Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Infect Dis (Lond). 2022 Dec;54(12):881-896. doi: 10.1080/23744235.2022.2115126. Epub 2022 Sep 1.
Occult Hepatitis B virus infection (OBI) is of great significance to the transmission of Hepatitis B virus (HBV) and the evolution of the patient's clinical outcome. We conducted a systematic review and meta-analysis to estimate the prevalence of OBI in Asia.
Literature search was conducted in PubMed, Cochrane Library database, Web of Science and Embase with the keywords of 'Hepatitis B virus', 'occult infection', 'prevalence'. 70 studies were included in the meta-analysis. Meta-analysis was performed using random-effects models to calculate the pooled prevalence of OBI and 95% confidence interval (CI). The data were analyzed in R 4.1.2.
The overall prevalence of OBI was 4% (95%CI: 0.03-0.06) in Asia. Subgroup analysis based on geographic region showed a prevalence of 3% (95%CI 0.02-0.06) in East Asia, 9% (95%CI 0.05-0.15) in West Asia, 3% (95%CI 0.01-0.11) in Southern Asia and 9% (95%CI 0.05-0.15) in Southeast Asia. Subgroup analysis demonstrated a prevalence of 1% (95%CI 0.00-0.02) in general population, 5% (95%CI: 0.03-0.08) in high-risk population, 9% (95%CI: 0.03-0.22) in the human immunodeficiency virus (HIV)-infected patient, 18% (95%CI: 0.09-0.32) in the hepatopathy patients.
Based on the meta-analysis of the prevalence of OBI in different populations, we concluded that the prevalence of OBI in the high-risk population, hepatopathy patients, and HIV-infected patients was higher than that in the general population. A systematic review showed that OBI was associated with disease progression and prognosis. Therefore, these populations should be routinely screened for OBI and promptly intervened to avoid promoting disease progression.
隐匿性乙型肝炎病毒感染（OBI）对乙型肝炎病毒（HBV）的传播和患者临床结局的演变具有重要意义。我们进行了一项系统评价和荟萃分析，以估计亚洲 OBI 的流行率。
使用关键词“乙型肝炎病毒”、“隐匿性感染”、“流行率”在 PubMed、Cochrane 图书馆数据库、Web of Science 和 Embase 中进行文献检索。共纳入 70 项研究进行荟萃分析。使用随机效应模型进行荟萃分析，计算 OBI 的合并流行率及其 95%置信区间（CI）。数据在 R 4.1.2 中进行分析。
亚洲 OBI 的总体流行率为 4%（95%CI：0.03-0.06）。基于地理位置的亚组分析显示，东亚的流行率为 3%（95%CI 0.02-0.06），西亚为 9%（95%CI 0.05-0.15），南亚为 3%（95%CI 0.01-0.11），东南亚为 9%（95%CI 0.05-0.15）。亚组分析显示，一般人群的流行率为 1%（95%CI 0.00-0.02），高危人群为 5%（95%CI：0.03-0.08），人类免疫缺陷病毒（HIV）感染者为 9%（95%CI：0.03-0.22），肝病患者为 18%（95%CI：0.09-0.32）。
基于不同人群 OBI 流行率的荟萃分析，我们得出结论，高危人群、肝病患者和 HIV 感染者的 OBI 流行率高于一般人群。系统评价显示，OBI 与疾病进展和预后有关。因此，这些人群应常规筛查 OBI，并及时进行干预，以避免促进疾病进展。
