Hepatitis C in key populations in Latin America and the Caribbean: systematic review and meta-analysis

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Abstract

Objectives

Summarize hepatitis C virus (HCV) prevalence in injecting (IDU) and non-injecting drug users (NIDU), men who have sex with men (MSM), sex workers, and prison inmates in Latin America and the Caribbean (LAC).

Methods

Systematic review on HCV prevalence in sub-populations in LAC. Databases searched from 1-1-2000 to 10-30-2013. Inclusion criteria: prevalence studies in sub-populations in LAC. HCV-antibody was marker for prevalence of current/past HCV infection and HCV-RNA for prevalence of HCV current infection.

Results

IDU HCV current/past infection presented highest prevalence, from 1.7 % in Colombia to over 95 % in Ciudad Juarez and Tijuana, Mexico and pooled regional anti-HCV prevalence was 49 % (CI 95 % 22.6–76.3 %). NIDU, MSM and sex workers anti-HCV prevalence was below 10 %, and pooled regional prevalence of 4 % (CI 95 % 2.6–4.5 %), 3 % (CI 95 % 1.7–4.5 %) and 2 % (CI 95 % 1.0–3.4 %), respectively. Prison inmates presented higher values, but prevalence decreased over the 15-year time span ( p < 0.001). Current HCV infection from three countries showed prevalence under 10 % in prison inmates and 1–46 % among drug users.

Conclusions

Disease burden is high and surveillance, prevention and treatment should target these groups in LAC.

Electronic supplementary material

The online version of this article (doi:10.1007/s00038-015-0708-5) contains supplementary material, which is available to authorized users.

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Most cited references 53

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Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence.

Khayriyyah Mohd Hanafiah, Justina Groeger, Abraham Flaxman … (2013)

In efforts to inform public health decision makers, the Global Burden of Diseases, Injuries, and Risk Factors 2010 (GBD2010) Study aims to estimate the burden of disease using available parameters. This study was conducted to collect and analyze available prevalence data to be used for estimating the hepatitis C virus (HCV) burden of disease. In this systematic review, antibody to HCV (anti-HCV) seroprevalence data from 232 articles were pooled to estimate age-specific seroprevalence curves in 1990 and 2005, and to produce age-standardized prevalence estimates for each of 21 GBD regions using a model-based meta-analysis. This review finds that globally the prevalence and number of people with anti-HCV has increased from 2.3% (95% uncertainty interval [UI]: 2.1%-2.5%) to 2.8% (95% UI: 2.6%-3.1%) and >122 million to >185 million between 1990 and 2005. Central and East Asia and North Africa/Middle East are estimated to have high prevalence (>3.5%); South and Southeast Asia, sub-Saharan Africa, Andean, Central, and Southern Latin America, Caribbean, Oceania, Australasia, and Central, Eastern, and Western Europe have moderate prevalence (1.5%-3.5%); whereas Asia Pacific, Tropical Latin America, and North America have low prevalence (<1.5%). The high prevalence of global HCV infection necessitates renewed efforts in primary prevention, including vaccine development, as well as new approaches to secondary and tertiary prevention to reduce the burden of chronic liver disease and to improve survival for those who already have evidence of liver disease. Copyright © 2012 American Association for the Study of Liver Diseases.

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Incidence and prevalence of hepatitis C in prisons and other closed settings: results of a systematic review and meta-analysis.

Karolien P B Van den Bergh, Sarah Larney, Holly Hagan … (2013)

