内脏利什曼病患者中乙型和丙型肝炎病毒感染的患病率：一项系统评价和荟萃分析。
Prevalence of hepatitis B and C virus infections among visceral leishmaniasis patients: a systematic review and meta-analysis.
作者信息
Assefa Muluneh, Biset Sirak
机构信息
Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Front Microbiol. 2024 Jun 25;15:1415330. doi: 10.3389/fmicb.2024.1415330. eCollection 2024.
BACKGROUND
Visceral leishmaniasis (VL) patients are at high risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infections during multiple injections and the anti-leishmanial treatment possesses a potential hepatotoxic effect. This systematic review and meta-analysis determined the pooled prevalence of HBV and HCV infections in VL patients.
METHODS
This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO), with the assigned number CRD42024516889, and conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Medline, EMBASE, Google Scholar, Web of Science, and Science Direct databases. Data were extracted using Microsoft Excel and analyzed using STATA version 11.0 software. A random-effects model was used to estimate the pooled effect size of outcome variables across studies with a 95% confidence interval and was displayed in a forest plot. The statistic was used to check for heterogeneity. The presence of publication bias was determined using a funnel plot and Egger's test with a value <0.05 evidence of statistically significant bias.
RESULTS
Among 216 retrieved records, seven studies were eligible for systematic review and meta-analysis. A total of 937 VL patients were examined, revealing that 105 and 93 were infected with HBV and HCV, respectively. The pooled prevalence of HBV was 16.15% (95% CI: -4.10 to 36.39), with a significant heterogeneity ( = 91.4%, 0.001). The combined prevalence of HCV was 13.74% (95% CI: 1.32-26.16, = 71.6%, = 0.003). The funnel plot (symmetry), and Egger's test in both HBV ( value = 0.650) and HCV ( value = 0.841) revealed no publication bias. In subgroup analysis, high HBV and HCV prevalence was detected in Sudan; 20.64% (95% CI: -13.60 to 54.88) and India; 18.26% (95% CI: -0.40 to 36.92%), respectively.
CONCLUSION
This study revealed a high prevalence of both HBV and HCV infections in VL patients. In subgroup analysis, the prevalence of HBV and HCV was high in Sudan and India, respectively. Therefore, screening of VL patients for HBV and HCV, vaccination of VL patients in endemic regions, and collaboration between kala-azar and hepatitis elimination programs are required.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/export_details_pdf.php#page=1.00&gsr=0, identifier: CRD42024516889.
背景
内脏利什曼病（VL）患者在多次注射过程中感染乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的风险很高，且抗利什曼原虫治疗具有潜在的肝毒性作用。本系统评价和荟萃分析确定了VL患者中HBV和HCV感染的合并患病率。
方法
本研究在国际前瞻性系统评价注册库（PROSPERO）中注册，注册号为CRD42024516889，并按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。使用PubMed、Medline、EMBASE、谷歌学术、科学网和科学Direct数据库进行文献检索。使用Microsoft Excel提取数据，并使用STATA 11.0软件进行分析。采用随机效应模型估计各研究中结局变量的合并效应量，并给出95%置信区间，结果以森林图展示。采用I²统计量检验异质性。使用漏斗图和Egger检验确定是否存在发表偏倚，P值<0.05表示存在统计学显著偏倚。
结果
在检索到的216条记录中，有7项研究符合系统评价和荟萃分析的纳入标准。共检查了937例VL患者，结果显示分别有105例和93例感染了HBV和HCV。HBV的合并患病率为16.15%（95%CI：-4.10至36.39），异质性显著（I²=91.4%，P=0.001）。HCV的合并患病率为13.74%（95%CI：1.32-26.16，I²=71.6%，P=0.003）。漏斗图（对称性）以及HBV（P值=0.650）和HCV（P值=0.841）的Egger检验均未显示发表偏倚。在亚组分析中，苏丹的HBV和HCV患病率较高，分别为20.64%（95%CI：-13.60至54.88）和印度的18.26%（95%CI：-0.40至36.92%）。
结论
本研究显示VL患者中HBV和HCV感染的患病率较高。在亚组分析中，苏丹的HBV患病率和印度的HCV患病率较高。因此，需要对VL患者进行HBV和HCV筛查，在流行地区对VL患者进行疫苗接种，并开展黑热病和肝炎消除项目之间的合作。
系统评价注册
https://www.crd.york.ac.uk/prospero/export_details_pdf.php#page=1.00&gsr=0，标识符：CRD42024516889。
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