Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Liver Int. 2024 Dec;44(12):3238-3249. doi: 10.1111/liv.16102. Epub 2024 Sep 13.
Although the evidence is uncertain, existing estimates for hepatitis C virus (HCV) in sub-Saharan Africa (SSA) indicate a high burden. We estimated HCV seroprevalence and viraemic prevalence among the general population in SSA.
We searched Medline, Embase, Web of Science, APA PsycINFO, and World Health Organization Africa Index Medicus for community-based studies. Study quality was assessed using the Joanna Briggs Institute critical appraisal tool, and heterogeneity using the index of heterogeneity (I). Two approaches were deployed. First, we used random-effects meta-analysis to pool prevalence. Second, to derive representative estimates, we weighted each country's HCV seroprevalence using 2021 United Nations country population sizes.
We synthesized 130 studies. Overall, SSA HCV seroprevalence from the random-effects model was 4.17% (95% confidence interval [CI]: 3.71-4.66, I = 99.30%). There were no differences between males (4.31%) and females (4.03%). Seroprevalence was 2.25%, 3.31%, and 16.23% for ages ≤20, 21-64, and ≥65 years, respectively, and was higher in rural (6.63%) versus urban (2.93%). There was indication of decrement overtime from 5.74% to 4.35% to 3.03% in the years 1984-2000, 2001-2014, and 2015-2023, respectively. The weighted overall SSA HCV seroprevalence was estimated to be 2.30% (95% CI: 1.59-3.00) with regional variation: Africa-Southern (.79%), Africa-Central (1.47%), Africa-Eastern (2.71%), and Africa-Western (2.88%). HCV viremia among HCV seropositives was 54.77% (95% CI: 47.80-61.66).
HCV seroprevalence in SSA remains high. Populations aged ≥65 years, rural communities, Africa-Western, and some countries in Africa-Central and Africa-Eastern appear disproportionately affected. These results underline the need for governmental commitment to achieve the 2030 global HCV elimination targets.
尽管证据不确定，但现有的撒哈拉以南非洲（SSA）丙型肝炎病毒（HCV）估计表明负担沉重。我们估计了 SSA 一般人群中的 HCV 血清流行率和病毒血症流行率。
我们在 Medline、Embase、Web of Science、APA PsycINFO 和世界卫生组织非洲医学索引中搜索了基于社区的研究。使用 Joanna Briggs 研究所的批判性评估工具评估研究质量，并使用异质性指数（I）评估异质性。我们采用了两种方法。首先，我们使用随机效应荟萃分析来汇总流行率。其次，为了得出具有代表性的估计值，我们使用 2021 年联合国国家人口规模对每个国家的 HCV 血清流行率进行加权。
我们综合了 130 项研究。总体而言，来自随机效应模型的 SSA HCV 血清流行率为 4.17%（95%置信区间[CI]：3.71-4.66，I=99.30%）。男性（4.31%）和女性（4.03%）之间没有差异。年龄≤20 岁、21-64 岁和≥65 岁的血清流行率分别为 2.25%、3.31%和 16.23%，农村（6.63%）高于城市（2.93%）。从 1984-2000 年的 5.74%到 2001-2014 年的 4.35%，再到 2015-2023 年的 3.03%，表明时间上呈递减趋势。加权后的 SSA HCV 血清流行率估计为 2.30%（95%CI：1.59-3.00），区域差异如下：非洲南部（0.79%）、非洲中部（1.47%）、非洲东部（2.71%）和非洲西部（2.88%）。HCV 血清阳性者的 HCV 病毒血症为 54.77%（95%CI：47.80-61.66）。
SSA 的 HCV 血清流行率仍然很高。≥65 岁的人群、农村社区、非洲西部以及非洲中部和东部的一些国家似乎受到不成比例的影响。这些结果强调了政府承诺实现 2030 年全球 HCV 消除目标的必要性。
