Mbaga Donatien Serge, Kenmoe Sebastien, Bikoï Jacky Njiki, Takuissu Guy Roussel, Amougou-Atsama Marie, Okobalemba Etienne Atenguena, Ebogo-Belobo Jean Thierry, Bowo-Ngandji Arnol, Oyono Martin Gael, Magoudjou-Pekam Jeannette Nina, Kame-Ngasse Ginette Irma, Nka Alex Durand, Feudjio Alfloditte Flore, Zemnou-Tepap Cromwel, Velhima Elie Adamou, Ondigui Juliette Laure Ndzie, Nayang-Mundo Rachel Audrey, Touangnou-Chamda Sabine Aimee, Takeu Yrene Kamtchueng, Taya-Fokou Jean Bosco, Mikangue Chris Andre Mbongue, Kenfack-Momo Raoul, Kengne-Ndé Cyprien, Sake Carole Stephanie, Esemu Seraphine Nkie, Njouom Richard, Ndip Lucy, Essama Sara Honorine Riwom
Department of Microbiology, The University of Yaounde I, Yaounde 00237, Cameroon.
Department of Microbiology and Parasitology, University of Buea, Buea 00237, Cameroon.
World J Methodol. 2022 May 20;12(3):179-190. doi: 10.5662/wjm.v12.i3.179.
Occult hepatitis C infection (OCI) is characterized by the presence of hepatitis C virus (HCV) RNA in the liver, peripheral blood mononuclear cells (PBMC) and/or ultracentrifuged serum in the absence of detectable HCV-RNA in serum. OCI has been described in several categories of populations including hemodialysis patients, patients with a sustained virological response, immunocompromised individuals, patients with abnormal hepatic function, and apparently healthy subjects.
To highlight the global prevalence of OCI.
We performed a systematic and comprehensive literature search in the following 4 electronic databases PubMed, EMBASE, Global Index Medicus, and Web of Science up to 6th May 2021 to retrieve relevant studies published in the field. Included studies were unrestricted population categories with known RNA status in serum, PBMC, liver tissue and/or ultracentrifuged serum. Data were extracted independently by each author and the Hoy tool was used to assess the quality of the included studies. We used the random-effect meta-analysis model to estimate the proportions of OCI and their 95% confidence intervals (95%CI). The Cochran's -test and the test statistics were used to assess heterogeneity between studies. Funnel plot and Egger test were used to examine publication bias. R software version 4.1.0 was used for all analyses.
The electronic search resulted in 3950 articles. We obtained 102 prevalence data from 85 included studies. The pooled prevalence of seronegative OCI was estimated to be 9.61% (95%CI: 6.84-12.73) with substantial heterogeneity [² = 94.7% (95%CI: 93.8%-95.4%), < 0.0001]. Seropositive OCI prevalence was estimated to be 13.39% (95%CI: 7.85-19.99) with substantial heterogeneity [ = 93.0% (90.8%-94.7%)]. Higher seronegative OCI prevalence was found in Southern Europe and Northern Africa, and in patients with abnormal liver function, hematological disorders, and kidney diseases. Higher seropositive OCI prevalence was found in Southern Europe, Northern America, and Northern Africa.
In conclusion, in the present study, it appears that the burden of OCI is high and variable across the different regions and population categories. Further studies on OCI are needed to assess the transmissibility, clinical significance, long-term outcome, and need for treatment.
隐匿性丙型肝炎感染（OCI）的特征是肝脏、外周血单个核细胞（PBMC）和/或超速离心血清中存在丙型肝炎病毒（HCV）RNA，而血清中检测不到HCV-RNA。OCI已在几类人群中被描述，包括血液透析患者、病毒学持续应答患者、免疫功能低下个体、肝功能异常患者以及看似健康的受试者。
强调OCI的全球患病率。
我们在以下4个电子数据库（PubMed、EMBASE、全球医学索引和科学网）中进行了系统全面的文献检索，截至2021年5月6日，以检索该领域发表的相关研究。纳入的研究为血清、PBMC、肝组织和/或超速离心血清中RNA状态已知的无限制人群类别。每位作者独立提取数据，并使用Hoy工具评估纳入研究的质量。我们使用随机效应荟萃分析模型来估计OCI的比例及其95%置信区间（95%CI）。使用 Cochr an's Q检验和I²检验统计量来评估研究间的异质性。漏斗图和Egger检验用于检查发表偏倚。所有分析均使用R软件版本4.1.0。
电子检索共得到3950篇文章。我们从85项纳入研究中获得了102个患病率数据。血清阴性OCI的合并患病率估计为9.61%（95%CI：6.84 - 12.73），异质性较大[I² = 94.7%（95%CI：93.8% - 95.4%），P < 0.0001]。血清阳性OCI患病率估计为13.39%（95%CI：7.85 - 19.99），异质性较大[I² = 93.0%（90.8% - 94.7%）]。在南欧、北非以及肝功能异常、血液系统疾病和肾脏疾病患者中发现血清阴性OCI患病率较高。在南欧、北美和北非发现血清阳性OCI患病率较高。
总之，在本研究中，OCI的负担似乎很高，且在不同地区和人群类别中存在差异。需要对OCI进行进一步研究，以评估其传播性、临床意义、长期结局以及治疗需求。
