Magri Mariana Cavalheiro, Manchiero Caroline, Dantas Bianca Peixoto, Bernardo Wanderley Marques, Abdala Edson, Tengan Fátima Mitiko
Laboratorio de Investigacao Medica em Hepatologia por Virus (LIM-47), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Instituto de Medicina Tropical de Sao Paulo, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
Trop Med Int Health. 2025 Jan;30(1):4-13. doi: 10.1111/tmi.14070. Epub 2024 Dec 13.
Hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) affect 340 million people worldwide and have a high impact on vulnerable populations. The aim of this systematic review and meta-analysis was to estimate the prevalence of these infections among inmates in Latin America and the Caribbean.
Searches were conducted in Medline, Embase, LILACS and Web of Science databases on 17 May 2024, without time or language restriction, according to PRISMA guidelines. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the bias risk in the selected studies. Meta-analysis was performed by using the random-effects model and heterogeneity between studies was assessed with I statistic. Subgroup analyses and meta-regression were performed to investigate possible sources of heterogeneity.
Seventy-nine studies were included, encompassing over 230,000 inmates. The estimated prevalences of HBV, HCV and HIV were 1.0% (95% CI: 0.0-1.0), 7.0% (95% CI: 6.0-8.0) and 4.0% (95% CI: 3.0-4.0), respectively. Subgroup analysis showed the following prevalences: HBV among females was 1.0% (95% CI: 0.0-3.0) and among males was 10.0% (95% CI: 3.0-17.0); HCV among females and males was 12.0% (95% CI: 7.0%-17.0%); and HIV among females was 10.0% (95% CI: 5.0-15.0) and among males was 8.0% (95% CI: 6.0-10.0).
A substantial proportion of inmates in Latin America and the Caribbean are infected with HBV, HCV or HIV, underscoring the need for viral infection testing, primary care for inmates and increased efforts to promote public health policies for the prison system.
乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）影响着全球3.4亿人，对弱势群体有很大影响。本系统评价和荟萃分析的目的是估计拉丁美洲和加勒比地区囚犯中这些感染的流行率。
根据PRISMA指南，于2024年5月17日在Medline、Embase、LILACS和Web of Science数据库中进行检索，无时间或语言限制。使用乔安娜·布里格斯研究所的批判性评价清单评估所选研究中的偏倚风险。采用随机效应模型进行荟萃分析，并用I统计量评估研究间的异质性。进行亚组分析和荟萃回归以调查异质性的可能来源。
纳入79项研究，涵盖超过230,000名囚犯。HBV、HCV和HIV的估计流行率分别为1.0%（95%CI：0.0 - 1.0）、7.0%（95%CI：6.0 - 8.0）和4.0%（95%CI：3.0 - 4.0）。亚组分析显示以下流行率：女性中HBV为1.0%（95%CI：0.0 - 3.0），男性中为10.0%（95%CI：3.0 - 17.0）；女性和男性中HCV均为12.0%（95%CI：7.0% - 17.0%）；女性中HIV为10.0%（95%CI：5.0 - 15.0），男性中为8.0%（95%CI：6.0 - 10.0）。
拉丁美洲和加勒比地区相当一部分囚犯感染了HBV、HCV或HIV，这突出表明需要对病毒感染进行检测，为囚犯提供初级保健，并加大力度推动监狱系统的公共卫生政策。
