巴基斯坦血液透析患者丙型肝炎病毒感染率的系统评价和荟萃分析。
The prevalence of hepatitis C virus in hemodialysis patients in Pakistan: A systematic review and meta-analysis.
机构信息
Department of Statistics, Government College University Lahore, Lahore, Pakistan.
Department of Statistics, University of Peshawar, Peshawar, Pakistan.
出版信息
PLoS One. 2020 May 14;15(5):e0232931. doi: 10.1371/journal.pone.0232931. eCollection 2020.
BACKGROUND
Hepatitis C virus (HCV) infection is one of the most common bloodborne viral infections reported in Pakistan. Frequent dialysis treatment of hemodialysis patients exposes them to a high risk of HCV infection. The main purpose of this paper is to quantify the prevalence of HCV in hemodialysis patients through a systematic review and meta-analysis.
METHODS
We systematically searched PubMed, Medline, EMBASE, Pakistani Journals Online and Web of Science to identify studies published between 1 January 1995 and 30 October 2019, reporting on the prevalence of HCV infection in hemodialysis patients. Meta-analysis was performed using a random-effects model to obtain pooled estimates. A funnel plot was used in conjunction with Egger's regression test for asymmetry and to assess publication bias. Meta-regression and subgroup analyses were used to identify potential sources of heterogeneity among the included studies. This review was registered on PROSPERO (registration number CRD42019159345).
RESULTS
Out of 248 potential studies, 19 studies involving 3446 hemodialysis patients were included in the meta-analysis. The pooled prevalence of HCV in hemodialysis patients in Pakistan was 32.33% (95% CI: 25.73-39.30; I2 = 94.3%, p < 0.01). The subgroup analysis showed that the prevalence of HCV among hemodialysis patients in Punjab was significantly higher (37.52%; 95% CI: 26.66-49.03; I2 = 94.5, p < 0.01) than 34.42% (95% CI: 14.95-57.05; I2 = 91.3%, p < 0.01) in Baluchistan, 27.11% (95% CI: 15.81-40.12; I2 = 94.5, p < 0.01) in Sindh and 22.61% (95% CI: 17.45-28.2; I2 = 78.6, p < 0.0117) in Khyber Pukhtoonkhuwa.
CONCLUSIONS
In this study, we found a high prevalence (32.33%) of HCV infection in hemodialysis patients in Pakistan. Clinically, hemodialysis patients require more attention and resources than the general population. Preventive interventions are urgently needed to decrease the high risk of HCV infection in hemodialysis patients in Pakistan.
背景
丙型肝炎病毒（HCV）感染是巴基斯坦报告的最常见的血源性病毒感染之一。血液透析患者经常接受透析治疗，使他们面临感染 HCV 的高风险。本文的主要目的是通过系统评价和荟萃分析来量化 HCV 在血液透析患者中的流行率。
方法
我们系统地检索了 PubMed、Medline、EMBASE、巴基斯坦在线期刊和 Web of Science，以确定 1995 年 1 月 1 日至 2019 年 10 月 30 日期间发表的研究报告，这些研究报告了血液透析患者中 HCV 感染的流行率。使用随机效应模型进行荟萃分析以获得汇总估计值。使用漏斗图结合 Egger 回归检验评估不对称性，并评估发表偏倚。进行荟萃回归和亚组分析以确定纳入研究中潜在的异质性来源。本综述已在 PROSPERO（注册号 CRD42019159345）上注册。
结果
在 248 项潜在研究中，有 19 项研究涉及 3446 名血液透析患者，被纳入荟萃分析。在巴基斯坦，血液透析患者中 HCV 的总流行率为 32.33%（95%CI：25.73-39.30；I2=94.3%，p<0.01）。亚组分析显示，旁遮普省血液透析患者的 HCV 流行率明显高于（37.52%；95%CI：26.66-49.03；I2=94.5，p<0.01），而俾路支省的 HCV 流行率为 34.42%（95%CI：14.95-57.05；I2=91.3%，p<0.01），信德省为 27.11%（95%CI：15.81-40.12；I2=94.5，p<0.01），开伯尔-普赫图赫瓦省为 22.61%（95%CI：17.45-28.2；I2=78.6，p<0.0117）。
结论
在这项研究中，我们发现巴基斯坦血液透析患者 HCV 感染的流行率很高（32.33%）。临床上，血液透析患者比一般人群需要更多的关注和资源。迫切需要采取预防措施，以降低巴基斯坦血液透析患者感染 HCV 的高风险。
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