People detained in prisons and other closed settings are at elevated risk of infection with hepatitis C virus (HCV). We undertook a systematic review and meta-analysis with the aim of determining the rate of incident HCV infection and the prevalence of anti-HCV among detainees in closed settings. We systematically searched databases of peer-reviewed literature and widely distributed a call for unpublished data. We calculated summary estimates of incidence and prevalence among general population detainees and detainees with a history of injection drug use (IDU), and explored heterogeneity through stratification and meta-regression. The summary prevalence estimates were used to estimate the number of anti-HCV positive prisoners globally. HCV incidence among general detainees was 1.4 per 100 person-years (py; 95% confidence interval [CI]: 0.1, 2.7; k = 4), and 16.4 per 100 py (95% CI: 0.8, 32.1; k = 3) among detainees with a history of IDU. The summary prevalence estimate of anti-HCV in general detainees was 26% (95% CI: 23%, 29%; k = 93), and in detainees with a history of IDU, 64% (95% CI: 58%, 70%; k = 51). The regions of highest prevalence were Central Asia (38%; 95% CI 32%, 43%; k = 1) and Australasia (35%; 95% CI: 28%, 43%; k = 9). We estimate that 2.2 million (range: 1.4-2.9 million) detainees globally are anti-HCV positive, with the largest populations in North America (668,500; range: 553,500-784,000) and East and Southeast Asia (638,000; range: 332,000-970,000). HCV is a significant concern in detained populations, with one in four detainees anti-HCV-positive. Epidemiological data on the extent of HCV infection in detained populations is lacking in many countries. Greater attention towards prevention, diagnosis, and treatment of HCV infection among detained populations is urgently required. Copyright © 2013 by the American Association for the Study of Liver Diseases.

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Global estimates of prevalence of HCV infection among injecting drug users.

Carmen Aceijas, Tim Rhodes (2007)

In this paper, we review evidence of HCV prevalence among injecting drug users (IDUs) worldwide. We undertook a desk-based review of both 'grey' and published literature released between 1998 and 2005. Data on HCV prevalence among IDUs was found in 57 countries and in 152 sub-national areas. We found reports of HCV prevalence of at least 50% among IDUs in 49 countries or territories. Available regional estimates varied widely, from 10 to 96% in Eastern Europe and Central Asia, from 10 to 100% in South and South-East Asia, from 34 to 93% in East-Asia and the Pacific, from 5 to 60% in North Africa and the Middle-East, from 2 to 100% in Latin America, from 8 to 90% in North America, from 25 to 88% in Australia and New Zealand, and from 2 to 93% in Western Europe. Only in Colombia and Lebanon were all HCV prevalence estimates below 20%. In addition, evidence of HIV/HCV co-infection among IDUs was found in 16 countries. In China, Poland, Puerto Rico, Russia, Spain, Switzerland, Thailand and Viet Nam, estimates of the prevalence of HIV/HCV co-infection among IDUs reached 90%. Taken together, data suggest high global prevalence of HCV and HIV/HCV co-infection among IDUs. We suggest exploring protective factors in sites of low HCV prevalence.

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Author and article information

Contributors

Monica Alonso: alonsomon@paho.org

Journal

Journal ID (nlm-ta): Int J Public Health

Journal ID (iso-abbrev): Int J Public Health

Title: International Journal of Public Health

Publisher: Springer Basel (Basel )

ISSN (Print): 1661-8556

ISSN (Electronic): 1661-8564

Publication date (Electronic): 23 August 2015

Publication date PMC-release: 23 August 2015

Publication date (Print): 2015

Volume: 60

Issue: 7

Pages: 789-798

Affiliations

[ ]Pan American Health Organization, HIV/STI/TB and Viral Hepatitis, 525 23rd St NW, Washington, DC 20037 USA

[ ]Pan American Health Organization, Knowledge Management, Bioethics and Research, Washington, DC USA

Article

Publisher ID: 708

DOI: 10.1007/s00038-015-0708-5

PMC ID: 4636523

PubMed ID: 26298439

SO-VID: bd9c63c1-3b7e-4155-9d1e-bc60d43ba752

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 3.0 IGO License ( http://creativecommons.org/licenses/by/3.0/igo/), which permits unrestricted use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article’s original URL.

History

Date received : 8 January 2015

Date revision received : 18 June 2015

Date accepted : 22 June 2015

Custom metadata

ScienceOpen disciplines: Public health

Keywords: hepatitis c,latin america,caribbean,drug users,men who have sex with men,prisoners

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ScienceOpen disciplines: Public health

Keywords: hepatitis c, latin america, caribbean, drug users, men who have sex with men, prisoners

Hepatitis C in key populations in Latin America and the Caribbean: systematic review and meta-analysis

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Abstract

Objectives

Methods

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Conclusions

Electronic supplementary material

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Point-Of-Care Testing for Hepatitis

Most cited references 53

Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence.

Incidence and prevalence of hepatitis C in prisons and other closed settings: results of a systematic review and meta-analysis.

Global estimates of prevalence of HCV infection among injecting drug users.

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