by persons who inject drugs and kidney disease patients.
乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）有几个重要的相似之处，包括全球分布、嗜肝性、相似的传播方式以及引发可能导致肝硬化和肝细胞癌的慢性感染的能力。由于已知这两种病毒各自都会引发上述病理状况，因此预计HBV和HCV的合并感染会与更高的发病率和死亡率相关，并影响医疗资源的利用。需要对HBV/HCV合并感染的患病率进行精确估计，以便制定政策决策和规划公共卫生干预措施。因此，本系统评价和荟萃分析旨在根据现有文献了解印度HBV和HCV合并感染的患病率。遵循PRISMA指南，通过在PubMed、谷歌学术、Medline、Cochrane图书馆、世界卫生组织报告、印度和国际在线期刊上进行检索，获取报告印度HBV/HCV合并感染患病率的原始研究。所有在线检索均在2016年12月至2017年2月之间进行。使用StatsDirect统计软件进行荟萃分析。本评价纳入了2000年至2016年间在印度六个地区开展的30项研究。这30项研究中HBV/HCV合并感染的合并患病率为1.89%（95%置信区间[CI]=1.2%-2.4%）。在患病率估计值之间观察到高度异质性。不同亚组中HBV/HCV合并感染的患病率从0.02%（95%CI=0.0019%-0.090%）到3.2%（95%CI=1.3%-5.9%）不等。发现印度HBV/HCV合并感染的合并患病率为1.89%。本系统评价和荟萃分析显示，慢性肝病患者中HBV/HCV合并感染的患病率较高，其次是HIV阳性患者，然后是注射吸毒者和肾病患者。
