Hepatitis C prevalence in incarcerated settings between 2013–2021: a systematic review and meta-analysis

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Abstract

Background

The introduction of highly effective direct-acting antiviral therapy has changed the hepatitis C virus (HCV) treatment paradigm. However, a recent update on HCV epidemiology in incarcerated settings is necessary to accurately determine the extent of the problem, provide information to policymakers and public healthcare, and meet the World Health Organization's goals by 2030. This systematic review and meta-analysis were performed to determine the prevalence of HCV Ab and RNA in incarcerated settings.

Methods

For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and Web of Science for papers published between January 2013 and August 2021. We included studies with information on the prevalence of HCV Ab or RNA in incarcerated settings. A random-effects meta-analysis was done to calculate the pooled prevalence and meta-regression to explore heterogeneity.

Results

Ninety-two unique sources reporting data for 36 countries were included. The estimated prevalence of HCV Ab ranged from 0.3% to 74.4%. HCV RNA prevalence (available in 46 sources) ranged from 0% to 56.3%. Genotypes (available in 19 sources) 1(a) and 3 were most frequently reported in incarcerated settings. HCV/HIV coinfection (available in 36 sources) was highest in Italy, Estonia, Pakistan, and Spain. Statistical analysis revealed that almost all observed heterogeneity reflects real differences in prevalence between studies, considering I ² was very high in the meta-analysis.

Conclusions

HCV in incarcerated settings is still a significant problem with a higher prevalence than in the general population. It is of utmost importance to start screening for HCV (Ab and RNA) in incarcerated settings to give clear, reliable and recent figures to plan further treatment. This is all in the context of meeting the 2030 WHO targets which are only less than a decade away.

Trial registration

PROSPERO: CRD42020162616

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14623-6.

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Most cited references 109

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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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Global epidemiology and genotype distribution of the hepatitis C virus infection.

Erin Gower, Chris Estes, Sarah Blach … (2014)

The treatment of chronic hepatitis C virus (HCV) infection has the potential to change significantly over the next few years as therapeutic regimens are rapidly evolving. However, the burden of chronic infection has not been quantified at the global level using the most recent data. Updated estimates of HCV prevalence, viremia and genotypes are critical for developing strategies to manage or eliminate HCV infection. To achieve this, a comprehensive literature search was conducted for anti-HCV prevalence, viraemic prevalence and genotypes for all countries. Studies were included based on how well they could be extrapolated to the general population, sample size and the age of the study. Available country estimates were used to develop regional and global estimates. Eighty-seven countries reported anti-HCV prevalence, while HCV viraemic rates were available for fifty-four countries. Total global viraemic HCV infections were estimated at 80 (64-103) million infections. Genotype distribution was available for ninety-eight countries. Globally, genotype 1 (G1) was the most common (46%), followed by G3 (22%), G2 (13%), and G4 (13%). In conclusion, the total number of HCV infections reported here are lower than previous estimates. The exclusion of data from earlier studies conducted at the peak of the HCV epidemic, along with adjustments for reduced prevalence among children, are likely contributors. The results highlight the need for more robust surveillance studies to quantify the HCV disease burden more accurately. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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Seriously misleading results using inverse of Freeman‐Tukey double arcsine transformation in meta‐analysis of single proportions

Guido Schwarzer, Hiam Chemaitelly, Laith Abu-Raddad … (2019)

Standard generic inverse variance methods for the combination of single proportions are based on transformed proportions using the logit, arcsine, and Freeman‐Tukey double arcsine transformations. Generalized linear mixed models are another more elaborate approach. Irrespective of the approach, meta‐analysis results are typically back‐transformed to the original scale in order to ease interpretation. Whereas the back‐transformation of meta‐analysis results is straightforward for most transformations, this is not the case for the Freeman‐Tukey double arcsine transformation, albeit possible. In this case study with five studies, we demonstrate how seriously misleading the back‐transformation of the Freeman‐Tukey double arcsine transformation can be. We conclude that this transformation should only be used with special caution for the meta‐analysis of single proportions due to potential problems with the back‐transformation. Generalized linear mixed models seem to be a promising alternative.

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Author and article information

Contributors

Dana Busschots:

ORCID: http://orcid.org/0000-0003-0887-4119

dana.busschots@uhasselt.be

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 24 November 2022

Publication date PMC-release: 24 November 2022

Publication date Collection: 2022

Volume: 22

Electronic Location Identifier: 2159

Affiliations

[1 ]GRID grid.12155.32, ISNI 0000 0001 0604 5662, Faculty of Medicine and Life Sciences, , Hasselt University, ; Martelarenlaan 42, Diepenbeek, 3500 Hasselt, Belgium

[2 ]GRID grid.470040.7, ISNI 0000 0004 0612 7379, Department of Gastroenterology and Hepatology, , Ziekenhuis Oost-Limburg, ; Genk, Belgium

[3 ]GRID grid.12155.32, ISNI 0000 0001 0604 5662, Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-Biostat), Data Science Institute, , Hasselt University, ; Diepenbeek, Belgium

[4 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Medical Microbiology, School of NUTRIM, , Maastricht University Medical Centre, ; Maastricht, the Netherlands

[5 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, School of NUTRIM, , Maastricht University Medical Centre, ; Maastricht, the Netherlands

[6 ]GRID grid.410569.f, ISNI 0000 0004 0626 3338, Department of Gastroenterology and Hepatology, , University Hospitals KU, ; Leuven, Belgium

[7 ]GRID grid.5284.b, ISNI 0000 0001 0790 3681, Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, ; Antwerp, Belgium

Author information

Dana Busschots http://orcid.org/0000-0003-0887-4119

Article

Publisher ID: 14623

DOI: 10.1186/s12889-022-14623-6

PMC ID: 9685883

PubMed ID: 36419013

SO-VID: c52f1420-2560-43ae-b98a-fec843edfb47

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 6 November 2021

Date accepted : 14 November 2022

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ScienceOpen disciplines: Public health

Keywords: hepatitis c,incarcerated setting,prevalence,global health,meta-analysis

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ScienceOpen disciplines: Public health

Keywords: hepatitis c, incarcerated setting, prevalence, global health, meta-analysis

Hepatitis C prevalence in incarcerated settings between 2013–2021: a systematic review and meta-analysis

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Global Health Next Generation Network

Most cited references 109

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

Global epidemiology and genotype distribution of the hepatitis C virus infection.

Seriously misleading results using inverse of Freeman‐Tukey double arcsine transformation in meta‐analysis of single proportions

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